A study on the duration of the Golden Time for operation after traumatic intestinal perforations.
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概要
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The first purpose of this study is to clarify the duration of"the Golden Time"for operation after traumatic intestinal perforation from the analysis of postoperative water redistribution. Another purpose is to evaluate the influence of colloid administration on postoperative water redistribution in patients with traumatic intestinal perforation. The post-operative water redistributions of 26 cases with traumatic perforation of the small intestine were analysed using two parameters. The first parameter is the time between operation and beginning of the diuresis period (T2-T1). The second parameter is the estimated amount of water, termed"Lost Water (LW)", that moves out of the intravascular space to the extravascular space during the oliguric period, but never returns to the intravascular space even after the diuretic period. Cases were divided into two groups according to the interval between the injury and the operation. When the point of discrimination was set at 6hrs after the injury, the differences in both parameters (T2-T1 and LW/h) between the two groups were significant (p<0.05). This meant that the Golden Time after traumatic intestinal perforation is presumably 6hrs from the viewpoint of water redistribution. There was also a significant difference in the duration of time that PEEP was necessary, and in maximum FIO2 between the two groups. The administration of colloids had no significant influence on T2-T1, but reduced LW/h significantly. The prolongation of T2-T1 may be considered to result from over-secretion of antidiuretic hormone (ADH). The infusion of colloids increases the serum osmotic pressure of intravascular fluid which promotes greater secretion of ADH and may result in prolongation of T2-T1. On the other hand, increased plasma osmotic pressure may inhibit the displacement of water from the intra-to the extravascular space and promote the displacement from the extra-to the intravascular space, resulting in a decrease in"Lost Water".
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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