Effectiveness of the perfusion index in determining the grade of hemorrhagic shock in patients applied to the emergency department due to trauma

Bleeding is the most common preventable cause of death in trauma patients after injury. Therefore, early detection of bleeding in trauma patients is of vital importance. Perfusion index measurements, as a non-invasive, fast and easy-to-apply method, can be a candidate measurement system for predicting the development of hemorrhagic shock in trauma patients, determining the severity of hemorrhagic shock, and determining the need for blood product replacement early. In our study, 46 patients who were admitted to our emergency department due to trauma, were diagnosed with hemorrhagic shock and were over 18 years old and were not pregnant were evaluated. Vital parameters and perfusion index values of the patients were recorded; in addition, demographic information, shock scoring values, blood product requirement in the first 24 hours, and patient outcome were also recorded. Statistical analyzes were performed among all recorded data. In our study, the median age was 35.5 (IQR 30), and 73.9% of the patients were male. A significant difference was found between the patient groups with stage I and stage IV shock in terms of PI values. PI values and other hemorrhagic shock scoring systems were evaluated in terms of predicting the need for blood product replacement, and PI measurements were found to be more successful than other hemorrhagic shock scoring systems in predicting the need for blood product replacement. As a result of our study, we determined that PI measurements predicted the need for blood product replacement. PI measurements, together with other parameters, can be used to determine the severity of hemorrhagic shock and can predict the need for blood product replacement. Keywords: Trauma, Hemorrhagic Shock, Perfusion Index