Rapid volume replacement with warmed blood and fluids.
A prospective clinical study was undertaken in 50 consecutive patients suffering from severe traumatic shock to evaluate the clinical efficacy of a set for rapid administration of solutions (RSAS), which allows for rapid infusion and simultaneous warming of blood and fluids. The mechanism of injury was blunt in 37 patients and penetrating in 13. Admission trauma score averaged 7.5, and the injury severity score averaged 46. Average preresuscitation systolic blood pressure was 71 mmHg, pulse was 105 beats/minute, and temperature was 34.3 degrees C. Initial resuscitation was with the RSAS, and total fluid infused in the first twenty-four hours averaged 4,632 mL of blood, 1,914 mL of blood products, and 11,248 mL of crystalloid. The average postresuscitation systolic blood pressure was 120 mmHg, pulse was 96 beats/minute, and temperature averaged 34.9 degrees C. Survival at twenty-four hours was 29/50 (58%). There were no local complications of RSAS use and no evidence of infusion-related coagulopathy. The RSAS provided an effective and safe way to infuse large volumes of blood and fluid at body temperature.
Falcone
R E
RE
Department of Cardiovascular Services, Grant Medical Center, Columbus, Ohio.
Fried
S J
SJ
Zeeb
P
P
Satiani
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D005069:Evaluation Studies as Topic; D005260:Female; D005440:Fluid Therapy; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012151:Resuscitation; D012769:Shock / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D014947:Wounds and Injuries / Q000097:blood / Q000150:complications / Q000401:mortality