A prospective randomized study of end points of resuscitation after major trauma: global oxygen transport indices versus organ-specific gastric mucosal pH.

摘要: BACKGROUND Gastric tonometry, as a method of organ-specific monitoring the status splanchnic circulation, has demonstrated prognostic and therapeutic implications in critically ill patients. The experience with this patients trauma been limited. STUDY DESIGN Fifty-seven were prospectively randomized into two groups: group 1, n = 30, normalization maintenance gastric mucosal pH (pHi) at or above 7.3 2, 27, oxygen delivery index 600 an consumption greater than 150. groups had statistically similar injury severity scores, lactate levels, base deficits. RESULTS Of 44 pHi 24 hours, three (6.8 percent) died multiple organ dysfunction syndrome compared seven (53.9 13 whom was not optimized, p 0.006. Optimization times for index, excess between survivors nonsurvivors. time optimization significantly longer Multiple points higher who did have optimized within hours (6.08 2.5, 0.03). predictive mortality on regression. Persistently low frequently associated systemic intra-abdominal complications. It first finding all nonsurvivors least 48 to 72 before death. CONCLUSIONS may be important marker assess adequacy resuscitation. Monitoring provide early warning complications postresuscitation period.