Shehu et al reported a definition of occult hypoperfusion in a trauma patient. Occult hypoperfusion is associated with a worse prognosis compared to a patient with normal perfusion. The authors are from the University Hospital Zurich.
Patient selection: trauma patient
Features of occult hypoperfusion:
(1) hypoperfusion resulting in inadequate oxygenation
(2) normal vital signs
Occult hypoperfusion is present if both of the following are present:
(1) systolic blood pressure > 90 mm Hg AND pulse < 120 beats per minute
(2) serum lactate > 2 mmol/L OR serum base excess < -3 mmol/L (as criteria for inadequate tissue oxygenation)
where:
• For vital signs to be normal there probably should be a lower limit on the pulse to cover bradycardia.
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