{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:05:50Z","timestamp":1784610350115,"version":"3.55.0"},"reference-count":147,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011019","name":"National Research Development and Innovation Office OTKA Research","doi-asserted-by":"publisher","award":["FK138839"],"award-info":[{"award-number":["FK138839"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011019","name":"National Research Development and Innovation Office OTKA Research","doi-asserted-by":"publisher","award":["BO\/00605\/21\/5"],"award-info":[{"award-number":["BO\/00605\/21\/5"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hungarian Academy of Sciences: J\u00e1nos Bolyai Research","award":["FK138839"],"award-info":[{"award-number":["FK138839"]}]},{"name":"Hungarian Academy of Sciences: J\u00e1nos Bolyai Research","award":["BO\/00605\/21\/5"],"award-info":[{"award-number":["BO\/00605\/21\/5"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The majority of potentially preventable mortality in trauma patients is related to bleeding; therefore, early recognition and effective treatment of hemorrhagic shock impose a cardinal challenge for trauma teams worldwide. The reduction in mesenteric perfusion (MP) is among the first compensatory responses to blood loss; however, there is no adequate tool for splanchnic hemodynamic monitoring in emergency patient care. In this narrative review, (i) methods based on flowmetry, CT imaging, video microscopy (VM), measurement of laboratory markers, spectroscopy, and tissue capnometry were critically analyzed with respect to their accessibility, and applicability, sensitivity, and specificity. (ii) Then, we demonstrated that derangement of MP is a promising diagnostic indicator of blood loss. (iii) Finally, we discussed a new diagnostic method for the evaluation of hemorrhage based on exhaled methane (CH4) measurement. Conclusions: Monitoring the MP is a feasible option for the evaluation of blood loss. There are a wide range of experimentally used methodologies; however, due to their practical limitations, only a fraction of them could be integrated into routine emergency trauma care. According to our comprehensive review, breath analysis, including exhaled CH4 measurement, would provide the possibility for continuous, non-invasive monitoring of blood loss.<\/jats:p>","DOI":"10.3390\/jcm12103571","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T02:00:27Z","timestamp":1684720827000},"page":"3571","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impairment of Mesenteric Perfusion as a Marker of Major Bleeding in Trauma Patients"],"prefix":"10.3390","volume":"12","author":[{"given":"P\u00e9ter","family":"J\u00e1vor","sequence":"first","affiliation":[{"name":"Department of Traumatology, University of Szeged, H-6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3793-9647","authenticated-orcid":false,"given":"Tibor","family":"Donka","sequence":"additional","affiliation":[{"name":"Department of Traumatology, University of Szeged, H-6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"Institute of Surgical Research, University of Szeged, H-6724 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilla","family":"S\u00e1ndor","sequence":"additional","affiliation":[{"name":"Department of Traumatology, University of Szeged, H-6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"T\u00f6r\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Traumatology, University of Szeged, H-6725 Szeged, Hungary"},{"name":"Department of Sports Medicine, University of Szeged, H-6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3139-0235","authenticated-orcid":false,"given":"Andrea","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Institute of Surgical Research, University of Szeged, H-6724 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4746-9792","authenticated-orcid":false,"given":"Petra","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Traumatology, University of Szeged, H-6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1111\/trf.15161","article-title":"Outcomes of Traumatic Hemorrhagic Shock and the Epidemiology of Preventable Death from Injury","volume":"59","author":"Eastridge","year":"2019","journal-title":"Transfusion"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S124","DOI":"10.1016\/j.wem.2017.02.002","article-title":"Remote Damage Control Resuscitation in Austere Environments","volume":"28","author":"Chang","year":"2017","journal-title":"Wilderness Environ. 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