Analysis Of The Efficacy Of Limited Fluid Resuscitation In Patients With Traumatic Hemorrhagic Shock

Objective: A combination of clinical data and meta-analysis was used to systematically assess the efficacy of restrictive fluid resuscitation(LFR)strategies.Method: First of all,the computer was used to search Pubmed,CNKI and other databases.Randomised controlled trials(RCTs)collecting fluid resuscitation in people with traumatic haemorrhagic shock.Outcome measures included: mortality,cure rate,complication rate,arterial lactate value and alkali remains,coagulation function,serum ions,blood count,etc.Selected and extracted studies.Meta-analysis of the resulting data using Rev Man software version 5.4 to look for common and controversial issues.Then,according to the results of meta-analysis,a total of 73 patients admitted to the hospital with traumatic hemorrhagic shock and underwent fluid resuscitation from October 2019 to January 2023 were retrospectively collected for statistical analysis.Mutual validation was carried out in combination with previous meta-analyses.Results: A total of 36 RCTS were included,involving 3065 patients with traumatic hemorrhagic shock.The results showed that compared with the control group,LFR could significantly reduce the mortality rate of THS patients [OR=0.29,95%CI(0.22,0.38),P <0.01] and the incidence of complications [OR=0.31,95%CI(0.26,0.39).P <0.01],improve the cure rate of patients [OR=2.86,95%CI(1.94,4.21),P <0.01].At the same time,it is helpful to improve the blood lactic acid level of patients [SMD=-1.48,95%CI(-2.04,-0.92),P < 0.0001].However,there was no significant effect on BE value [WMD=1.02,95%CI(-0.56,2.68),P > 0.05].PT: [WMD=-2.59,95%CI(-3.99,-1.19),P < 0.01];APTT: [WMD=-0.90,95%CI(-1.64,-0.17),P < 0.05];TT: [WMD=-2.47,95%CI(-4.08,-0.87),P <0.01].LFR also played a positive role in blood count,Hct: [WMD=0.11,95%CI(0.10,0.12),P < 0.0001];Hb: [WMD=16.59,95%CI(14.78,14.81),P< 0.0001];PLT: [WMD=21.50,95%CI(12.14,29.96),P < 0.0001]].However,it has little effect on ions.2)Sodium bicarbonate Ringer compared with the control group could significantly reduce the mortality rate of THS patients[OR=0.34,95%CI(0.14,0.83),P=0.02],complication rate [OR=0.27,95%CI(0.15,0.61),P < 0.0001] and blood lactic acid [SMD=-1.33,95%CI(-1.73,-0.93),P < 0.0001].At the same time,sodium bicarbonate can play a role in improving inflammatory factors in THS patients tumor necrosis factor:[WMD=-7.75,95%CI(-8.15,-7.35),P<0.0001];Interleukin-6: [SMD=-10.25,95%CI(-11.63,-8.88),P < 0.0001].(Figure 16).Conclusion: LFR can significantly reduce the mortality rate and complication rate of THS patients,improve the cure rate of patients,and improve the lactic acid,alkali residue,coagulation function and blood count of patients,and has little effect on the ion level of patients.The use of sodium bicarbonate Ringer can reduce mortality,complication rate and blood lactic acid in patients.At the same time,it can improve the serum inflammatory factors of patients.Conclusion: LFR can significantly reduce the mortality rate and complication rate of THS patients,improve the cure rate of patients,and improve the lactic acid,coagulation function and blood count of patients,and has little effect on the ion level of patients.The use of sodium bicarbonate Ringer can reduce mortality,complication rate and blood lactic acid in patients.At the same time,it can improve the serum inflammatory factors of patients.