Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2004 Jan 19:4:3.
doi: 10.1186/1471-2482-4-3.

Emergency department spirometric volume and base deficit delineate risk for torso injury in stable patients

C Michael Dunham  1 , Eilynn K Sipe, LeeAnn Peluso
Affiliations

Emergency department spirometric volume and base deficit delineate risk for torso injury in stable patients

C Michael Dunham et al. BMC Surg. .

Abstract

Background: We sought to determine torso injury rates and sensitivities associated with fluid-positive abdominal ultrasound, metabolic acidosis (increased base deficit and lactate), and impaired pulmonary physiology (decreased spirometric volume and PaO2/FiO2).

Methods: Level I trauma center prospective pilot and post-pilot study (2000-2001) of stable patients. Increased base deficit was < 0.0 in ethanol-negative and < or = -3.0 in ethanol-positive patients. Increased lactate was > 2.5 mmol/L in ethanol-negative and > or = 3.0 mmol/L in ethanol-positive patients. Decreased PaO2/FiO2 was < 350 and decreased spirometric volume was < 1.8 L.

Results: Of 215 patients, 66 (30.7%) had a torso injury (abdominal/pelvic injury n = 35 and/or thoracic injury n = 43). Glasgow Coma Scale score was 14.8 +/- 0.5 (13-15). Torso injury rates and sensitivities were: abdominal ultrasound negative and normal base deficit, lactate, PaO2/FiO2, and spirometric volume--0.0% & 0.0%; normal base deficit and normal spirometric volume--4.2% & 4.5%; chest/abdominal soft tissue injury--37.8% & 47.0%; increased lactate--39.7% & 47.0%; increased base deficit--41.3% & 75.8%; increased base deficit and/or decreased spirometric volume--43.8% & 95.5%; decreased PaO2/FiO2--48.9% & 33.3%; positive abdominal ultrasound--62.5% & 7.6%; decreased spirometric volume--73.4% & 71.2%; increased base deficit and decreased spirometric volume--82.9% & 51.5%.

Conclusions: Trauma patients with normal base deficit and spirometric volume are unlikely to have a torso injury. Patients with increased base deficit or lactate, decreased spirometric volume, decreased PaO2/FiO2, or positive FAST have substantial risk for torso injury. Increased base deficit and/or decreased spirometric volume are highly sensitive for torso injury. Base deficit and spirometric volume values are readily available and increase or decrease the suspicion for torso injury.

PubMed Disclaimer

References

    1. American College of Surgeons Committee on Trauma . Advanced Trauma Life Support, Instructor Manual. Sixth. Chicago: American College of Surgeons; 1997.
    1. Buduhan G, McRitchie DI. Missed injuries in patients with multiple trauma. J Trauma. 2000;49:600–605. - PubMed
    1. Robertson R, Mattox R, Collins T, Parks-Miller C, Eidt J, Cone J. Missed injuries in a rural area trauma center. Am J Surg. 1996;172:564–567. doi: 10.1016/S0002-9610(96)00247-4. - DOI - PubMed
    1. Enderson BL, Reath DB, Meadors J, Dallas W, DeBoo JM, Maull KI. The tertiary trauma survey: a prospective study of missed injury. J Trauma. 1990;30:666–669. - PubMed
    1. Mattox KL, Feliciano DV, Moore EE. Trauma. Fourth. New York: McGraw-Hill; 2000.

MeSH terms