CORRELATION BETWEEN TOTAL CRYSTALLOID VOLUME ADMINISTERED IN THE FIRST 24 HOURS AND IN-HOSPITAL MORTALITY RATE IN CRITICALLY INJURED PATIENTS

Minh Toàn Trầm , Minh Giảng Trương

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Abstract

Introduction: Crystalloid fluid resuscitation aimed at restoring circulatory volume is fundamental in trauma emergency care. However, excessive crystalloid resuscitation may lead to adverse outcomes. Objective: To investigate the correlation between the total volume of crystalloid fluid administered within the first 24 hours and the rates of in-hospital mortality and multiple organ dysfunction syndrome (MODS) in severely injured trauma patients. Study Methods: This retrospective, cross-sectional descriptive study with analytical components was conducted on patients aged 18 years or older admitted to the Emergency Department at Cho Ray Hospital with an Injury Severity Score (ISS) of ≥16. Patients who died within the first 48 hours were excluded from the study. Results: A total of 177 patients met the inclusion criteria, with 9 cases of mortality and 19 cases of multiple organ dysfunction syndrome (MODS). The results indicate that the volume of crystalloid fluids administered within the first 24 hours was not an independent predictor of in-hospital mortality. However, the total amount of crystalloid fluids administered in the first 24 hours was independently  associated with MODS, with an odds ratio (OR) of 1.39 and a 95% confidence interval (CI) of 1.13 - 1.71. Notably, when the total crystalloid volume administered reached 5 liters or more, the risk of MODS increased significantly, with an OR of 8.59 and a 95% CI of 1.45 - 50.8. Conclusion: It is essential to establish reasonable fluid administration limits during trauma resuscitation to mitigate the risk of adverse outcomes such as multiple organ dysfunction syndrome.

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References

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