A Systematic Review of the Relationship between Blood Loss and Clinical Signs
Publication Date
March 06, 2013
Journal
PLOS ONE
Authors
Rodolfo Carvalho Pacagnella, João Paulo Souza, Jill Durocher, Pablo Perel, et al
Volume
8
Issue
3
Pages
e57594
DOI
https://dx.plos.org/10.1371/journal.pone.0057594
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0057594
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/23483915
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590203
Europe PMC
http://europepmc.org/abstract/MED/23483915
Web of Science
000316936100031
Scopus
84874610475
Mendeley
http://www.mendeley.com/research/systematic-review-relationship-between-blood-loss-clinical-signs-2
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Mendeley | Further Information

{"title"=>"A Systematic Review of the Relationship between Blood Loss and Clinical Signs", "type"=>"generic", "authors"=>[{"first_name"=>"Rodolfo Carvalho", "last_name"=>"Pacagnella", "scopus_author_id"=>"35095506200"}, {"first_name"=>"João Paulo", "last_name"=>"Souza", "scopus_author_id"=>"13205307600"}, {"first_name"=>"Jill", "last_name"=>"Durocher", "scopus_author_id"=>"7003296254"}, {"first_name"=>"Pablo", "last_name"=>"Perel", "scopus_author_id"=>"14631128400"}, {"first_name"=>"Jennifer", "last_name"=>"Blum", "scopus_author_id"=>"56246194900"}, {"first_name"=>"Beverly", "last_name"=>"Winikoff", "scopus_author_id"=>"7006388882"}, {"first_name"=>"Ahmet Metin", "last_name"=>"Gülmezoglu", "scopus_author_id"=>"7006645199"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"368465819", "sgr"=>"84874610475", "issn"=>"19326203", "pmid"=>"23483915", "scopus"=>"2-s2.0-84874610475", "doi"=>"10.1371/journal.pone.0057594", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)"}, "id"=>"82a4c0e9-b024-346a-9bed-6fe516ac8866", "abstract"=>"INTRODUCTION This systematic review examines the relationship between blood loss and clinical signs and explores its use to trigger clinical interventions in the management of obstetric haemorrhage. METHODS A systematic review of the literature was carried out using a comprehensive search strategy to identify studies presenting data on the relationship of clinical signs & symptoms and blood loss. Methodological quality was assessed using the STROBE checklist and the general guidelines of MOOSE. RESULTS 30 studies were included and five were performed in women with pregnancy-related haemorrhage (other studies were carried in non-obstetric populations). Heart rate (HR), systolic blood pressure (SBP) and shock index were the parameters most frequently studied. An association between blood loss and HR changes was observed in 22 out of 24 studies, and between blood loss and SBP was observed in 17 out of 23 studies. An association was found in all papers reporting on the relationship of shock index and blood loss. Seven studies have used Receiver Operating Characteristic Curves to determine the accuracy of clinical signs in predicting blood loss. In those studies the AUC ranged from 0.56 to 0.74 for HR, from 0.56 to 0.79 for SBP and from 0.77 to 0.84 for shock index. In some studies, HR, SBP and shock index were associated with increased mortality. CONCLUSION We found a substantial variability in the relationship between blood loss and clinical signs, making it difficult to establish specific cut-off points for clinical signs that could be used as triggers for clinical interventions. However, the shock index can be an accurate indicator of compensatory changes in the cardiovascular system due to blood loss. Considering that most of the evidence included in this systematic review is derived from studies in non-obstetric populations, further research on the use of the shock index in obstetric populations is needed.", "link"=>"http://www.mendeley.com/research/systematic-review-relationship-between-blood-loss-clinical-signs-2", "reader_count"=>87, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>5, "Student > Doctoral Student"=>3, "Researcher"=>10, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>7, "Student > Master"=>15, "Other"=>4, "Student > Bachelor"=>15, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>8}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>5, "Student > Doctoral Student"=>3, "Researcher"=>10, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>7, "Student > Master"=>15, "Other"=>4, "Student > Bachelor"=>15, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>8}, "reader_count_by_subject_area"=>{"Unspecified"=>7, "Engineering"=>6, "Nursing and Health Professions"=>5, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>64, "Agricultural and Biological Sciences"=>2, "Psychology"=>1, "Social Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>6}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>64}, "Social Sciences"=>{"Social Sciences"=>1}, "Psychology"=>{"Psychology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>5}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>7}}, "reader_count_by_country"=>{"Canada"=>1, "Korea (South)"=>1, "Turkey"=>1, "Brazil"=>2, "Germany"=>1}, "group_count"=>3}

