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Diagnostic Performance of Serial bedside Capillary Lactate, Hemoglobin, and shock index for Severe Postpartum

Advances in Reproductive Sciences 2021年第4期9卷 189-198页

作者： Roberto Arturo Castillo-Reyther Idelia Natalie Plata-Alcocer Salvador De la Maza-Labastida Venance Basil Kway Ma. del Pilar Fonseca-Leal Department of Obstetrics and Gynecology Hospital Central Dr. Ignacio Morones Prieto San Luis Potosi Mexico Research and Clinical Postgraduate Department of the Faculty of Medicine Universidad Autonoma de San Luis Potosi Mexico

Objective: To assess the diagnostic capacity of bedside capillary lactate (CLact), capillary Haemoglobin (CHb), and shock index (SI) for severe postpartum haemorrhage (SPPH > 2000 ml) at diagnosis, 15 minutes and 30 minutes later. Method: A cohort study was carried out in a reference hospital in San Luis Potosi, Mexico from February 2020 to March 2021, and included sixty women in vaginal labor or c-section who presented PPH (≥500 ml in labor or ≥1000 ml in c-section) measured by the gravimetric method. CLact, SI, and CHb concentrations were analyzed at diagnosis of PPH, 15 minutes, and 30 minutes. Patients who presented total blood loss of >2000 ml were considered SPPH. A T-test or Wilcox test was performed to compare the groups of non-severe and severe. Sensitivity, specificity, and performance were calculated by A Receiver Operating Curve. Results: A CLact measurement at 30 minutes was significantly different between the non-severe and severe groups (4.0 + 1.9 vs 4.8 + 1.15 P-value 0.001, with an optimal cut point of 4.3 mmol/dl at AUC 0.75, sensitivity 0.85, and specificity of 0.62. With a cut-point of 1.17, an AUC of 0.76, sensitivity of 0.43, and specificity of 0.98, SI at diagnosis was significantly different between the non-severe and severe groups (0.70 + 0.20 vs. 0.90 + 0.38 P-value 0.0228). Conclusion: SI is an early sign of SPPH;CLact can significantly identify SPPH after 30 minutes.

关键词： Capillary Haemoglobin Lactate Obstetric Haemorrhage shock index

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Effectiveness of Combined Application of shock index and Early Warning Scoring System in Patients with Acute Gastrointestinal Hemorrhage

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Journal of Clinical and Nursing Research 2024年第7期8卷 342-348页

作者： Dalei Chen Affiliated Hospital of Hebei University Baoding 071000Hebei ProvinceChina

Objective:To explore the effect of the combined application of the shock index(SI)and the Early Warning Score(EWS)in patients with acute gastrointestinal ***:Seventy patients with acute gastrointestinal bleeding admitted to a hospital from June 2022 to May 2024 were selected and randomly divided into two groups:the control group and the observation group,with 35 patients in each *** control group received conventional emergency care measures,while the observation group received SI combined with NEWS emergency care *** treatment effects in both groups were ***:The observation group had shorter waiting times for consultation(4.45±1.59 minutes),intravenous access establishment(6.79±2.52 minutes),hemostasis time(4.41±1.52 hours),and hospital stays(8.39±2.13 days)compared to the control group,which had times of 5.46±1.34 minutes,8.41±2.16 minutes,5.16±1.47 hours,and 10.26±2.98 days,*** differences were statistically significant(P0.05).However,after systematic emergency management,the serum indexes in both groups significantly improved,with the observation group showing greater improvement than the control group,and these differences were statistically significant(Pshock,anemia,multi-organ failure,cardiovascular complications,and gastrointestinal rebleeding,with an incidence rate of 22.85%.The difference between the groups was statistically significant(Pindexes,shorten resuscitation t

关键词： Acute gastrointestinal bleeding shock index Early Warning Score Clinical assessment Prognosis optimization

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The role of shock index in predicting adverse events in elderly patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention

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South China Journal of Cardiology 2020年第4期21卷 240-246页

作者： CHEN Jiao-hua HUANG Ying-jie WANG Li-yun BAI Lu WU Ying Department of Cardiology Guangdong Cardiovascular InstituteGuangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhou 510180GuangdongChina

