2024-03-28T20:15:52Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00019244
2022-12-15T03:50:12Z
453:456
471:537:538:1148
The Present Status of Early Menagements of Patients with Traumatic Shock and Further Problems (Emerency Medical Care : Current Advances and Problems in Treatment of the Severely Injured)
1) 外傷ショック患者の初期治療の現状と課題(シンポジウム 救急医療 : 重度外傷治療の進歩と今日の課題, 第492回新潟医学会)
1) 外傷ショック患者の初期治療の現状と課題(シンポジウム 救急医療 : 重度外傷治療の進歩と今日の課題, 第492回新潟医学会)
遠藤, 裕
119878
Traumatic Shock
Fluid Resuscitation
Therapuetic Priority
外傷性ショック
輸液蘇生
治療優先順位
Fluid resuscition is crucial for management of traumatic shock. The kind and the amount of fluids infused in 1 hour after admittance were evaluated in 34 critically ill patients with sustained traumatic shock by chart review. Their mean age was 34.4±4.3 (mean±SE) years old. Twenty seven of 34 patients were injured by traffic accidents, six had a free fall injury, and one had a stab wound. Mortality rate was 24/34. Their mean shock score (Ogawa's) was 7.6±0.5 (survivor: 5.9±0.4 versus non-survivor 8.3±0.6), and their mean injury severity score (ISS) was 25.5±1.8 (survivor: 19.7±2.5 versus non-survivor: 27.9±10.2). In patients with systolic blood pressure (SBP) <60mmHg, lactate solution and plasma expander amounted to 1,291±189ml , 292±168, respectively. In patients with 60≦SBP<90mmHg, lactate solution was in amount of 1,077±148ml, and plasma expander was 269±134ml. In patients with SBP≧90mmHg, lactate solution was 1,078±230ml, and plasma expander was 56±55ml. There were no significant differences among these 3 groups. With regard to the use of vasopressors, in patients, with SBP<60mmHg, dopamine, epinephrine, and nor-epinephrine were administered in 83%, 50% and 42% of patients, respectively. These observations indicate that the amount of fluid resuscitation was inadequate, and also that hypotension was treated with excessive uses of vasopressors. There may be several reasons for this improper fluid resuscitation, such as a wrong priority to obtain information about injury with CT or X-ray examination as early as possible without an establishment of stable vital signs.
departmental bulletin paper
新潟医学会
1994-07
application/pdf
新潟医学会雑誌
7
108
485
488
新潟医学会雑誌
AN00182415
00290440
https://niigata-u.repo.nii.ac.jp/record/19244/files/108(7)_485-488.pdf
jpn