caa a22 4500 475790642 CHVBK 20180406123709.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1007/s004230000152 doi (NATIONALLICENCE)springer-10.1007/s004230000152 Volume replacement in trauma patients within the first 24h and its impact on the interpretation of biochemical data [Elektronische Daten] [Florian Gebhard, Christof Riepl, Ulrich C. Liener, Lothar Kinzl, Uwe B. Brückner] Abstract.: Background and aims: Patients of the same and particularly of different trauma studies are primarily incomparable due to different volume replacements. The aim of this prospective study was to analyze the amount of initially administered fluids in trauma patients during the first 24h and to estimate the impact of dilution on plasma protein concentrations (PPCs) of prostanoids. These substances are vascular endothelium-derived and are thus influenced by blood pressure. Patients/methods: Sixty-nine casualties suffering from multiple injuries were enrolled in the study. The amount of any fluid administered was scrutinized during the first 24h. Patients were divided into subsets according to trauma severity by Injury Severity Score (ISS) (group=G-I: ≤9; G-II: 10-18; G-III: 19-32; G-IV: >32) and between survivorsand non-survivors. At corresponding time points, hemoglobin, hematocrit (Hct) and PPC as well as prostaglandins (PGI, TxA, PGF2a) were evaluated at the site of accident, at hospital admission, and every hour thereafter for the first 24h. Results: During this period, the total amount of infused fluids ranged between 0.5l (G-I) and >48l (G-IV). The higher the trauma severity, the greater the volume infused (G-III/IV P=0.0003 vs G-I/II). Simultaneously, PPC dropped markedly (P<0.01). Patients who died within 36h required higher volumes (P<0.003) than survivors. PPC was linearly related (r 2=.6685, P<0.001) to Hct. During the first 24h, the time course of prostanoid concentration was altered when dilution is not taken into account. Conclusion: PPC proved a suitable parameter to estimate dilution effects and to adjust plasma concentrations of prostanoids. We recommend that consideration be given to possible dilution effects during the first 24h when interpreting biochemical data in trauma patients. Springer-Verlag, 2000 Clinical study Trauma Dilution Inflammatory response nationallicence Gebhard Florian Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut Riepl Christof Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut Liener Ulrich C. Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut Kinzl Lothar Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut Brückner Uwe B. Division of Surgical Research, Department of General Surgery, University of Ulm, 89075 Ulm, Germany, Germany aut Langenbeck's Archives of Surgery Springer-Verlag 385/6(2000-10-01), 406-411 1435-2443 385:6<406 2000 385 423 https://doi.org/10.1007/s004230000152 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000152 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gebhard Florian Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut NATIONALLICENCE 700 1- Riepl Christof Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut NATIONALLICENCE 700 1- Liener Ulrich C. Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut NATIONALLICENCE 700 1- Kinzl Lothar Department of Traumatology, Hand and Reconstructive Surgery, Department of General Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany, Germany aut NATIONALLICENCE 700 1- Brückner Uwe B. Division of Surgical Research, Department of General Surgery, University of Ulm, 89075 Ulm, Germany, Germany aut NATIONALLICENCE 773 0- Langenbeck's Archives of Surgery Springer-Verlag 385/6(2000-10-01), 406-411 1435-2443 385:6<406 2000 385 423 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer