14. EVALUATION RELATIONSHIP BETWEEN SHOCK INDEX WITH RISKS OF ANESTHESIA IN PATIENTS WITH POLYTRAUMA
Main Article Content
Abstract
Objective: To evaluate the relationship between shock index when entering emergency surgery room with risk of hypotension postintubation and amount of tranfusion during surgery.
Research objects and methods: 82 patients diagnosed with polytrauma (without traumatic brain injury and spinal cord injury) were admitted to the emergency operating room within the first 24 hours of injury. Record blood pressure when entering the operating room and after induction of anesthesia, blood volume, intraoperative fluid volume and calculate the predicted value through the area under the curve.
Result: The cut-off of admission shock index predicted postintubation hypotension was 0.96 (sensitivity 94.12%, specificity 77.42%) and predicted massive tranfusion was 1.1 (sensitivity 81%, specificity 71%). The area under the ROC curves were 0.87 and 0.79, respectively.
Conclusion: We found that shock index (SI) ≥ 0.96 as a good predictor of hypotension postintubation and shock index ≥ 1.1 as a predictor of massive tranfusion in operation.
Article Details
Keywords
Shock index, hypotension postintubation, massive tranfusion
References
[2] Keel M, Trentz O, Pathophysiology of polytrauma, Injury, 2005, 36 (6): 691-709, doi:10.1016/j.injury.2004.12.037.
[3] Transfusion strategies for major haemorrhage in trauma Curry 2019, British Journal of Haematology - Wiley Online Library, Accessed August 4, 2022, https://onlinelibrary.wiley.com/doi/10.1111/bjh.15737.
[4] Mutschler M, Nienaber U, Münzberg M et al, The Shock Index revisited - a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU®, Crit Care, 2013, 17(4): R172, doi:10.1186/cc12851.
[5] Phạm Thái Dũng, Nghiên cứu mối tương quan giữa nồng độ lactat, độ bão hòa oxy máu tĩnh mạch trung tâm với chỉ số sốc và tỷ lệ PaO2/
FiO2 ở bệnh nhân đa chấn thương, Accessed September 24, 2023, http://thuvien.hmu.edu.vn/pages/cms/FullBookReader.aspx?Url=/pages/cms/TempDir/books/202001141447-c9211741-
34e9-4dfb-849f-bf6099916115//FullPreview&-TotalPage=7&ext=jpg#page/6/mode/2up.
[6] Green RS, Edwards J, Sabri E, Fergusson D, Evaluation of the incidence, risk factors, and impact on patient outcomes of postintubation hemodynamic instability, Can J Emerg Med, 2012,
14(2): 74-82, doi:10.2310/8000.2012.110548.
[7] A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study - ScienceDirect, Accessed September 3,
2022, https://www.sciencedirect.com/science/article/abs/pii/S0002961009000750.
[8] Heffner AC, Swords DS, Nussbaum ML, Kline JA, Jones AE, Predictors of the complication of postintubation hypotension during emergency
airway management, J Crit Care, 2012, 27(6): 587-593, doi:10.1016/j.jcrc.2012.04.022.
[9] Mutschler M, Nienaber U, Münzberg M et al, The Shock Index revisited - a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU®, Crit Care, 2013, 17(4): R172, doi:10.1186/cc12851.
[10] Vandromme MJ, Griffin RL, Kerby JD, McGwin G, Rue LW, Weinberg JA, Identifying risk for massive transfusion in the relatively normotensive patient: utility of the prehospital shock index, J Trauma, 2011, 70(2): 384-388, discussion 388-390, doi:10.1097/TA.0b013e3182095a0a.