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By Richard Gough Paramedic tutor, Post Qualification Manager
Krisztián Tánczos, Márton Németh, Zsolt Molnár
Hemodynamic instability often leads to hypoperfusion, which has a significant impact on outcome in both medical and surgical patients. Measures to detect and treat tissue hypoperfusion early by correcting the imbalance between oxygen delivery and consumption is of particular importance. There are several studies targeting different hemodynamic endpoints in order to investigate the effects of goal-directed therapy on outcome. A so-called multimodal concept putting several variables in context follows simple logic and may provide a broader picture...
2014: Frontiers in Public Health
Rebecca M Hasler, Eveline Nüesch, Peter Jüni, Omar Bouamra, Aristomenis K Exadaktylos, Fiona Lecky
INTRODUCTION: Non-invasive systolic blood pressure (SBP) measurement is a commonly used triaging tool for trauma patients. A SBP of <90mmHg has represented the threshold for hypotension for many years, but recent studies have suggested redefining hypotension at lower levels. We therefore examined the association between SBP and mortality in penetrating trauma patients. METHODS: We conducted a prospective cohort study in adult (≥16 years) penetrating trauma patients...
April 2012: Resuscitation
Tolulope A Oyetunji, David C Chang, Joseph G Crompton, Wendy R Greene, David T Efron, Elliott R Haut, Edward E Cornwell, Adil H Haider
BACKGROUND: Recent debate concerns the most appropriate definition of hypotension. Some have advocated raising the systolic blood pressure (BP) threshold to 110 mm Hg while others favor 80 mm Hg. HYPOTHESIS: The optimal definition of hypotension differs by age group. DESIGN: An analysis was performed of trauma victims 18 years and older in the National Trauma Data Bank, excluding burn injury patients and those with incomplete data. SETTING: Injured patients who were hospitalized in various trauma centers across the continental United States...
July 2011: Archives of Surgery
Rebecca M Hasler, Eveline Nuesch, Peter Jüni, Omar Bouamra, Aristomenis K Exadaktylos, Fiona Lecky
INTRODUCTION: Non-invasive systolic blood pressure (SBP) measurement is often used in triaging trauma patients. Traditionally, SBP< 90 mm Hg has represented the threshold for hypotension, but recent studies have suggested redefining hypotension as SBP < 110 mm Hg. This study aims to examine the association of SBP with mortality in blunt trauma patients. METHODS: This is an analysis of prospectively recorded data from adult (≥ 16 years) blunt trauma patients...
September 2011: Resuscitation
Brent C Taylor, Timothy J Wilt, H Gilbert Welch
BACKGROUND: The National Heart, Lung and Blood Institute currently defines a blood pressure under 120/80 as "normal." OBJECTIVE: To examine the independent effects of diastolic (DBP) and systolic blood pressure (SBP) on mortality and to estimate the number of Americans affected by accounting for these effects in the definition of "normal." DESIGN, PARTICIPANTS AND MEASURES: Data on adults (age 25-75) collected in the early 1970s in the first National Health and Nutrition Examination Survey were linked to vital status data through 1992 (N = 13,792) to model the relationship between blood pressure and mortality rate adjusting for age, sex, race, smoking status, BMI, cholesterol, education and income...
July 2011: Journal of General Internal Medicine
Brandon Bruns, Larry Gentilello, Alan Elliott, Shahid Shafi
BACKGROUND: The American College of Surgeons Committee on Trauma suggests prehospital systolic blood pressure (PSBP) < 90 mm Hg as a criterion for triage of injured patients to trauma centers. However, Advanced Trauma Life Support recognizes this threshold as a late sign of shock. We undertook the current study to determine whether a higher PSBP threshold may identify patients at significant risk of death. METHODS: A retrospective analysis of an urban, Level I trauma center registry data was undertaken in patients with complete information on PSBP (n = 16,365; 1994-2003)...
December 2008: Journal of Trauma
Brian J Eastridge, Jose Salinas, John G McManus, Lorne Blackburn, Eileen M Bugler, William H Cooke, Victor A Convertino, Victor A Concertino, Charles E Wade, John B Holcomb
BACKGROUND: Clinicians routinely refer to hypotension as a systolic blood pressure (SBP) < or =90 mm Hg. However, few data exist to support the rigid adherence to this arbitrary cutoff. We hypothesized that the physiologic hypoperfusion and mortality outcomes classically associated with hypotension were manifest at higher SBPs. METHODS: A total of 870,634 patient records from the National Trauma Data Bank with emergency department SBP and mortality data were analyzed...
August 2007: Journal of Trauma
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