Rapid assessment of shock in a nonhuman primate model of uncontrolled hemorrhage: Association of traditional and nontraditional vital signs to mortality risk.

摘要: BACKGROUND Heart rate (HR), systolic blood pressure (SBP) and mean arterial (MAP) are traditionally used to guide patient triage resuscitation; however, they correlate poorly shock severity. Therefore, improved acute diagnostic capabilities needed. Here, we correlated alterations in tissue oxygen saturation (StO2) end-tidal carbon dioxide (ETCO2) mortality a rhesus macaque model of uncontrolled hemorrhage. METHODS Uncontrolled hemorrhage was induced anesthetized macaques by laparoscopic 60% left-lobe hepatectomy (T = 0 minute). StO2, ETCO2, HR, as well invasive SBP MAP were continuously monitored through T 480 minutes. At 120 minutes, bleeding surgically controlled, loss quantified. Data analyses compared nonsurvivors (expired before n 5) with survivors (survived 11) using repeated-measures analysis variance Bonferroni correction. All p < 0.05 considered statistically significant. Results reported ± SEM. RESULTS Baseline values equivalent between groups for each parameter. In versus at 5 StO2 (55% 10% vs. 78% 3%, 0.02) ETCO2 (15 2 25 mm Hg, 0.0005) lower, while (18 1 23 0.2), (26 34 3 0.4), HR (104 13 105 6 beats/min, 0.3) similar. Association over 5-30 minutes demonstrated equivalency significant group effect (p ≤ 0.009 parameter; R(2) 0.92 0.90, respectively). associated later into the period 0.04 0.91 0.89, respectively), yielded lowest association 0.8, 0.83). CONCLUSION Acute strongly preceded those traditional vital signs. The continuous, noninvasive aspects Food Drug Administration-approved monitoring devices provide logistical benefits other methodologies thus warrant further investigation.