Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran
Purpose: Traumatic hemorrhagic shock is a life-threatening event worldwide. Severe brain trauma accompanying femoral fractures can trigger inflammatory responses in the body and increase pre-inflammatory cytokines such as TNF-α, IL-1. The primary treatment in these cases is hydration with crystalloi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127520301735 |
| _version_ | 1819160695425466368 |
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| author | Shahram Paydar Ali Taheri Akerdi Sadra Nikseresht Hossein Abdolrahimzadeh-Fard Leila Shayan Zahra Ghahramani Shahram Bolandparvaz Hamid Reza Abbasi |
| author_facet | Shahram Paydar Ali Taheri Akerdi Sadra Nikseresht Hossein Abdolrahimzadeh-Fard Leila Shayan Zahra Ghahramani Shahram Bolandparvaz Hamid Reza Abbasi |
| author_sort | Shahram Paydar |
| collection | DOAJ |
| description | Purpose: Traumatic hemorrhagic shock is a life-threatening event worldwide. Severe brain trauma accompanying femoral fractures can trigger inflammatory responses in the body and increase pre-inflammatory cytokines such as TNF-α, IL-1. The primary treatment in these cases is hydration with crystalloids, which has both benefits and complications. The purpose of this study was to investigate the effects of fluid therapy on the hemodynamics, coagulation profiles, and blood gases in such patients. Methods: In this cross-sectional study, patients were divided into two groups: femoral fracture group and non-femoral group. The hemodynamic status, coagulation profile, and blood gases of patients in both groups were evaluated upon arrival at the hospital and again 2 h later. Data were analyzed by t-test and ANOVA with repeated data and paired samples t-test. Results: A total of 681 trauma patients (605 men and 76 women) participated in this study, including 69 (86.3%) men and 11 (13.8%) women in femoral fracture group and 536 men (89.2%) and 65 women (10.8%) in non-femoral group. The laboratory parameters were evaluated in response to the equal amount of crystalloid fluid given upon arrival and 2 h later. Blood gases decreased in the fracture group despite fluid therapy (p < 0.003), and the coagulation profile worsened although the change was not statistically significant. Conclusion: The treatment of multiple-trauma patients with femoral bone fractures should be more concerned with the need for the infusion of vasopressors such as norepinephrine. If there is evidence of clinical shock, excessive crystalloid infusion (limited to 1 L) should be avoided, and blood and blood products should be started as soon as possible. |
| first_indexed | 2024-12-22T17:00:32Z |
| format | Article |
| id | doaj.art-bf92b6f7b9f943af8f31378aa0ed5557 |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-12-22T17:00:32Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-bf92b6f7b9f943af8f31378aa0ed55572022-12-21T18:19:20ZengElsevierChinese Journal of Traumatology1008-12752021-02-012413033Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, IranShahram Paydar0Ali Taheri Akerdi1Sadra Nikseresht2Hossein Abdolrahimzadeh-Fard3Leila Shayan4Zahra Ghahramani5Shahram Bolandparvaz6Hamid Reza Abbasi7Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranCorresponding author.; Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranPurpose: Traumatic hemorrhagic shock is a life-threatening event worldwide. Severe brain trauma accompanying femoral fractures can trigger inflammatory responses in the body and increase pre-inflammatory cytokines such as TNF-α, IL-1. The primary treatment in these cases is hydration with crystalloids, which has both benefits and complications. The purpose of this study was to investigate the effects of fluid therapy on the hemodynamics, coagulation profiles, and blood gases in such patients. Methods: In this cross-sectional study, patients were divided into two groups: femoral fracture group and non-femoral group. The hemodynamic status, coagulation profile, and blood gases of patients in both groups were evaluated upon arrival at the hospital and again 2 h later. Data were analyzed by t-test and ANOVA with repeated data and paired samples t-test. Results: A total of 681 trauma patients (605 men and 76 women) participated in this study, including 69 (86.3%) men and 11 (13.8%) women in femoral fracture group and 536 men (89.2%) and 65 women (10.8%) in non-femoral group. The laboratory parameters were evaluated in response to the equal amount of crystalloid fluid given upon arrival and 2 h later. Blood gases decreased in the fracture group despite fluid therapy (p < 0.003), and the coagulation profile worsened although the change was not statistically significant. Conclusion: The treatment of multiple-trauma patients with femoral bone fractures should be more concerned with the need for the infusion of vasopressors such as norepinephrine. If there is evidence of clinical shock, excessive crystalloid infusion (limited to 1 L) should be avoided, and blood and blood products should be started as soon as possible.http://www.sciencedirect.com/science/article/pii/S1008127520301735ResuscitationVictimsFemoral fracturesHemorrhagic shock |
| spellingShingle | Shahram Paydar Ali Taheri Akerdi Sadra Nikseresht Hossein Abdolrahimzadeh-Fard Leila Shayan Zahra Ghahramani Shahram Bolandparvaz Hamid Reza Abbasi Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran Chinese Journal of Traumatology Resuscitation Victims Femoral fractures Hemorrhagic shock |
| title | Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran |
| title_full | Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran |
| title_fullStr | Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran |
| title_full_unstemmed | Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran |
| title_short | Should we change our approach to resuscitating victims of femoral fracture? A clinical experience in a busy trauma hospital in Shiraz, Iran |
| title_sort | should we change our approach to resuscitating victims of femoral fracture a clinical experience in a busy trauma hospital in shiraz iran |
| topic | Resuscitation Victims Femoral fractures Hemorrhagic shock |
| url | http://www.sciencedirect.com/science/article/pii/S1008127520301735 |
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