• Catherine Carlile, Charles E Wade, Mary Sarah Baraniuk, John B Holcomb, and Laura J Moore.
• Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA. Electronic address: Catherine.R.Carlile@uth.tmc.edu.
• Am. J. Surg. 2015 Dec 1; 210 (6): 1070-5; discussion 1075.

BackgroundHemorrhage remains the leading cause of mortality in preventable trauma deaths. Earlier recognition of hemorrhagic shock decreases the time to implementation of life-saving interventions improves patient survival. The presence of hemorrhagic shock is not always apparent using standard vital signs monitoring, a clinical state referred to as occult shock.MethodsThis prospective, observational study was performed at Memorial Hermann Hospital in Houston, TX. Prisoners, pregnant women, and patients with burn injuries greater than 20% total body surface area or bilateral upper extremity fractures were excluded. Hutchinson Technologies Spot Check StO2 device was used to measure StO2 values.ResultsStO2 values less than 75% were predictive of the need for blood product transfusions (P < .01) and the need for emergency surgeries. Nearly one-third of patients who presented with a systolic blood pressure 120 mm Hg or more presented with StO2 less than 75% and had a median base deficit of 5 (3 to 6.5).ConclusionsAdmission StO2 measurements less than 75% predict the need for blood products and emergent surgical procedures and may be used as an adjunct method for identifying shock. StO2 measurements can aid where laboratory values are unavailable.Copyright © 2015 Elsevier Inc. All rights reserved.

24 keywords...

hide…