Objective:

In trauma patients determining and excluding occult bleeding is a difficult and error-prone work in emergency services.

Material and Methods:

The vena cava inferior diameters were measured by ultrasound at reference time, first hour and third hour, in sixty patients who were admitted to our university hospital and suffered multiple trauma. Their hemoglobin levels and vital signs were observed simultaneously. Follow-up results were compared to each other.

Results:

No serious bleeding was found in our patient population. The reference time vena cava inferior diameter mean value of our study group was 16.84±3.93 mms. This value was 16.79±3.74 mms for the first hour and 16.49±3.23 mms for the third hour. In the statistical evaluation of data there was no significant difference between the measurements (Pillai analyse p=0.29). In contrast, there was a decrease-mean of 0.68±0.91 mg/dl in hemoglobin values particularly between the reference and the third time and it was statistically significant (p=0.000). During this time a decrease in hemoglobin level was observed at gretaer than1 mg/dl and in 30% of patients. These changes in measuring hemoglobin levels were not correlated with fluid given to the patients. During all time intervals vena cava inferior measurement’s specivity was determined as approximately 95% and was 70% for hemoglobin level follow-up.

Conclusion:

Vena cava inferior serial measurements with ultrasound may be more beneficial to hemogram follow up for excluding occult bleeding in trauma patients.

Keywords: Vena cava inferior, ultrasound, trauma, hemoglobin, emergency department