Hemodynamics and Oxygen Metabolism Changes in Different Types of Fluid Resuscitation in Multiple Trauma

Uncontrolled post-traumatic bleeding is the leading cause of death in multiple trauma patients. Hypervolaemia as a result of liberal fluid resuscitation leads to a multiple organ failure syndrome. The purpose of the study was to examine the hemodynamics, acid-base balance and oxygen metabolism in multiple trauma patients, depending on the fluid resuscitation type. Material and methods. 90 patients with multiple trauma were divided into two groups, depending on the fluid resuscitation type (liberal or restrictive). We studied central and peripheral hemodynamics parameters, rate and duration of vasopressor support, ventilation, pneumonia rate, acid-base state and blood gas. Results and discussion. Systolic, diastolic and mean arterial pressures were restored to normal within the first 6 hours in both groups. In patients with restrictive fluid resuscitation, tachycardia duration was reduced by 4 days, ventilation – by 8.7 hours, need for vasopressor support – for 7 days. Normalization of the acid-base balance and blood gas in restrictive fluid resuscitation group occurred 18 hours earlier. Complications rate was 56.5% in liberal fluid resuscitation and 36.4% in restrictive, lethality – 8.7% and 4.5%, respectively. Conclusions. Restrictive fluid resuscitation type accelerates normalization of central and peripheral hemodynamics, acid-base balance and oxygen metabolism in multiple trauma patients, which reduces the number of complications and lethality.