Clinical Analysis of Rapid Infusion System for 12 Traumatic Hemorrhagic Shock Patients

Abstract

Hypovolemic shock resulting from an intraoperative or traumatic hemorrhage requires urgent, aggressive resuscitation to achieve a successful prognosis. Common difficulties encountered indude the need for venous access, restoration of blood volume and, most importantly, maintenance of normothermia. The rapid infusion system (Haemonetics corporation, U.S.A., RIS) allows normothermic volume restoration at flow rates of up to 2000 ㎖/min when two 10 gauge catheters are used. During the period of June 1996 and December 1997, we used RIS for 12 traumatic hemorrhagic shock patients in operating room and a retrospective dinical study was undertaken in these patients. Statistical significances (p< 0.05) were analyzed by one way ANOVA and two-tailed Students t-test. The Results are as follows. 1) The initial Emergency Department Trauma Score (TS) was an average of 10.3±3.6 and the initial operating room APACHE III score was 71.2±30.1. 2) The average emergency department systolic blood pressure was 60.5±25.0 ㎜Hg and pulse rate was an average of 123.0±20.2 beats/min. 3) The average preoperative systolic blood pressure was 79.2±30.4 ㎜Hg, pulse rate was 112.1±33.9 beats/min and body temperature averaged 33.8±1.0℃. 4) Corresponding postoperative values were 100.0±26.0 ㎜Hg, 111.8±15.7 beats/min and 35.7±0.8℃. 5) The average preoperative prothrombin time was 15.8±2.7 sec, activated partial thromboplastin time was 56.3±34.8 sec and platelet count was 134.7±65.6 (x 10³/㎕). 6) Corresponding postoperative values were 23.0±9.4 sec, 70.9±27.5 sec and 50.1±43.5 (x10³/㎕). 7) The average preoperative ionized sodium value was 140.8±45.0 m㏖/ℓ and postoperative value was 142.4±5.4 m㏖/ℓ. 8) Changes for systolic blood pressure, temperature, platelet count and ionized sodium were statistically significant (p< 0.05). 9) Mortality rate was 2/12 at 24 hrs and 5/12 overall. In summary, the rapid infusion system was effectively employed in operating room for 12 traumatic hemorrhagic hypovolemic shock patients with no significant complications except thrombocytopenia. The mortality rate was 16.7% at 24 hrs and 41.7% overall.