Trouwborst, N.M. (2019) Fluid resuscitation and CCUS in trauma patients Too wet or too dry? thesis, Medicine.
Full text available on request.Abstract
Objective: This study investigated the fluid status of trauma patients by tracking the fluid in- and output. Furthermore, this study investigated whether critical care ultrasonography (CCUS) could evaluate the occurrence of under- and/or over resuscitation, and its relation with observed fluid status. Method: This study was conducted in the University Medical Center of Groningen from October 2018 till January 2019. All patients with an A-trauma (expected Injury Severity Score ≥ 16) were included. Fluid balance and CCUS measurement of the lungs and Inferior Vena Cava (IVC) were obtained at day one and three. IVC measurements consisted of IVC diameter and collapsibility. The amount of Kerley B-lines was recorded during lung CCUS. Outcomes were considered significant when p<0.05. Results: At day one 38 patients were included, of whom 23 had a follow up at day three. Between day one (2722 ± 3543ml) and day three (3527± 1860ml.) there was a significant rise in fluid balance (p=0.031). Median IVC collapsibility’s at day one and three were 25% and 27% respectively. There was no significant correlation between fluid balance and IVC collapsibility. Median total amount of B-lines was 1±2 and 1±5 at day one and three respectively. Significant correlations were found between fluid balance and total amount of Blines at all exam moments (p<0.005). Conclusion: There was a significant rise in fluid balance during the first 48 hours of admission. CCUS measurements of the lung demonstrated a significant correlation with fluid balance, while IVC measurements did not. Keywords: Trauma patients, fluid balance, Critical Care Ultrasonography, IVC collapsibility, Kerley B-lines, Emergency Department, Intensive Care Unit
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and IJpma, F. F. A. and Other supervisors: and KJoeze, J. and Horst, J. C. C. van der and Wiersema, R. and Universitair Medisch Centrum Groningen and Department of Trauma Surgery, Intensive Care Unit and Emerge |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2089 |
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