Abstract
Hypothesis: Women respond better to standardized shock resuscitation compared with similarly severely injured men. Design: Severely injured patients who met specific criteria were resuscitated using a standardized protocol with no adjustment for gender. The resuscitation protocol was used to attain and to maintain an oxygen delivery index of 600 mL/min·m2 or greater (DO 2I≥600) for the first 24 hours in the intensive care unit (ICU). Interventions, responses, and outcomes for the 2 cohorts were compared. Data were analyzed using analysis of variance, X 2, and t tests; P<.05 was considered significant. Setting: A 20-bed regional level I trauma center ICU. Patients: Patients at high risk of postinjury multiple organ failure (major organ or vascular injury and/or skeletal fractures, initial arterial base deficit of 6 mEq/L or greater, requirement for 6 units or more of packed red blood cells in the first 12 hours after hospital admission, or age ≥65 years with any 2 previous criteria). Interventions: Pulmonary artery catheter, packed red blood cell transfusion, crystalloid fluid infusion, inotrope, and vasopressor support, as needed, in that sequence, to maintain DO 2I≥600. Main Outcome Measures: Hemodynamic response to resuscitation, fluid, and packed red blood cell volume. Results: During 2000, 58 patients (38 men, 20 women) met criteria and were resuscitated using our standardized protocol. Demographics and outcomes were similar for both cohorts. Requirements for and responses to standardized resuscitation were also similar, except for volume loading. The female cohort required less lactated Ringer solution volume (12± 1 vs 8±2 L, P<.05), required less Starling curve intervention (42% vs 15%, P<.05), and maintained the DO 2I goal with average pulmonary capillary wedge pressure that was less than that of the male cohort. Conclusion: Review of prospective data from standardized shock resuscitation for female and male cohorts demonstrates that women respond better to standardized resuscitation compared with similarly severely injured men.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 578-584 |
| Number of pages | 7 |
| Journal | Archives of Surgery |
| Volume | 137 |
| Issue number | 5 |
| State | Published - 2002 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
Cite this
Standardized trauma resuscitation : Female hearts respond better. / McKinley; Kozar, ; Cocanour, Christine S; Sailors; Ware; Moore; Valdivia.
In: Archives of Surgery, Vol. 137, No. 5, 2002, p. 578-584.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Standardized trauma resuscitation
T2 - Female hearts respond better
AU - McKinley,
AU - Kozar,
AU - Cocanour, Christine S
AU - Sailors,
AU - Ware,
AU - Moore,
AU - Valdivia,
PY - 2002
Y1 - 2002
N2 - Hypothesis: Women respond better to standardized shock resuscitation compared with similarly severely injured men. Design: Severely injured patients who met specific criteria were resuscitated using a standardized protocol with no adjustment for gender. The resuscitation protocol was used to attain and to maintain an oxygen delivery index of 600 mL/min·m2 or greater (DO 2I≥600) for the first 24 hours in the intensive care unit (ICU). Interventions, responses, and outcomes for the 2 cohorts were compared. Data were analyzed using analysis of variance, X 2, and t tests; P<.05 was considered significant. Setting: A 20-bed regional level I trauma center ICU. Patients: Patients at high risk of postinjury multiple organ failure (major organ or vascular injury and/or skeletal fractures, initial arterial base deficit of 6 mEq/L or greater, requirement for 6 units or more of packed red blood cells in the first 12 hours after hospital admission, or age ≥65 years with any 2 previous criteria). Interventions: Pulmonary artery catheter, packed red blood cell transfusion, crystalloid fluid infusion, inotrope, and vasopressor support, as needed, in that sequence, to maintain DO 2I≥600. Main Outcome Measures: Hemodynamic response to resuscitation, fluid, and packed red blood cell volume. Results: During 2000, 58 patients (38 men, 20 women) met criteria and were resuscitated using our standardized protocol. Demographics and outcomes were similar for both cohorts. Requirements for and responses to standardized resuscitation were also similar, except for volume loading. The female cohort required less lactated Ringer solution volume (12± 1 vs 8±2 L, P<.05), required less Starling curve intervention (42% vs 15%, P<.05), and maintained the DO 2I goal with average pulmonary capillary wedge pressure that was less than that of the male cohort. Conclusion: Review of prospective data from standardized shock resuscitation for female and male cohorts demonstrates that women respond better to standardized resuscitation compared with similarly severely injured men.
AB - Hypothesis: Women respond better to standardized shock resuscitation compared with similarly severely injured men. Design: Severely injured patients who met specific criteria were resuscitated using a standardized protocol with no adjustment for gender. The resuscitation protocol was used to attain and to maintain an oxygen delivery index of 600 mL/min·m2 or greater (DO 2I≥600) for the first 24 hours in the intensive care unit (ICU). Interventions, responses, and outcomes for the 2 cohorts were compared. Data were analyzed using analysis of variance, X 2, and t tests; P<.05 was considered significant. Setting: A 20-bed regional level I trauma center ICU. Patients: Patients at high risk of postinjury multiple organ failure (major organ or vascular injury and/or skeletal fractures, initial arterial base deficit of 6 mEq/L or greater, requirement for 6 units or more of packed red blood cells in the first 12 hours after hospital admission, or age ≥65 years with any 2 previous criteria). Interventions: Pulmonary artery catheter, packed red blood cell transfusion, crystalloid fluid infusion, inotrope, and vasopressor support, as needed, in that sequence, to maintain DO 2I≥600. Main Outcome Measures: Hemodynamic response to resuscitation, fluid, and packed red blood cell volume. Results: During 2000, 58 patients (38 men, 20 women) met criteria and were resuscitated using our standardized protocol. Demographics and outcomes were similar for both cohorts. Requirements for and responses to standardized resuscitation were also similar, except for volume loading. The female cohort required less lactated Ringer solution volume (12± 1 vs 8±2 L, P<.05), required less Starling curve intervention (42% vs 15%, P<.05), and maintained the DO 2I goal with average pulmonary capillary wedge pressure that was less than that of the male cohort. Conclusion: Review of prospective data from standardized shock resuscitation for female and male cohorts demonstrates that women respond better to standardized resuscitation compared with similarly severely injured men.
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M3 - Article
C2 - 11982472
AN - SCOPUS:0036254652
VL - 137
SP - 578
EP - 584
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 5
ER -