Document Detail


Effects of age and obesity on hemodynamics, tissue oxygenation, and outcome after trauma.
MedLine Citation:
PMID:  17495724     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aims of this study are (1) to describe the early time course of hemodynamic and tissue perfusion/oxygenation patterns in the elderly and in obese patients who survive and those who die after trauma; and (2) to evaluate postinjury hemodynamic patterns for use as guides for resuscitation and subsequent treatment. METHODS: We noninvasively monitored 625 trauma patients upon arrival in the emergency department to assess the temporal hemodynamic patterns associated with age and obesity. Cardiac index (CI), mean arterial pressure, and heart rate were monitored to assess cardiac function, pulse oximetry (Sapo2) to reflect changes in pulmonary function and transcutaneous oxygen (PtcO2), carbon dioxide (PtcCO2), and oxygen delivery (DO2) to reflect tissue perfusion. We evaluated these hemodynamic data after they were stratified by the patient age and body mass index. RESULTS: When all trauma patients were considered together, the predominant findings were high CI, transient hypotension, tachycardia, normal pulmonary function, and reduced tissue oxygenation. The elderly and, to a lesser extent the obese, had lower flow and tissue perfusion. The survivors had higher CI and better tissue oxygenation than did the nonsurvivors of each category. CONCLUSIONS: Elderly and obese nonsurvivors of severe injury had low CI with reduced tissue oxygenation associated with organ failures and death. The study suggests that survivors' CIs and tissue oxygenation may be used as markers of circulatory deterioration and shock as well as resuscitation.
Authors:
Howard Belzberg; Charles C J Wo; Demetrios Demetriades; William C Shoemaker
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of trauma     Volume:  62     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-14     Completed Date:  2007-07-18     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1192-200     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Los Angeles County/University of Southern California Medical Center, School of Medicine 90033, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Body Mass Index
Cardiac Output / physiology*
Female
Humans
Length of Stay
Male
Middle Aged
Obesity / complications*,  physiopathology
Oxygen Consumption / physiology*
Respiratory Function Tests
Survival Rate
Wounds and Injuries / complications,  mortality*,  physiopathology*
Grant Support
ID/Acronym/Agency:
GM-65619/GM/NIGMS NIH HHS; RR-11526/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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