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Predictive Significance of Oxygen Transport Values for Assessment of Aqueous Sectors in Severe Concomitant Injury

https://doi.org/10.15360/1813-9779-2008-6-16

Abstract

Objective: to reveal a relationship between the impaired oxygen transport and the sectoral distribution of fluids in severe concomitant injury (SCI). Subjects and methods: A follow-up covered 29 patients with SCI. The severity of the condition was evaluated using the traumatic shock scale (Dzhanelidze Research Institute of Emergency Care, Saint Petersburg). Differences were estimated between the groups of patients with varying traumatic shock and between the surviving and deceased victims. The victims were examined by the generally accepted standards of clinical and laboratory studies; noninvasive monitoring of hemodynamics and fluid distribution along the body’s aqueous sectors was made in all the patients, by applying integral tetrapolar rheovasography and two-frequency bioimpedance study (Diamant-M, Saint Petersburg). Results. The diagnostic and predictive values of determination of the cardiac index have been ascertained by the Tishchenko tetrapolar rheovasography in patients with SCI. The cardiac index of less than 3.2 l/min^m2 in the first 24 hours after referral to an intensive care unit (ICU) is a predictor of mortality. The above cardiac index is consistent with the presence of evident oxygen debt along with the respective oxygen extraction coefficient of greater than 42%. With lower cardiac index, there may be associated dyshidria: hyperosmolar hyperhydration of the intravascular sector and interstice with a tendency for intracellular sector dehydration. On the basis of determination of a low cardiac index (less than 3.2 l/min^m2 in the first 24 hours after referral to the ICU), intensive care tactics aimed at preventing and correcting the above-mentioned homeostatic disorders should be chosen. Key words: severe injury, cardiac index, oxygen transport, water electrolyte disorders.

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Review

For citations:


Pavlova T.A., Grigoryev Ye.V., Kameneva Ye.A. Predictive Significance of Oxygen Transport Values for Assessment of Aqueous Sectors in Severe Concomitant Injury . General Reanimatology. 2008;4(6):16. (In Russ.) https://doi.org/10.15360/1813-9779-2008-6-16

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ISSN 1813-9779 (Print)
ISSN 2411-7110 (Online)