Effect of preoperative limited fluid resuscitation to the patients with traumatic shock

ObjectiveTo investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock.MethodsEighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital between January 2002 to October 2005 and were divided into 3 groups according to the preoperative levels of systolic blood pressure (SBP). SBP of group A and group B were about 70 and 80 mmHg, respectively; and the SBP of group C was over 90 mmHg.Results(1) There was no significant difference in age, gender, and injury severity score (ISS), initiated resuscitation time and initiated operation time among the 3 groups. Preoperatively, there was significant difference in the amount of fluid resuscitation and infused erythrocyte suspension among group A, B and C (1687 ± 96 ml, 2096 ± 87 ml, 2976 ± 93 ml, P < 0.05; and 294 ± 110 ml, 404 ± 113 ml, 798 ± 230 ml, P < 0.05). (2) The hemoglobin level in group C (94 ± 45 g/L) was lower than that in group A (110 ± 22 g/L) and group B (103 ± 24 g/L) (P < 0.05). However, there was no significant difference in the level of hemoglobin between group A and B. (3) There was no significant difference in the incidence of acute renal failure (ARF) among the 3 groups. The incidence of acute respiratory distress syndrome (ARDS) of group C (31.2%) was higher than that of group A (16.7%) and group B (18.2%) (P < 0.05). The mortality of group C (34.4%) was higher than that of group A (12.5%) and group B (12.1%) (P < 0.05).ConclusionPreoperative limited resuscitation applied on patients with traumatic shock can reduce blood loss, incidence of ARDS and mortality.