Изменение Клинических И Лабораторных Показателей В Зависимости От Тяжести Травматического Шока: Ретроспективное Когортное Исследование
Annals of critical care（2024）
ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» МО РФ | ФГКУ «442 военный клинический госпиталь им. З.П. Соловьева» МО РФ
Abstract
INTRODUCTION: Traumatic shock is a complex pathophysiological process that includes impaired tissue perfusion, the development of circulatory and tissue hypoxia, metabolic disorders, and homeostasis disorders. MATERIALS AND METHODS: A retrospective cohort study that included 329 people with combat injury. The level of systolic blood pressure (SBP), heart rate (HR), acid-base state (CBS), general and gas blood tests were examined upon admission. RESULTS: There were 55 patients without shock (30 %), 83 (25 %) with I degree shock, 80 (25 %) of II degree, 51 (15 %) of III degree, 16 (5 %) of IV degree. The analysis of the values of the SBP, HR and shock index (SI), base deficiency (BE) showed the presence of statistical differences depending on the degree of shock. SI without shock was 0.7 (0.7; 0.8); with shock of the I degree — 0.8 (0.7; 0.9); II degree — 1.3 (1.1; 1.5), III degree — 1.8 (1.5; 2.1), IV degree — 2.5 (2.1; 3.8). The value without shock was –3.1 (3.9; –2.2); with degree I shock –3.7 (–2.1; –6.2); II degree: –4.6 (–3.1; –6.8); III degree: –8.5 (–6.5; –11.8); IV degree: –22.1 (–15.6; –26.1). Regression analysis of the relationship with the degree of shock showed two models that described a 45.9 % and 50.2 % probability. The first model includes a constant and VE (p < 0.01). The second model includes the constant, VE and the number of platelets (p < 0.01). CONCLUSION: A retrospective analysis of clinical and laboratory parameters for traumatic shock demonstrated differences in SBP, HR, SI, red blood counts, CBS, lactate levels depending on the degree of shock. The severity of acidosis and lactate levels turned out to be higher than expected for the degree of shock, due to the nature and severity of the injuries received. Base deficiency and platelet count were associated with the severity of shock.
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Key words
травматический шок,анализ газов крови,кислотно-щелочное равновесие,артериальное давление,раны и ушибы,лактат
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