Background The prognostic value of shock index(SI)in elderly patients with ST-segment elevation myocardial infarction(STEMI)is *** study was to explore the association of shock index with long-term mortality in elderly STEMI patients undergoing percutaneous coronary intervention(PCI).Methods A total of 731 elderly patients with STEMI undergoing PCI were included and divided into three groups according to the tertiles of shock index:shock index is the ratio of heart rate to systolic blood *** operating characteristic(ROC)curves were conducted and the area under the curve(AUC)of SI for predicting in-hospital mortality was *** association of shock index with in-hospital and one-year mortality was evaluated using multivariate regression *** In patients with shock index in the first to third tertiles,in-hospital death occurred in 2.5%,4.3%and 11.3%of patients,*** major adverse clinical events(MACEs)occurred in 8.7%,10.3%and 21.4%of patients,*** analysis showed that shock index>0.74 was the best threshold for predicting in-hospital *** index>0.74 was independently associated with increased risk of in-hospital death[adjusted odds ratio(OR):3.68,95%confidence interval(CI):1.85-7.32,Pshock index>0.74 had a worse prognosis than those with shock index≤0.74(Log-rank test:33.58,Pshock index was independently associated with in-hospital and one-year mortality.

关键词： shock index ST elevation myocardial infarction prognosis

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Traumatic brain injury and variants of shock index

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World Journal of Critical Care Medicine 2024年第3期13卷 1-4页

作者： Sai Doppalapudi Muhammad Adrish Department of Pulmonary and Critical Care Medicine BronxCare Health System/Icahn School of Medicine at Mount SinaiBronxNY 10467United States Section of Pulmonary Critical Care and Sleep MedicineBaylor College of MedicineHoustonTX 77030United States

Traumatic Brain Injury is a major cause of death and long-term *** early identification of patients at high risk of mortality is important for both management and *** many modified scoring systems have been developed for improving the prediction accuracy in patients with trauma,few studies have focused on prediction accuracy and application in patients with traumatic brain *** shock index(SI)which was first introduced in the 1960s has shown to strongly correlate degree of circulatory shock with increasing *** this editorial we comment on a publication by Carteri et al wherein they perform a retrospective analysis studying the predictive potential of SI and its variants in populations with severe traumatic brain injury.

关键词： Predictive tools Traumatic brain injury shock index Neurocardiogenic stress Myocardial ischemia

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Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department

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World Journal of Emergency Medicine 2024年第4期15卷 273-282页

作者： Rex Pui Kin Lam Zonglin Dai Eric Ho Yin Lau Carrie Yuen Ting Ip Ho Ching Chan Lingyun Zhao Tat ChiTsang Matthew Sik Hon Tsui Timothy Hudson Rainer Department of Emergency Medicine School of Clinical MedicineLi Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina School of Public Health Li Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina Accident and Emergency Department Queen Mary HospitalHong KongChina

BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong *** primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED *** c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time ***:We analyzed 601 patients,of whom 166(27.6%)developed ***2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary ***,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),*** discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time ***:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.

关键词： Sepsis Emergency department Clinical prediction rule Early warning score shock index

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Wearable Smart Sensor System for Medical Monitoring with an Assessment of the Level of Blood Loss and Pain shock Because of Trauma or Injury

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International Journal of Analytical Mass Spectrometry and Chromatography 2023年第2期11卷 11-21页

作者： Volodymyr Romanov Igor Galelyuka Ozar Mintser Ilia Brondz V. M. Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine Kyiv Ukraine Department of Informatics Informatically Technology and Transdisciplinary Education P.L. Shupyk National University of Health of Ukraine Kyiv Ukraine Norwegian Drug Control and Drug Discovery Institute (NDCDDI) AS Ski Norway

Blood loss in peacetime is mainly due to the normal menstrual cycle in women or diseases with surgical intervention. In wartime, blood loss in military personnel is a characteristic sign of a closed or open injury of the body during internal or external bleeding. Access to clinical care for wounded military personnel injured on the battlefield is limited and has long delays compared to patients in peacetime. Most of the deaths of wounded military personnel on the battlefield occur within the first hour after being wounded. The most common causes are delay in providing medical care, loss of time for diagnosis, delay in stabilization of pain shock and large blood loss. Some help in overcoming these problems is provided by the data in the individual capsule, which each soldier of the modern army possesses;however, data in an individual capsule is not sufficient to provide emergency medical care in field and hospital conditions. This paper considers a project for development of a smart real-time monitoring wearable system for blood loss and level of shock stress in wounded persons on the battlefield, which provides medical staff in field and hospital conditions with the necessary information to give timely medical care. Although the hospital will require additional information, the basic information about the victims will already be known before he enters the hospital. It is important to emphasize that the key term in this approach is monitoring. It is tracking, and not a one-time measurement of indicators, that is crucial in a valid definition of bleeding.

