Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients – a retrospective Analysis

Autor: Nikolaus Umlauf, T. Schlechtriemen, Stefan Schmid, Hanno Ulmer, Janett Kreutziger, Maarten W. N. Nijsten, Wolfgang Lederer, Daniel Werner
Přispěvatelé: Microbes in Health and Disease (MHD), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Tachycardia
Emergency Medical Services
STRESS-INDUCED HYPERGLYCEMIA
Respiratory rate
Cardiac rhythms
CELL-SURVIVAL
ILL PATIENTS
BRAIN-INJURY
030204 cardiovascular system & hematology
Carbohydrate metabolism
Critical Care and Intensive Care Medicine
Trauma
03 medical and health sciences
0302 clinical medicine
Heart Rate
Heart rate
medicine
Humans
Blood glucose
Myocardial infarction
Blood Glucose Measurement
Original Research
Retrospective Studies
ARREST
business.industry
lcsh:Medical emergencies. Critical care. Intensive care. First aid
INTENSIVE INSULIN THERAPY
HEMORRHAGIC-SHOCK
030208 emergency & critical care medicine
lcsh:RC86-88.9
Middle Aged
medicine.disease
HIGHER MORTALITY
Cardiac arrest
ADMISSION
Tachyarrhythmia
Bradyarrhythmia
Cardiopulmonary Resuscitation
Heart Arrest
Blood pressure
MYOCARDIAL-INFARCTION
Anesthesia
Emergency Medicine
Wounds and Injuries
Female
medicine.symptom
business
Pre-hospital care
Zdroj: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 26, Iss 1, Pp 1-10 (2018)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Scandinavian journal of trauma resuscitation & emergency medicine, 26:58. BMC
ISSN: 1757-7241
DOI: 10.1186/s13049-018-0516-z
Popis: Background Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma. Methods We retrospectively investigated adult trauma patients treated by a nationwide helicopter emergency medical service (34 bases) between 2005 and 2013. All patients with recorded initial cardiac rhythms and blood glucose levels were enrolled. Blood glucose concentrations were categorised; descriptive and regression analyses were performed. Results In total, 18,879 patients were included, of whom 185 (1.0%) patients died on scene. Patients with tachycardia (≥100/min, 7.0 ± 2.4 mmol/L p 10.0 mmol/L, 70/1271; 5.5%, p 10 mmol/L; 47/69; 68.1%) than in hypoglycaemic (≤4.2 mmol/L; 13/31; 41.9%) trauma patients (p = 0.01). Conclusions In adult trauma patients, pre-hospital higher blood glucose levels were related to tachycardic and shockable rhythms. Cardiac arrest was more frequently observed in hypoglycaemic and hyperglycaemic pre-hospital trauma patients. The rate of ROSC rose significantly with rising blood glucose concentration. Blood glucose measurements in addition to common vital parameters (GCS, heart rate, blood pressure, breathing frequency) may help identify patients at risk for cardiopulmonary arrest and dysrhythmias.
Databáze: OpenAIRE
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