CrossRef

Scopus | Further Information

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  • {"files"=>["https://ndownloader.figshare.com/files/979397"], "description"=>"<p>Inclusion and exclusion criteria.</p>", "links"=>[], "tags"=>["exclusion"], "article_id"=>646118, "categories"=>["Cell Biology", "Mathematics", "Medicine"], "users"=>["Rodolfo Carvalho Pacagnella", "Joao Paulo Souza", "Jill Durocher", "Pablo Perel", "Jennifer Blum", "Beverly Winikoff", "Ahmet Metin Gülmezoglu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057594.g001", "stats"=>{"downloads"=>2, "page_views"=>29, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Inclusion_and_exclusion_criteria_/646118", "title"=>"Inclusion and exclusion criteria.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-03-07 11:13:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/979406", "https://ndownloader.figshare.com/files/979409"], "description"=>"<div><p>Introduction</p><p>This systematic review examines the relationship between blood loss and clinical signs and explores its use to trigger clinical interventions in the management of obstetric haemorrhage.</p> <p>Methods</p><p>A systematic review of the literature was carried out using a comprehensive search strategy to identify studies presenting data on the relationship of clinical signs & symptoms and blood loss. Methodological quality was assessed using the STROBE checklist and the general guidelines of MOOSE.</p> <p>Results</p><p>30 studies were included and five were performed in women with pregnancy-related haemorrhage (other studies were carried in non-obstetric populations). Heart rate (HR), systolic blood pressure (SBP) and shock index were the parameters most frequently studied. An association between blood loss and HR changes was observed in 22 out of 24 studies, and between blood loss and SBP was observed in 17 out of 23 studies. An association was found in all papers reporting on the relationship of shock index and blood loss. Seven studies have used Receiver Operating Characteristic Curves to determine the accuracy of clinical signs in predicting blood loss. In those studies the AUC ranged from 0.56 to 0.74 for HR, from 0.56 to 0.79 for SBP and from 0.77 to 0.84 for shock index. In some studies, HR, SBP and shock index were associated with increased mortality.</p> <p>Conclusion</p><p>We found a substantial variability in the relationship between blood loss and clinical signs, making it difficult to establish specific cut-off points for clinical signs that could be used as triggers for clinical interventions. However, the shock index can be an accurate indicator of compensatory changes in the cardiovascular system due to blood loss. Considering that most of the evidence included in this systematic review is derived from studies in non-obstetric populations, further research on the use of the shock index in obstetric populations is needed.</p> </div>", "links"=>[], "tags"=>["systematic", "signs"], "article_id"=>646127, "categories"=>["Cell Biology", "Mathematics", "Medicine"], "users"=>["Rodolfo Carvalho Pacagnella", "Joao Paulo Souza", "Jill Durocher", "Pablo Perel", "Jennifer Blum", "Beverly Winikoff", "Ahmet Metin Gülmezoglu"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0057594.s001", "https://dx.doi.org/10.1371/journal.pone.0057594.s002"], "stats"=>{"downloads"=>2, "page_views"=>22, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/A_Systematic_Review_of_the_Relationship_between_Blood_Loss_and_Clinical_Signs__/646127", "title"=>"A Systematic Review of the Relationship between Blood Loss and Clinical Signs", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-03-07 11:15:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/979402"], "description"=>"<p>Flow diagram of identification and retrieval of examined studies.</p>", "links"=>[], "tags"=>["diagram", "retrieval", "examined"], "article_id"=>646123, "categories"=>["Cell Biology", "Mathematics", "Medicine"], "users"=>["Rodolfo Carvalho Pacagnella", "Joao Paulo Souza", "Jill Durocher", "Pablo Perel", "Jennifer Blum", "Beverly Winikoff", "Ahmet Metin Gülmezoglu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057594.g002", "stats"=>{"downloads"=>0, "page_views"=>25, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_of_identification_and_retrieval_of_examined_studies_/646123", "title"=>"Flow diagram of identification and retrieval of examined studies.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-03-07 11:13:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/1006405"], "description"=>"<p>BLE - Blood loss estimation; HR - Heart Rate; SBP - Systolic Bood Pressure; SI - Shock Index; PSBP - Prehospital Systolic Blood Pressure; MAP - Mean Arterial Pressure; DBP - Diastolic Blood Pressure; PP - pulse pressure; BT - Body Temperature; RR - respiratory rate;</p><p>•there is an association between blood loss and changes in the vital sign; ○: there is no association between blood loss and changes in the vital sign;</p>*<p>•: no specification if systolic or diastolic.</p>", "links"=>[], "tags"=>["Critical care and emergency medicine", "obstetrics", "women's health"], "article_id"=>667030, "categories"=>["Cell Biology", "Mathematics", "Medicine"], "users"=>["Rodolfo Carvalho Pacagnella", "Joao Paulo Souza", "Jill Durocher", "Pablo Perel", "Jennifer Blum", "Beverly Winikoff", "Ahmet Metin Gülmezoglu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057594.t003", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_blood_loss_and_changes_in_vital_signs_/667030", "title"=>"Association between blood loss and changes in vital signs.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-03-06 01:57:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/1006479"], "description"=>"<p>AUC –Area under curve; HR - Heart Rate; SBP - Systolic Bood Pressure; SI - Shock Index; PSBP - Prehospital Systolic Blood Pressure; MAP - Mean Arterial Pressure; DPBP - Diastolic Blood Pressure; PP - pulse pressure; BT - Body Temperature; RR - respiratory rate; *BP – no specification if systolic or diastolic.</p>", "links"=>[], "tags"=>["signs"], "article_id"=>667105, "categories"=>["Cell Biology", "Mathematics", "Medicine"], "users"=>["Rodolfo Carvalho Pacagnella", "Joao Paulo Souza", "Jill Durocher", "Pablo Perel", "Jennifer Blum", "Beverly Winikoff", "Ahmet Metin Gülmezoglu"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057594.t005", "stats"=>{"downloads"=>2, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_signs_statistical_analysis_/667105", "title"=>"Clinical signs statistical analysis.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-03-06 01:58:25"}

PMC Usage Stats | Further Information

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Relative Metric

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