Trauma
Conditions
Keywords
adults admitted in vital emergency unit
Brief summary
13% of injured normotensive patients arriving in emergency unit need mass blood-transfusion of six or more units of packed Red Blood Cells. It is currently difficult to predict the need for such a mass blood-transfusion. Indeed hemoglobin point of care testing (hemocue) and blood pressure can be normal during the first hours despite intensive bleeding. It's well known that blood or arterial lactate measures correlate with trauma severity but these measures are not available in a pre-hospital setting. The investigators want to test whether capillary lactate measures also correlate with trauma severity and can therefore predicts earlier transfusion needs.
Interventions
OTHERCapillary lactate level
Use of capillary sample to determine lactate level upon arrival at vital emergency unit and at 2 hours
Sponsors
University Hospital, Grenoble
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult admitted in vital emergency unit * Severe trauma * normotensive (Systolic Blood Pressure \>90mmHg) * patient subjected to capillary haemoglobin and glucose measurements * patient beneficiary of social security
Exclusion criteria
* pregnant woman * liver deficiency * pre-hospital transfusion * hypothermia below 35°C * protected persons according to the law * Nor epinephrine \> 0.1gamma/kg/min
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Transfusion of 6 or more units of packed Red Blood Cells (RBC) | 48 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| injury scores (ISS,SOFA) | 24h | — |
| transfusion of 4 units of packed RBC | 48 hours | — |
| blood lactate measure | upon arrival at vital emergency unit | — |
| arterial lactate measures | upon arrival at the vital emergency unit | — |
| Bleeding Predictive Score | upon arrival at vital emergency unit | 3 questions are asked to the doctor in emergency room. Could patient be admitted directly at the CT scan ? Do you think that the patient need transfusion ? If Yes : and how many units ? Do you think that the patient will be hospitalized in an intensive care unit after the emergency room? |
| Mortality | 28 days | — |
| Intensity of medical care | upon arrival at vital emergency unit | Body scan Central venous catheterisation arterial catheterisation |
Countries
France
Outcome results
None listed