Danger signals in traumatic hemorrhagic shock and new lines for clinical applications

Dufour-Gaume, Frédérique; Frescaline, Nadira; Cardona, Venetia; Prat, Nicolas

doi:10.3389/fphys.2022.999011

Cited by 5 publications

(3 citation statements)

References 86 publications

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“…By assessing the patient's disease severity and employing a targeted approach to fluid infusion, restrictive fluid resuscitation ensures the rationality of the infusion process, ultimately improving blood volume, enhancing cardiac function, and contributing to favorable prognoses [9]. Its primary benefits are summarized as follows [7][8][9][10] Through comparative analysis, this study revealed a lower incidence of complications in the study group, suggesting that the restrictive fluid resuscitation protocol is associated with reduced complications and enhanced safety, minimizing the disruption of the internal environment, which may be closely related to the regimen's restrictions on infusion volume and speed, thereby helping maintain a dynamic equilibrium between the body's coagulation and fibrinolytic systems and ultimately reducing blood loss [13,14].…”

Section: Discussionmentioning

confidence: 84%

Effects of restrictive fluid resuscitation on the clinical efficacy of treating traumatic hemorrhagic shock combined with traumatic coagulopathy

2024

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This study aims to assess the clinical efficacy of limited fluid resuscitation on traumatic hemorrhagic shock combined with traumatic coagulopathy. A cohort of 120 patients with traumatic hemorrhagic shock complicated with traumatic coagulopathy at admission were divided into two groups based on their emergency fluid resuscitation: the study group (received restrictive fluid resuscitation) and the control group (received conventional fluid resuscitation). Then, the incidence of complications, coagulation parameters, blood gas parameters and electrolyte parameters between the two groups were compared. The incidence of complications in the study group was 6.67%, which was significantly lower than the 20.00% observed in the control group (p < 0.05). Before resuscitation, there was no significant difference in coagulation parameters, blood gas parameters and electrolyte parameters between the two groups (p > 0.05), and in both groups, before and after resuscitation, the coagulation parameters after resuscitation were higher than those before resuscitation, blood gas parameters were lower than those before resuscitation, Mg2+, Cl− and Na+ levels were higher than those before resuscitation, K+ was lower than that before resuscitation, and the difference had statistical significance (p < 0.05). After resuscitation, the coagulation parameters in the study group were significantly lower than those in the control group, the BL (Blood Lactic Acid) and PaCO2 (partial pressure of carbon dioxide in arterial blood) levels in the study group were lower than those in the control group, the BE (base excess) and PaO2 levels were higher than those in the control group, and the differences were statistically significant (p < 0.05). However, after resuscitation, we found no significant difference in electrolyte parameters between both groups (p > 0.05). Restrictive fluid resuscitation was found to significantly enhance coagulation and blood gas function, stabilize water and electrolyte balance and reduce complications in traumatic hemorrhagic shock patients complicated with traumatic coagulopathy. These findings hold substantial clinical significance and merit further exploration.

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Section: Discussionmentioning

confidence: 84%

Effects of restrictive fluid resuscitation on the clinical efficacy of treating traumatic hemorrhagic shock combined with traumatic coagulopathy

2024

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“…When compounded by tissue injury, this so-called haemorrhagic shock is capable of triggering TIC. Injurious insults to tissues lead to extensive necrosis, provoking the release of damage-associated molecular patterns (DAMPs), such as histones, HMGB1, polyphosphates (e.g., ATP), and nuclear and mitochondrial DNA, which are capable of engaging cells of the innate immune system by signalling via pattern recognition receptors [ 21 , 22 , 23 , 24 , 25 ]. Physical trauma also triggers an inflammatory response, characterised by a cytokine “breeze” or “storm”, depending on the severity of the injury [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Experimental Models of Traumatic Injuries: Do They Capture the Coagulopathy and Underlying Endotheliopathy Induced by Human Trauma?

Barrett

Curry

Abu-Hanna

2023

IJMS

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Trauma-induced coagulopathy (TIC) is a major cause of morbidity and mortality in patients with traumatic injury. It describes the spectrum of coagulation abnormalities that occur because of the trauma itself and the body’s response to the trauma. These coagulation abnormalities range from hypocoagulability and hyperfibrinolysis, resulting in potentially fatal bleeding, in the early stages of trauma to hypercoagulability, leading to widespread clot formation, in the later stages. Pathological changes in the vascular endothelium and its regulation of haemostasis, a phenomenon known as the endotheliopathy of trauma (EoT), are thought to underlie TIC. Our understanding of EoT and its contribution to TIC remains in its infancy largely due to the scarcity of experimental research. This review discusses the mechanisms employed by the vascular endothelium to regulate haemostasis and their dysregulation following traumatic injury before providing an overview of the available experimental in vitro and in vivo models of trauma and their applicability for the study of the EoT and its contribution to TIC.

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“…Every year, 60,000 people die in the United States as a result of traumatic hemorrhage, and 1.5 million people die worldwide as a result of physical trauma [5] [6]. Approximately 60% and 25% of all trauma-related deaths are attributed to immediate and early mortality, respectively, while the remaining 10% to 30% of deaths are attributed to late mortality [7]. According to data from the World Health Organization (WHO), injuries account for over 5 million fatalities globally year, and by 2030, injury mortality is predicted to rise sharply.…”

Section: Introductionmentioning

confidence: 99%

A Review of Nurses’ Perceptions of Traumatic Haemorrhagic Shock Management in Emergency Nursing

Amponsem-Boateng,

Boakye-Yiadom,

P. Amertil

2023

OJN

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Haemorrhagic shock (HS) is a subset of hypovolaemic shock in which there is minimal to massive loss of blood either internally or externally in trauma or injured patients. Data from the World Health Organization (WHO) affirm that injuries account for over 5 million fatalities globally every year, and by 2030, injury mortality is predicted to rise severely. Public health research typically uses the KAP models, which may be divided into three parts: acquiring accurate knowledge, forming an attitude, and adopting behavior, to analyze people's health behaviors and explain changes in them. This review is about the nurses' perspectives of the concept of Knowledge, Attitude, and Practice (KAP) Model of hemorrhagic shock in trauma patients and assesses clinical practice tools used by nurses to keep an eye on patients who have the condition. Nurses' knowledge of indications of shock is either high or very high. The knowledge of nurses was related to their training before working in accident and emergency units. The nurses' attitude is considered significant, commendable, appropriate, and pertinent to the provision of care for a patient experiencing hemorrhagic shock. And the nurse's practice of early patient identification, prompt and continuous monitoring, control of the bleeding source, maintenance of hemostasis, and the correction of significant blood loss that can occur quickly to cause death, are the strengths of management.

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Danger signals in traumatic hemorrhagic shock and new lines for clinical applications

Cited by 5 publications

References 86 publications

Effects of restrictive fluid resuscitation on the clinical efficacy of treating traumatic hemorrhagic shock combined with traumatic coagulopathy

Effects of restrictive fluid resuscitation on the clinical efficacy of treating traumatic hemorrhagic shock combined with traumatic coagulopathy

Experimental Models of Traumatic Injuries: Do They Capture the Coagulopathy and Underlying Endotheliopathy Induced by Human Trauma?

A Review of Nurses’ Perceptions of Traumatic Haemorrhagic Shock Management in Emergency Nursing

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