Original scientific articleHemodynamic Patterns of Blunt and Penetrating Injuries
Section snippets
Clinical series
We studied 657 consecutive noninvasively monitored blunt and penetrating trauma patients. Of these, 221 patients had chest injuries, 266 had abdominal trauma, 175 had both chest and abdominal trauma, 57 had extremity injuries, and 113 had head injuries associated with their truncal trauma. Patients with severe head injury and those with brain death were evaluated separately because they had different hemodynamic patterns.22, 23 In addition, hemodynamic patterns of this series were calculated
Continuous noninvasive hemodynamic patterns from the time of ED admission
Table 2 summarizes the mean hemodynamic values ± SD for all trauma survivors compared with all nonsurvivors. Hemodynamic values included CI, HR, MAP, SapO2, PtcO2/FiO2, and the calculated SP. The CI, MAP, SapO2, PtcO2/FiO2, and SP values of the survivors were significantly higher than the corresponding values of those who died, although the HR and PtcCO2 were higher in the nonsurvivors during the first 24 hours after ED admission. Figure 2 illustrates the time course of survivors’ and
Discussion
The proposed mathematical representation of circulatory status defines the patient’s clinical-circulatory state by specific diagnostic categories; clinical covariates; and the patterns of hemodynamic variables, their first and second derivatives, and their integrals. Simply stated, the program picks out the patterns of patients in the database who have the closest clinical and hemodynamic patterns to the newly admitted study patient. These are statistically referred to as “nearest neighbors”
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Competing Interests Declared: None.
Supported in part by DOD BAA99-1, Award Number DAMD 17-01-2-0070 by the US Army Medical Research Acquisition Activity, Fort Detrick, MD. The content of the information does not necessarily reflect the position or the policy of the US government, and no official endorsement should be inferred.