Marie H. Dæhlen1, Sole L. Lie2, Jonny Hisdal1, Lars-Øivind Høiseth3, Marius Rehn1 1Faculty of Medicine, University of Oslo, Oslo, Norway; 2Department of Research and Development, Norwegian Air Ambulance Foundation, Oslo, Norway; 3Department of Anaesthesia and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway Correspondence: Marie H. Dæhlen (marie.holtet.daehlen@gmail.com)

Scand J Trauma Resusc Emerg Med 2023, 31(Suppl 2):A8

Background Haemorrhage is the leading cause of preventable deaths in trauma patients, and half of these cases occur during the prehospital period. Currently, precise methods to detect haemorrhage are lacking, and standard vital signs are insufficient to identify and monitor shock. As far as we know, there is no published review on advanced hemodynamic monitoring and its clinical impact in trauma patients. We therefore systemically reviewed the literature for availability and efficacy of advanced hemodynamic monitoring in prehospital adult trauma patients.

Methods We defined advanced hemodynamic monitoring as any monitoring device or technique that measures or estimates systemic, regional, or local blood flow, pressure, perfusion, or oxygenation, excluding standard vital signs. We searched MEDLINE, Embase, and CINAHL on October 20th, 2022. The search was limited to 1990 and forward, and comprised three terms: 1) Prehospital setting, 2) Advanced hemodynamic monitoring, 3) Trauma patients (≥18 years). The main outcomes were mortality, morbidity, and prehospital management. Articles were screened and identified by two independent authors in Covidence. The study follows PRISMA guidelines.

Results We screened 3681 and included 60 articles. Lactate (n = 19), end-tidal CO2 (n = 12), ultrasound (n = 8) and tissue oximetry (n = 7) were the most common advanced hemodynamic monitoring techniques (Figure 5).

Conclusion Various advanced haemodynamic monitoring techniques have been studied in adult prehospital trauma patients. Whether they improve clinical outcome is unclear.

Trial registration Registered in PROSPERO (CRD42022373051) on November 15th, 2022.

Figure 5 (abstract A8)

Frequency of various advanced haemodynamic monitoring techniques used in studies in prehospital adult trauma patients.