Controlled blood pressure elevation and limited fluid resuscitation in the treatment of multiple injuries in combination with shock

Objective: To explore the effectiveness of controlled blood pressure elevation and limited fluid resuscitation in treating patients with multiple injuries in combination with shock in Intensive Care Unit (ICU).

Methods: One hundred and sixty-four patients with multiple injuries in combination with shock who were admitted into the ICU of the hospital between June 2014 and November 2017 were selected and divided into an observation group and a control group using random number table, 82 each group. Controlled blood pressure elevation was given to both groups. Moreover, the control group was given conventional fluid resuscitation, while the observation group was given limited fluid resuscitation. The treatment effectiveness and complications were compared between the two groups.

Results: The resuscitation time, post-resuscitation PT and post-resuscitation C-reactive protein level of the observation group were significantly lower than those of the control group (P<0.05). The post-resuscitation hemoglobin level of the observation group was significantly higher than that of the control group (P<0.05). The lactate clearance rate (LCR) of the observation group was (0.22±0.01) and (0.37±0.06) respectively three and six hours after fluid resuscitation, which was remarkably different with that of the control group ((0.27±0.03) and (0.51±0.08)) (P<0.05), but the difference became insignificant 24 h after fluid resuscitation (P>0.05). The observation group had significantly lower incidences of complications such as disseminated intravascular coagulation, respiratory distress syndrome and multiple organ dysfunction syndromes of the observation group and death rate than the control group, and the differences had statistical significance (P<0.05).

Conclusion: Controlled blood pressure elevation in combination with limited fluid resuscitation is more effective than conventional fluid resuscitation in the treatment of patients with multiple injuries and shock in ICU as it can shorten recovery time, improve microcirculation perfusion and prognosis, and reduce related complications and fatality rate.