Changes of hematocrit and pH before and after blood transfusion in patients with traumatic hemorrhage and their relationship with coagulation function

ObjectiveTo investigate the changes of hematocrit (HCT) and pH before and after blood transfusion in patients with traumatic hemorrhage and their relationship with coagulation function.

MethodsA total of 102 patients wilh traumatic blood loss were enrolled for the prospective clinical trial.The HCT and pH indexes of each group were detected using coagulometer; the coagulation reaction time (R), coagulation angle (a-Angle), and maximum magnitude of thrombus (MA) were detected using the thromboelastography; the logistic regression analysis was used to analyze the correlation of coagulation function before and after blood transfusion with HCT, pH, R, a-Angle, and MA values.

ResultsBefore blood transfusion, HCT, pH, fibrinogen (Fib), a-Angle value, and MA value of group A, B and C were compared, and the corresponding result was group A < group B < group C(P < 0.05);prothrombin time(PT), thrombin time(TT), activated partial thrombopaltin time(APTT), R value were compared, and the result was group A >group B>group C(P < 0.05); after blood transfusion, there was no significant difference in coagulation indexes among groups A, B and C (P>0.05), and all indexes were improved compared with those before blood transfusion(P < 0.05).Before blood transfusion, pH, a-Angle value, MA value of group D, E and F were compared, and the corresponding result was group D < group E < group F (P < 0.05).PT, TT, APTT, R value of group D, E and F were compared, and the corresponding result was group D>group E>group F.pH value of group F and G were compared, and the corresponding result was group F < Group G.R value of group F and G were compared, and the corresponding result was group F>group G (P < 0.05 to P < 0.01).There was no significant difference in a-Angle value, MA value, PT.TT.APTT, and R value between group F and group G(P>0.05);there was no significant difference in the Fib value among group D, E, F(P>0.01) and the Fib values among group D, E, F were smaller than those in group G(P < 0.05 to P < 0.01).There was no significant difference in TT, APTT, R values, a-Angle values, and MA values of group D, E, F and group G after transfusion (P>0.05), and all indexes were significanlly improved compared wilh those before blood transfusion, and the difference within the group was statistically significant (P < 0.05).The higher the levels of HCT and pH, the shorter the ICU stay and bleeding time of traumatic blood loss patients(P < 0.05 to P < 0.01).Pearson correlation analysis found that HCT and pH(< 7.45) were negatively correlated PT, TT, APTT, R value, hospitalization time, bleeding time and other coagulation indexes (P < 0.01).There was a positive correlation between HCT and coagulation indexes such as Fib, a-Angle value, and MA value (P < 0.01).HCT and pH were also positively correlated with the coagulation indexes of traumatic hemorrhage(P < 0.01).

ConclusionsThe severity of coagulation dysfunction in patients with traumatic blood loss is associated with the decreases of HCT and pH.The lower the HCT level, the higher the incidence of acidosis and the worse the prognosis.Thus, the detection of HCT and pH before and after blood transfusion is inevitable for the clinical diagnosis and treatment of traumatic hemorrhage, which are also important indicators affecting the coagulation function.