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Detection and Management of Non-Compressible Hemorrhage by Vena Cava Ultrasonography

Principal Investigator:  Jay Doucet, MD Lead Institution: University of California at San Diego (UCSD) Participating Sites: University of Utah, Emory University, and University of Maryland School of Medicine This was a prospective, observational clinical trial of major trauma victims at four academic trauma centers using bedside ultrasound to identify patients with hypovolemia as determined by inferior vena cava (IVC) collapsibility. Patients with significant IVC collapsibility were enrolled. Participants were stratified at a second ultrasound IVC exam 30-40 minutes after admission by response or non-response to an intravenous fluid challenge. The objective was to demonstrate whether non-responder participants had significant shock physiology. This study provides an opportunity to demonstrate the ability of handheld ultrasound devices to detect and monitor hemorrhagic shock in initial trauma care and in the ICU. This technique may predict those patients who will require transfusions, surgery, or angiographic embolization. It may improve triage of major trauma victims and, thereby, avoid therapeutic delays and complications. This study was completed with funding from the Joint Warfighter Medical Research Program.


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