ABSTRACT
The effect of severe soft tissue injury on the severity of hemorrhagic shock is still unknown. Therefore, the present study was aimed to determine hemodynamic and metabolic changes in traumatic/hemorrhagic shock in an animal model. Forty male rats were randomly divided into 4 equal groups including sham, hemorrhagic shock, soft tissue injury, and hemorrhagic shock + soft tissue injury groups. The changes in blood pressure, central venous pressure [CVP] level, acidity [pH], and base excess were dynamically monitored and com-paredsented. Mean arterial blood pressure decreased significantly in hemorrhagic shock [df: 12; F=10.9; p<0.001] and severe soft tissue injury + hemorrhagic shock [df: 12; F=11.7; p<0.001] groups 15 minutes and 5 minutes after injury, respectively. A similar trend was observed in CVP in severe soft tissue injury + hemorrhagic shock group [df: 12; F=8.9; p<0.001]. After 40 minutes, pH was significantly lower in hemorrhagic shock [df: 12; F=6.8; p=0.009] and severe soft tissue injury + hemorrhagic shock [df: 12; F=7.9; p=0.003] groups. Base excess changes during follow ups have a similar trend. [df: 12; F=11.3; p<0.001]. The results of this study have shown that the effect of hemorrhage on the decrease of mean arterial blood pressure, CVP, pH, and base excess is the same in the presence or absence of soft tissue injury
ABSTRACT
The administration of crystalloid fluids is considered as the first line treatment in management of trauma patients. Infusion of intravenous fluids leads to various changes in hemodynamic, metabolic and coagulation profiles of these patients. The present study attempted to survey some of these changes in patients with mild severity trauma following normal saline infusion. This study comprised 84 trauma patients with injury of mild severity in Shahid Rajaei Hospital, Shiraz, Iran, during 2010-2011. The coagulation and metabolic values of each patient were measured before and one and six hours after infusion of one liter normal saline. Then, the values of mentioned parameters on one and six hours after infusion were compared with baseline measures using repeated measures analysis of variance. Eighty four patients included in the present study [76% male]. Hemoglobin [Hb] [df: 2; F=32.7; p<0.001], hematocrit [Hct] [df: 2; F=30.7; p<0.001], white blood cells [WBC] [df: 2; F=10.6; p<0.001], and platelet count [df: 2; F=4.5; p=0.01] showed the decreasing pattern following infusion of one liter of normal saline. Coagulation markers were not affected during the time of study [p>0.05]. The values of blood urea nitrogen [BUN] showed statistically significant decreasing pattern [df: 2; F=5.6; p=0.007]. Pressure of carbon dioxide [PCO2] [df: 2; F=6.4; p=0.002], bicarbonate [HCO3] [df: 2; F=7.0; p=0.001], and base excess [BE] [df: 2; F=3.3; p=0.04] values showed a significant deteriorating changes following hydration therapy. It seems that, the infusion of one liter normal saline during one hour will cause a statistically significant decrease in Hb, Hct, WBC, platelet, BUN, BE, HCO3, and PCO2 in trauma patients with mild severity of injury and stable condition. The changes in, coagulation profiles, pH, PvO2, and electrolytes were not statistically remarkable