Intervention Review

Medical anti-shock trousers (pneumatic anti-shock garments) for circulatory support in patients with trauma

  1. Ian Roberts1,*,
  2. Karen Blackhall1,
  3. Karen Joanna Dickinson2

Editorial Group: Cochrane Injuries Group

Published Online: 25 OCT 1999

Assessed as up-to-date: 4 APR 2007

DOI: 10.1002/14651858.CD001856

How to Cite

Roberts I, Blackhall K, Dickinson KJ. Medical anti-shock trousers (pneumatic anti-shock garments) for circulatory support in patients with trauma. Cochrane Database of Systematic Reviews 1999, Issue 4. Art. No.: CD001856. DOI: 10.1002/14651858.CD001856.

Author Information

  1. 1

    London School of Hygiene & Tropical Medicine, Cochrane Injuries Group, London, UK

  2. 2

    London School of Hygiene & Tropical Medicine, Nutrition & Public Health Intervention Research Unit, London, UK

*Ian Roberts, Cochrane Injuries Group, London School of Hygiene & Tropical Medicine, North Courtyard, Keppel Street, London, WC1E 7HT, UK. ian.roberts@lshtm.ac.uk.

Publication History

  1. Publication Status: Stable (no update expected for reasons given in 'What's new')
  2. Published Online: 25 OCT 1999

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Medical antishock trousers (MAST) have been used to increase venous return to the heart until definitive care could be given. This, combined with compression of blood vessels, is believed to cause the movement of blood from the lower body to the brain, heart and lungs. However, the equipment is expensive, and may have adverse effects.

Objectives

To quantify the effect on mortality and morbidity of the use of medical anti-shock trousers (MAST)/pneumatic anti-shock garments (PASG) in patients following trauma.

Search methods

Trials were identified by searches of the Cochrane Injuries Group Specialised Register (April 2007), the Cochrane Central Register of Controlled Trials (Issue 1, 2007), MEDLINE (April 2007), EMBASE (April 2007), ISI Web of Science (April 2007), National Research Register (Issue 1, 2007) and PubMed (April 2006). In addition we checked the reference lists of relevant trials and reviews. We contacted current researchers in the field for unpublished data and ongoing trials.

Selection criteria

Randomised and quasi-randomised trials of MAST/PASG in patients following trauma (excluding fractures of the extremities in which MAST/PASG may be used as a splint).

Data collection and analysis

Data were extracted independently by two authors. Data were collected on mortality, duration of hospitalisation and ICU stay, and quality of allocation concealment.

Main results

Two trials were identified that met the inclusion criteria. These trials included 1202 randomised patients in total; however, data for 1075 of these were available. The relative risk of death with MAST was 1.13 (95% CI 0.97 to 1.32). Duration of hospitalisation and of intensive care unit stay was longer in the MAST treated group. The weighted mean difference in the length of intensive care unit stay was 1.7 days (95% CI 0.33 to 2.98).

Authors' conclusions

There is no evidence to suggest that MAST/PASG application reduces mortality, length of hospitalisation or length of ICU stay in trauma patients and it is possible that it may increase these. These data do not support the continued use of MAST/PASG in the situation described. However, it should be recognised that, due to the poor quality of the trials, conclusions should be drawn with caution.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

No evidence that medical anti-shock trousers improve survival for people with trauma, and some suggestion they may worsen outcomes, but more trials are needed

About one third of injury deaths are due to shock from blood loss. Preventing shock in people with uncontrolled bleeding is therefore vital. Treatment aims to maintain blood pressure, so that tissue damage is minimised. Medical anti-shock trousers (MAST) are believed to increase blood pressure and blood flow to the heart and brain, helping to stabilise the person until they receive further treatment. The review of trials found no evidence that MAST application decreases deaths, with some suggestion that it may even do harm. More research is needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

用來支持外傷病患的血液循環的醫療用抗休克長褲(充氣式抗休克服)

在能提供特定的照顧之前,醫療用抗休克長褲(MAST)一直被用來增加靜脈血液回流到心臟。這點,再加上壓迫血管,據信會造成血液從下身往大腦、心臟和肺部的流動。然而,這種設備非常昂貴,而且可能產生負面影響。

目標

為量化使用醫療用抗休克長褲(MAST)/充氣式抗休克服(PASG)在創傷患者身上對於其死亡率和發病率的效果。

搜尋策略

我們經由搜尋Cochrane Injuries Group's specialised register (April 2007), the Cochrane Central Register of Controlled Trials (issue 1, 2007), MEDLINE (April 2007) EMBASE (April 2007), ISI Web of Science (April 2007), National Research Register (issue 1, 2007) and PubMed (April 2006)找出相關的試驗。此外,我們還檢查相關試驗和回顧的文獻清單。我們為了未發表的資料與進行中的試驗連絡了當時的研究者。

選擇標準

對於創傷患者(排除有關四肢骨折患者的試驗,其中MAST/PASG可能被作為托板)的MAST/PASG之隨機與準隨機臨床試驗。

資料收集與分析

資料分別由兩位作者擷取。蒐集了有關死亡率、住院和ICU停留期間,以及分組隱匿的品質的資料。

主要結論

找到了兩篇符合納入條件的試驗。這些試驗包含總數1,202名隨機分配的病患;但是只有其中1,075名的資料是可得的。使用MAST死亡的相對風險為1.13(95% CI 0.97 to 1.32)。採用MAST治療的群體其住院和ICU停留期間較長。ICU停留天數的加權平均差為1.7天(95% CI 0.33 to 2.98)。

作者結論

沒有證據認為MAST/PASG的應用能減少創傷患者的死亡率、住院或ICU停留天數,且它有可能會增加這些風險。這些資料並不支持在上述狀況中繼續使用MAST/PASG。然而,必須承認的是,由於這些試驗的品質不足,下此結論必須小心謹慎。

翻譯人

本摘要由高雄榮民總醫院徐圭璋翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有證據顯示醫療用抗休克長褲能夠增進創傷患者的存活,而且有的認為它們也許會造成更糟的結果,但是關於這點,需要更多的試驗。大約三分之一的受傷死亡案件是由於失血造成的休克。所以預防失控的出血所造成的休克是很重要的。相關的處置目標在於維持血壓,以使組織傷害最小化。醫療用抗休克長褲(MAST)據信能夠增加血壓以及血流至心臟和腦部,在他們獲得更進一步的治療之前,能對穩定患者有所幫助。但是本回顧試驗並未找到任何證據顯示應用MAST能夠減少死亡,有些人甚至認為它會造成傷害。我們需要更多的研究來證實。