@article{ref1,
title="Systemic hypotension is a late marker of shock after trauma: a validation study of Advanced Trauma Life Support principles in a large national sample",
journal="American journal of surgery",
year="2006",
author="Parks, Jennifer K. and Elliott, Alan C. and Gentilello, Larry M. and Shafi, Shahid",
volume="192",
number="6",
pages="727-731",
abstract="BACKGROUND: Systolic blood pressure is used extensively to triage trauma patients as stable or unstable, contrary to Advanced Trauma Life Support recommendations. We hypothesized that systemic hypotension is a late marker of shock. <br><br>METHODS: The National Trauma Data Bank was queried (n = 115,830). Base deficit was used as a measure of circulatory shock. Systolic blood pressure was correlated with the presence and the severity of base-deficit derangement. <br><br>RESULTS: Systolic blood pressure correlated poorly with base deficit (r =.28). There was wide variation in systolic blood pressure within each base-deficit group. The mean and median systolic blood pressure did not decrease to less than 90 mm Hg until the base deficit was worse than -20, with mortality reaching 65%. <br><br>CONCLUSIONS: We validated the Advanced Trauma Life Support principle that systemic hypotension is a late marker of shock. A normal blood pressure should not deter aggressive evaluation and resuscitation of trauma patients.<p /><p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2006.08.034",
url="http://dx.doi.org/10.1016/j.amjsurg.2006.08.034"
}