Browsing by Author "Edla, Shwetha"
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- ItemIs heart rate variability better than routine vital signs for prehospital identification of major hemorrhage?(2014-12-23) Edla, Shwetha; Reisner, Andrew T; Liu, Jianbo; Convertino, Victor A; Carter, Robert; Reifman, JaquesDuring initial assessment of trauma patients metrics of heart rate variability HRV have been associated with high risk clinical conditions Yet despite numerous studies the potential of HRV to improve clinical outcomes remains unclear Our objective was to evaluate whether HRV metrics provide additional diagnostic information beyond routine vital signs for making a specific clinical assessment identification of hemorrhaging patients who receive packed red blood cell PRBC transfusion
- ItemTachycardic and non-tachycardic responses in trauma patients with haemorrhagic injuries.(0000-00-00) Reisner, Andrew T; Edla, Shwetha; Liu, Jianbo; Liu, Jiankun; Khitrov, Maxim Y; Reifman, JaquesBACKGROUND Analyses of large databases have demonstrated that the association between heart rate HR and blood loss is weaker than what is taught by Advanced Trauma Life Support training However those studies had limited ability to generate a more descriptive paradigm because they only examined a single HR value per patient METHODS In a comparative retrospective analysis we studied the temporal characteristics of HR through time in adult trauma patients with haemorrhage based on documented injuries and transfusion of 3 units of red blood cells RBCs We analysed archived vital sign data of up to 60 min during either pre hospital or emergency department care RESULTS We identified 133 trauma patients who met the inclusion criteria for major haemorrhage and 1640 control patients without haemorrhage There were 55 haemorrhage patients with a normal median HR and 78 with tachycardia Median HR was 0 8 and 0 7 bpm per 10 min respectively Median time to documented hypotension was 8 and 5 min respectively RBCs were not significantly different median volumes were 6 IQR 4 13 and 10 units IQR 5 16 respectively Time to hypotension and mortality were not significantly different Tachycardic patients were significantly younger P Under 0 05 Only 10 patients with normal HR developed transient temporary tachycardia and only 11 tachycardic patients developed a transient temporary normal HR CONCLUSIONS The current analysis suggests that some trauma patients with haemorrhage are continuously tachycardic while others have a normal HR For both cohorts hypotension typically develops within 30 min without any consistent temporal increases or trends in HR