ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ CÁC THÔNG SỐ HUYẾT ĐỘNG Ở BỆNH NHÂN SỐC GIẢM THỂ TÍCH ĐO BẰNG PHƯƠNG PHÁP TRỞ KHÁNG LỒNG NGỰC

Abstract

Objective: To describe the clinical characteristics, bedsde findings, and some hemodynamic parameters using the transthoracic impedance method in patients with hypovolemic shock. Methods: A prospective observational study was conducted on 30 patients diagnosed with hypovolemic shock according to the criteria of the Ministry of Health's Hypovolemic Shock. Hemodynamic parameters were measured using the transthoracic impedance technique upon admission and at various time points within the first 24 hours at the Emergency Center A9 of Bach Mai Hospital. The study was conducted from October 2022 to October 2023. Results: Among the 30 patients in the study, 77.1% were male, with an average age of 49.96 ± 13.92. 93.33% of the patients survived and were discharged from the hospital, while 33.33% of patients required artificial ventilation. The mean arterial pressure at different time points were as follows: T0 116.37 ± 23.32, post-fluid bolus 112.5 ± 18.05, T1 105.5 ± 19.7, T6 98.03 ± 18.21, T12 91.57 ± 13.52, T24 82.26 ± 11.77. The hemoglobin concentration at admission was 64.83 ± 31.07 and 78.86 ± 19.48 after 24 hours. Stroke volume variation (SVV) values at different time points were: T0 22.67 ± 19.56, post-fluid bolus 20.45 ± 17.63, T1 18.98 ± 13.04, T6 15.53 ± 10.06, T12 12.31 ± 10.92, T24 10.06 ± 9.17. Thoracic Fluid Content (TFC) values at different time points were: T0 19.87 ± 15.60, post-fluid bolus 20.54 ± 17.22, T1 22.78 ± 17.93, T6 29.61 ± 18.6, T12 30.88 ± 20.04, T24 32.12 ± 21.12. Conclusion: Hypovolemic shock predominantly affects males, primarily due to hemorrhagic shock, with low hemoglobin concentration upon admission. Hemodynamic parameters measured using the transthoracic impedance method are consistent with clinical progression, with statistically significant differences noted immediately after fluid bolus, and further significant differences observed at subsequent time points.