Development and Validation of the Compensatory Reserve Measurement (CRM) in the Emergency Department
Abstract
Background: The Compensatory Reserve Measurement (CRM) is a novel method used to provide early assessment of shock based on arterial waveform morphology changes. We hypothesized that 1) CRM would be significantly lower in those trauma patients who received life-saving interventions compared to those not receiving interventions, and 2) CRM in patients who received interventions would recover after the intervention was performed. Study Design and Methods: We captured vital signs along with analog arterial waveform data from trauma patients meeting major activation criteria using a prospective study design. Study team members tracked interventions throughout the patients emergency department stay. Results: Ninety subjects met inclusion criteria, with 13 receiving a blood product and 10 receiving a major airway intervention. Most trauma was blunt (69%) with motor vehicle collisions making up the largest proportion (37%) of injury mechanism. Patients who received blood products had lower CRM values just prior to administration compared to those who did not (50% versus 58%), and had lower systolic (SBP; 95 versus 123 mmHg), diastolic (DBP; 62 versus 79 mmHg), and mean arterial pressures (MAP; 75 versus 95mmHg), and a higher pulse rate (HR; 101 versus 89 bpm); all were p<0.05. Patients who received an airway intervention had lower CRM values just prior to administration compared to those who did not (48% versus 58%, p=0.062); however, SBP, DBP, MAP and HR were not statistically distinguishable (p>/= 0.645). Discussion: Our results support our hypotheses, suggesting that CRM represents an advanced monitoring technology capable of distinguishing patients requiring blood and airway interventions and tracking their response.
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 06, 2020
- Accession Number
- AD1131299
Entities
People
- Allyson A. Araña
- Carlissa D. Linscomb
- Dylan C. Rodriguez
- Joseph K Maddry
- Michael D. April
- Mireya A. Escandon
- Steven G Schauer
- Víctor A. Convertino
Organizations
- 59th Medical Wing