Analysis in the Use of Rapid Infusion System for 14 Patients / 대한마취과학회지

ABSTRACT

BACKGROUND: Inadequate infusion flow rates and hypothermia are significant problems encountered in managing hypovolemic shdegrees Ck secondary to intraoperative or traumatic hemorrhage. The rapid infusion system(Haemonetics corporation., U.S.A., RIS) allows normothermic volume restoration at flow rates of up to 2000 ml/minute when two 10 gauge catheters are used. METHODS: From June 1996 to January 1997, we used RIS in 14 patients who expected to develop or had developed hemorrhagic hypovolemic shdegrees Ck and a retrospective clinical study was undertaken in these patients. Statistical significances (p<0.05) were analyzed by two-tailed Student's t-test. RESULTS: 1) There were 3 liver transplantation patients, 8 traumatic hypovolemic shdegrees Ck patients and 3 hypovolemic shdegrees Ck patients who underwent elective abdominal surgery. 2) Total fluid infused through RIS averaged 40.5+/-32.5(4~100) units of packed red cells, 22.9+/-21.8(3~82) units of fresh frozen plasma, and 16292.9+/-15382.4 ml of crystalloid. 3) In 8 traumatic hypovolemic shdegrees Ck patients, (1) The initial Emergency Department Trauma Score(TS) averaged 10.6+/-3.5 and initial operating room APACHE III score averaged 63.8+/-27.6. (2) The average preoperative systolic blood pressure was 77.5+/-28.7 mmHg, pulse rate was 119.6+/-10.2 beats/min. and body temperature averaged 34.5+/-2.2 degrees C. (3) Corresponding postoperative values were 111.4+/-12.5 mmHg, 110.7+/-20.1 beats/min and 35.8+/-1.5 degrees C. (4) The average preoperative prothrombin time was 16.4+/-2.4 sec, activated partial thromboplastin time was 53.0+/-31.2 sec and platelet count was 129.6+/-82.6( 103/microliter). (5) Corresponding postoperative values were 21.7+/-9.7 sec, 68.7+/-29.2 sec and 25.8+/-24.2( 103/microliter). (6) Changes for both systolic blood pressure and platelet count were statistically significant. (p<0.05) (7) Mortality rate was 1/8 at twenty-four hours and 3/8 overall. CONCLUSIONS: The rapid infusion system can be effectively employed in patients who expected to develop or had developed hemorrhagic hypovolemic shdegrees Ck. In 8 traumatic hypovolemic shdegrees Ck patients, there were no significant complications except thrombdegrees Cytopenia after RIS use, and, the mortality rate was 12.5% at twenty-four hours and 37.5% overall.