Comparative analysis of the hemodynamic and metabolic effects of alternative fluid resuscitation strategies in critically ill patients with combined chest trauma and hemorrhagic shock: impact on oxygen delivery-consumption balance and coagulation homeostasis.
- 1Department of Emergency, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, China.
- 2Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi 'an Jiaotong University, Xi 'an City, China.
- 3Department of Cardiovascular Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (Affiliated Hospital of University of Electronic Science and Technology of China), Chengdu City, Sichuan, China.
Abstract
This study aimed to investigate the effects of different fluid resuscitation strategies on clinical efficacy, oxygen metabolism, coagulation function, and inflammatory response in critically ill patients with chest trauma complicated by hemorrhagic shock, so as to provide evidence for optimizing emergency treatment strategies. A total of 107 patients with severe chest trauma and hemorrhagic shock who were admitted to our hospital between June 2023 and April 2025 were retrospectively enrolled. According to the type of treatment received, patients were divided into two groups. The control group (n = 55) received conventional fluid resuscitation, while the observation group (n = 52) received restrictive fluid resuscitation. The two groups were compared in terms of fluid resuscitation parameters, oxygen metabolism indicators [mixed venous oxygen saturation (SvO2), oxygen consumption (VO2), oxygen delivery (DO2)], coagulation indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), hematocrit (HCT)], inflammatory indicators [interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α)], as well as mortality and complication rates during resuscitation. Compared with the control group, the observation group had significantly lower fluid input volume (P < 0.05); there were no significant differences in early resuscitation time or colloid use between the two groups (P > 0.05). After resuscitation, SvO2, VO2, DO2, and HCT levels were all significantly increased compared with before resuscitation, while APTT, PT, IL-6, IL-10, and TNF-α levels were significantly decreased in both groups. The magnitude of changes in the observation group was significantly greater than in the control group (P < 0.05). During the resuscitation period, the survival rate of the observation group was significantly higher than that of the control group, while the incidence of ARDS, DIC, and MODS was significantly lower (P < 0.05). Compared with conventional fluid resuscitation, restrictive fluid resuscitation shows more significant clinical advantages. Its application in patients with severe chest trauma complicated by hemorrhagic shock can reduce unnecessary fluid overload, more effectively improve oxygen metabolism, correct coagulation dysfunction, suppress inflammatory responses, thereby increasing survival rates and reducing the risk of complications.
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BibTeX
@article{ke2026comparative,
title = {{Comparative analysis of the hemodynamic and metabolic effects of alternative fluid resuscitation strategies in critically ill patients with combined chest trauma and hemorrhagic shock: impact on oxygen delivery-consumption balance and coagulation homeostasis.}},
author = {Xianfei Ke and Zhi Hu and Tingzhong Wang and Yuejiao Wei and Xiaolin Hou and Qiang Song},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1891606},
url = {https://europepmc.org/article/MED/42952867},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative analysis of the hemodynamic and metabolic effects of alternative fluid resuscitation strategies in critically ill patients with combined chest trauma and hemorrhagic shock: impact on oxygen delivery-consumption balance and coagulation homeostasis.
AU - Xianfei Ke
AU - Zhi Hu
AU - Tingzhong Wang
AU - Yuejiao Wei
AU - Xiaolin Hou
AU - Qiang Song
PY - 2026
DA - 2026/10/14
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1891606
UR - https://europepmc.org/article/MED/42952867
AB - This study aimed to investigate the effects of different fluid resuscitation strategies on clinical efficacy, oxygen metabolism, coagulation function, and inflammatory response in critically ill patients with chest trauma complicated by hemorrhagic shock, so as to provide evidence for optimizing emergency treatment strategies. A total of 107 patients with severe chest trauma and hemorrhagic shock who were admitted to our hospital between June 2023 and April 2025 were retrospectively enrolled. According to the type of treatment received, patients were divided into two groups. The control group (n = 55) received conventional fluid resuscitation, while the observation group (n = 52) received restrictive fluid resuscitation. The two groups were compared in terms of fluid resuscitation parameters, oxygen metabolism indicators [mixed venous oxygen saturation (SvO2), oxygen consumption (VO2), oxygen delivery (DO2)], coagulation indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), hematocrit (HCT)], inflammatory indicators [interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α)], as well as mortality and complication rates during resuscitation. Compared with the control group, the observation group had significantly lower fluid input volume (P < 0.05); there were no significant differences in early resuscitation time or colloid use between the two groups (P > 0.05). After resuscitation, SvO2, VO2, DO2, and HCT levels were all significantly increased compared with before resuscitation, while APTT, PT, IL-6, IL-10, and TNF-α levels were significantly decreased in both groups. The magnitude of changes in the observation group was significantly greater than in the control group (P < 0.05). During the resuscitation period, the survival rate of the observation group was significantly higher than that of the control group, while the incidence of ARDS, DIC, and MODS was significantly lower (P < 0.05). Compared with conventional fluid resuscitation, restrictive fluid resuscitation shows more significant clinical advantages. Its application in patients with severe chest trauma complicated by hemorrhagic shock can reduce unnecessary fluid overload, more effectively improve oxygen metabolism, correct coagulation dysfunction, suppress inflammatory responses, thereby increasing survival rates and reducing the risk of complications.
SN - 2296-858X
ER -