Application of restrictive fluid resuscitation in emergency traumatic hemorrhagic shock and impact on blood gas indicators

Lin Li; Jiehao Zhou; Kun Song; Hongbo Liu; Xiao Wang; Yuqian Zhu; Zhijun Wang

doi:10.1016/j.avsg.2025.06.009

Application of restrictive fluid resuscitation in emergency traumatic hemorrhagic shock and impact on blood gas indicators

Ann Vasc Surg. 2025 Jun 18:S0890-5096(25)00414-5. doi: 10.1016/j.avsg.2025.06.009. Online ahead of print.

Authors

Lin Li¹, Jiehao Zhou², Kun Song³, Hongbo Liu¹, Xiao Wang⁴, Yuqian Zhu¹, Zhijun Wang¹

Affiliations

¹ Department of Emergency, Fuyang People's Hospital, Fuyang 236000, Anhui Province, China.
² Department of Emergency, Fuyang People's Hospital, Fuyang 236000, Anhui Province, China. Electronic address: Zhoujiehao3147@163.com.
³ Department of General Surgery, Fuyang People's Hospital, Fuyang 236000, Anhui Province, China.
⁴ Department of Urology, Fuyang People's Hospital, Fuyang 236000, Anhui Province, China.

PMID: 40541774
DOI: 10.1016/j.avsg.2025.06.009

Abstract

Objective: The study aimed to observe the application of restrictive fluid resuscitation in emergency traumatic hemorrhagic shock (THS) and impact on blood gas indicators.

Methods: THS patients (n = 80) were divided into two groups: 40 cases in the active group received active fluid resuscitation, and 40 cases in the restricted group received restrictive fluid resuscitation. Blood gas indicators [blood lactate (BL), partial pressure of arterial blood carbon dioxide (PaCO₂), and partial pressure of arterial blood oxygen (PaO₂)], coagulation parameters [activated partial thromboplastin time (APTT), prothrombin time (PT), and thromboplastin time (TT)], inflammation indicators [interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α)] levels, complications, and resuscitation outcomes in the two groups were compared.

Results: After 24 h of resuscitation in both groups, BL and PaCO₂ decreased and PaO₂ increased, and all of them were significantly improved in the restricted group compared with the active group. APTT, PT, and TT were prolonged, but were shorter in the restricted group than in the active group. Serum IL-6, IL-8, and TNF-α levels were reduced in both groups and were lower in the restricted group than in the active group. The overall incidence of complications within 1 week of resuscitation was [7.50% (3/40)] in the restricted group, which was lower than in the active group 25.00% (10/40). The success rate of resuscitation within 1 week after resuscitation was 95.00% (38/40) higher in the restricted group than 77.50% (31/40) in the active group (all P < 0.05).

Conclusion: Compared with active fluid resuscitation, restrictive fluid resuscitation applied in the emergency treatment of THS patients has a better effect on the improvement of patients' blood gas indices, coagulation indices, and inflammation indices, and can effectively reduce the incidence of complications and enhance the success rate of resuscitation.

Keywords: Blood gas indicator; Coagulation indicator; Emergency; Inflammatory indicator; Restrictive fluid resuscitation; Traumatic hemorrhagic shock.