Application of three fluid resuscitation methods to the treatment of hemorrhagic traumatic shock patients

Objective To discuss the different methods of fluid resuscitation for the treatment of hemorrhagic traumatic shock (HTS). Methods 73 clinical records of hemorrhagic traumatic shock using different methods of fluid resuscitation in the emergency department of Tongren hospital from 2005-07 to 2007-11 were reviewed. These cases were randomly divided into three groups according to the methods of the resuscitation, which were the conventional resuscitation group (conventional group, 27cases), the limited fluid resuscitation group (limited group, 25cases) and the hypertonic saline solution resuscitation group(hypertonic saline group, 21 cases). The hemodynamic index, the input, the level of lactic acid and base excess before and after the resuscitation were analysed. Results The input in the conventional group was (3012±497)mL, and the limited group was (2156±541)mL. The difference of the input between two groups was significant (P0.05). The input of the hypertonic saline group was (2235±503)mL. The difference of the input between the conventional group and the hypertonic saline group was significant (P0.05), but there was no significant difference between the limited group and the hypertonic group (P0.05). There were no significant differences in the lactic acid and the base excess between the limited fluid resuscitation group, the hypertonic saline group and the conventional resuscitation group (P0.05). The value of lactic acid in 12 hrs' resuscitation and 24 hrs' resuscitation were significant, as well as the base excess. In this investigation, 61 patients (83.6%) were cured, and 12 patients (16.4%) died. 11 patients were ARDS. 15 patients were MODS. The differences of the cure rate, mortality, ARDS incidence and MODS incidence among these three groups were significant (P0.05). Conclusions Limited fluid resuscitation and the hypertonic saline solution resuscitation for the treatment of hemorrhagic traumatic shock can increase the effective circulating blood volume and improve the perfusion of tissue and organ, which not only raise the cure rate, but also decrease the mortality. The curative effect of two methods is better than the method of the conventional resuscitation.