关键词： Smart System Blood Loss Monitoring shock index Smart Wearable Monitoring System

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Association of low non-invasive near-infrared spectroscopic measurements during initial trauma resuscitation with future development of multiple organ dysfunction

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World Journal of Emergency Medicine 2015年第2期6卷 105-110页

作者： Bret A.Nicks Kevin M.Campons William P.Bozeman Department of Emergency Medicine Wake Forest School of Medicine2nd Meads HallMedical Center Boulevard

BACKGROUND: Near-infrared spectroscopy(NIRS) non-invasively monitors muscle tissue oxygen saturation(St O2). It may provide a continuous noninvasive measurement to identify occult hypoperfusion, guide resuscitation, and predict the development of multiple organ dysfunction(MOD) after severe trauma. We evaluated the correlation between initial St O2 and the development of MOD in multi-trauma ***: Patients presenting to our urban, academic, Level I Trauma Center/Emergency Department and meeting standardized trauma-team activation criteria were enrolled in this prospective trial. NIRS monitoring was initiated immediately on arrival with collection of St O2 at the thenar eminence and continued up to 24 hours for those admitted to the Trauma Intensive Care Unit(TICU). Standardized resuscitation laboratory measures and clinical evaluation tools were collected. The primary outcome was the association between initial St O2 and the development of MOD within the f irst 24 hours based on a MOD score of 6 or greater. Descriptive statistical analyses were performed; numeric means, multivariate regression and rank sum comparisons were utilized. Clinicians were blinded from the StO 2 ***: Over a 14 month period, 78 patients were enrolled. Mean age was 40.9 years(SD 18.2), 84.4% were male, 76.9% had a blunt trauma mechanism and mean injury severity score(ISS) was 18.5(SD 12.9). Of the 78 patients, 26(33.3%) developed MOD within the first 24 hours. The MOD patients had mean initial St O2 values of 53.3(SD 10.3), signifi cantly lower than those of nonMOD patients 61.1(SD 10.0); P=0.002. The mean ISS among MOD patients was 29.9(SD 11.5), significantly higher than that of non-MODS patients, 12.1(SD 9.1)(Pshock index(SI) among MOD patients was 0.92(SD 0.28), also signifi cantly higher than that of non-MODS patients, 0.73(SD 0.19)(P=0.0007). Lactate values were not signifi cantly different between ***: Non-invasive, continuous St O

关键词： Near-infrared spectroscopy Multiple organ dysfunction Injury severity score shock index Lactate

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Role of Anterior Division of Internal Iliac Artery Ligation in Refractory Postpartum Haemorrhage—A Tertiary Care Hospital Based Study

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Open Journal of Obstetrics and Gynecology 2016年第12期6卷 725-733页

作者： Shrinivas Gadappa Sonali Deshpande Kanan Yelikar Sachin Gadekar Obstetric & Gynaecology Department Government Medical College Aurangabad India

Objective: Postpartum haemorrhage (PPH) is one of the important obstetrical emergencies and a leading cause of maternal morbidity and mortality. According to the World Health Organization, postpartum haemorrhage constitutes 25% of all maternal deaths worldwide. In situations where medical line of management fails to control postpartum haemorrhage, anterior division of internal iliac artery ligation can play an important role as a lifesaving and fertility preserving surgical procedure. Keeping this in mind, our study aimed to analyze indications and efficacy of anterior division of Internal Iliac artery ligation in the form of uterine salvage and saving maternal life. Study design: This was a retrospective study carried out in the Department of Obstetrics and Gynaecology, Government Medical College, Aurangabad during the period of July 2014-January 2016. A total of 57 cases that had undergone ligation of anterior division of internal iliac artery were included in the study and different indications and efficacy were studied. Results: Atonic PPH (52.63%) leads the list of indications for ligation anterior division of internal iliac artery ligation followed by traumatic (19.29%), adherent placenta (12.2%), mixed variety (10.52%) and coagulopathy (5.26). Maximum efficacy in terms of preserving fertility and saving maternal life was 73.33% and 93.3% respectively in atonic PPH. Overall efficacy of this procedure in terms of uterine salvage was 54.38% and in terms of saving maternal life was 87.71%. Conclusion: Anterior division of IIAL was effective method in controlling refractory PPH, reducing morbidity and preserving uterus and future fertility. It is safe life saving procedure at experienced hands.

关键词： Internal Iliac Artery Ligation (IIAL) Postpartum Haemorrhage (PPH) Uterine Salvage shock index

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