tailieunhanh - Báo cáo y học: " Systemic central venous oxygen saturation is associated with clot strength during traumatic hemorrhagic shock: A preclinical observational model"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Systemic central venous oxygen saturation is associated with clot strength during traumatic hemorrhagic shock: A preclinical observational model | White et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 64 http content 18 1 64 a SCANDINAVIAN JOURNAL OF t emergency medicine ORIGINAL RESEARCH Open Access Systemic central venous oxygen saturation is associated with clot strength during traumatic hemorrhagic shock A preclinical observational model Nathan J White1 3 Erika J Martin2 4 Yongyun Shin5 Donald F Brophy1 2 4 Robert F Diegelmann1 6 Kevin R Ward1 3 Abstract Background Clot strength by Thrombelastography TEG is associated with mortality during trauma and has been linked to severity of tissue hypoperfusion. However the optimal method for monitoring this important relationship remains undefined. We hypothesize that oxygen transport measurements will be associated with clot strength during traumatic shock and test this hypothesis using a swine model of controlled traumatic shock. Methods N 33 swine were subjected to femur fracture and hemorrhagic shock by controlled arterial bleeding to a predetermined level of oxygen debt measured by continuous indirect calorimetry. Hemodynamics oxygen consumption systemic central venous oxygenation ScvO2 base excess lactate and clot maximal amplitude by TEG TEG-MA as clot strength were measured at baseline and again when oxygen debt 80 ml kg during shock. Oxygen transport and metabolic markers of tissue perfusion were then evaluated for significant associations with TEG-MA. Forward stepwise selection was then used to create regression models identifying the strongest associations between oxygen transport and TEG-MA independent of other known determinants of clot strength. Results Multiple markers of tissue perfusion oxygen transport and TEG-MA were all significantly altered during shock compared to baseline measurements p . However only ScvO2 demonstrated a strong bivariate association with TEG-MA measured during shock R p . ScvO2 measured during shock was also selected by forward stepwise selection as an .