New approaches to trauma management using severity of illness and outcome prediction based on noninvasive hemodynamic monitoring.
The mathematical model satisfactorily predicted outcome in acute emergencies based on noninvasively monitored flow, pressure, pulse oximetry, tissue perfusion values, and their cumulative deficits. A decision support system provided information on the relative effectiveness of various therapeutic modalities based on the responses of patients with very similar states. The concept that hypovolemia and oxygen debt is an early primary problem that plays an important role in low flow and poor tissue perfusion states is supported by direct observation of massive hemorrhage, estimated blood loss of hemoperitoneum and hemothorax at the time of surgery, and prior studies in the literature that documented blood volume deficits in posttraumatic and postoperative patients who subsequently developed organ failures and death.
Shoemaker
William C
WC
Department of Anesthesia and Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, 90033, USA. wcshoemaker00@hotmail.com
D001158:Arteries / Q000293:injuries* / Q000601:surgery; D002423:Cause of Death; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007362:Intensive Care Units; D008991:Monitoring, Physiologic; D011379:Prognosis; D012720:Severity of Illness Index; D013269:Stochastic Processes; D016019:Survival Analysis; D014680:Veins / Q000293:injuries* / Q000601:surgery; D014947:Wounds and Injuries / Q000145:classification / Q000401:mortality / Q000601:surgery*