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https://www.readbyqxmd.com/read/29434806/extracorporeal-membrane-oxygenation-support-for-a-multitrauma-patient-with-ards-a-case-report-and-literature-review
#1
Yuexing Tu, Qi Jin, Renhua Sun, Qian Li
Extracorporeal membrane oxygenation (ECMO) provides rescue treatment for patients with severe acute respiratory distress syndrome (ARDS) when conventional management fails. The present study reported ECMO as a life-saving treatment for ARDS due to bilateral pulmonary contusion in a 24-year-old male multiple trauma patient. ECMO therapy lasted 7 days for the patient and was successively stopped without any complications. ECMO modality should be chosen according to the respiratory and circulatory condition of each individual...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29422005/the-role-of-point-of-care-ultrasound-in-the-injured-paediatric-patient
#2
Victor Istasy, Drew Thompson, Mirielle Gharib, Rodrick Lim
The focus of this review is to examine the current state of paediatric Point of Care Ultrasound (POCUS) in the injured patient. POCUS has become useful across various medical specialties owing to its ease of use, reproducibility and non-ionizing qualities. Point of care ultrasound has advanced over the past years and has proven to be an extremely useful adjunct in the injured child. Discussion will center around the challenges on when and how to best utilize POCUS. This includes but is not limited to: detection of peritoneal free fluid, pneumothoraces, hemothoraces, pericardial effusions, a wide array of fractures, lung contusions and many other applications...
February 1, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29394242/pulmonary-arterial-thrombosis-in-a-murine-model-of-blunt-thoracic-trauma
#3
Ian E Brown, Robert R Rigor, Linda M Schutzman, Nasim Khosravi, Karen Chung, James A Becker, Christopher D Pivetti, Gavin T Best, Jessica C Chavez, Joseph M Galante
Pulmonary thromboembolic events cause significant morbidity and mortality after severe trauma. Clinically, these lesions are believed to be emboli arising secondary to deep venous thrombosis (DVT) in the lower extremities. Recently this notion has been challenged by clinical studies showing that pulmonary clots arise after trauma in the absence of DVT. This suggests that pulmonary blood clots arise in situ via de novo thrombosis. In the present study we characterize a murine weight-drop model of lateral blunt thoracic trauma...
February 1, 2018: Shock
https://www.readbyqxmd.com/read/29379803/delayed-cardiac-rupture-induced-by-traumatic-myocardial-infarction-consequence-of-a-45-magnum-blast-injury-a-comprehensive-case-review
#4
Holger Rupprecht, Katharina Gaab
A penetrating chest trauma, a myocardial contusion or a myocardial infarction can lead to a cardiac rupture, which is linked to an extreme high death rate. Only few cases with delayed perforation of the myocardium have been reported in literature. We report about a penetrating gunshot injury, which led to a myocardial contusion with secondary delayed rupture of the left ventricle and the left inferior lobe of the lung. The leakage of the lesion in the left ventricle could be sealed sufficiently with fibrin-coated collagen fleeces after adapting stitches with Prolene 2-0...
January 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29297607/signal-enhancement-ratio-imaging-of-the-lung-parenchyma-with-ultra-fast-steady-state-free-precession-mri-at-1-5t
#5
Orso Pusterla, Gregor Sommer, Francesco Santini, Mark Wiese, Didier Lardinois, Michael Tamm, Jens Bremerich, Grzegorz Bauman, Oliver Bieri
BACKGROUND: Lung perfusion MRI after i.v. gadolinium (Gd) contrast administration is commonly based on spoiled gradient-echo acquisitions, such as volume-interpolated breath-hold examinations (VIBE), suffering from low signal-to-noise in the parenchyma. PURPOSE: To investigate the lung signal enhancement ratio (SER) with ultra-fast steady-state free precession (ufSSFP) after Gd-administration. STUDY TYPE: Retrospective. SUBJECTS: Ten subjects with healthy lungs; nine patients with pulmonary diseases (chronic obstructive pulmonary disease [COPD], lung cancer, pulmonary fibrosis, lung contusion)...
January 3, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29261721/the-multistep-road-to-ventilator-associated-lung-abscess-a-retrospective-study-of-s-aureus-ventilator-associated-pneumonia
#6
Roman Mounier, David Lobo, Julia Voulgaropoulos, Mathieu Martin, Bouziane Aït-Mamar, Valérie Bitot, Paul-Henri Jost, Ron Birnbaum, Biba Nebbad, Fabrice Cook, Gilles Dhonneur
OBJECT: We observed some cases of lung abscess (LA) in ICU patients suffering S.aureus ventilator-associated pneumonia (S.aureus-VAP). We aimed to assess which of the host and/or bacteria-related features are associated with LA. METHODS: We conducted a retrospective study from January 2009 to July 2013 in a trauma surgical ICU within a teaching hospital. All adult patients presenting with S.aureus-VAP were included. We compared two groups of patients according to the formation or not of LA concomitantly to S...
2017: PloS One
https://www.readbyqxmd.com/read/29259067/retrospective-evaluation-of-140-dogs-involved-in-road-traffic-accidents
#7
Sigal Klainbart, Uri Bibring, Dalia Strich, Orit Chai, Tali Bdolah-Abram, Itamar Aroch, Efrat Kelmer
This study has retrospectively reviewed the medical records of 140 dogs sustaining road traffic accident (RTA), and has examined the population characteristics, medical history, injury type, physical examination, emergency laboratory tests and radiography findings, the animal trauma triage (ATT) score, the length of hospitalisation, the complications and the outcome. The survival rate was 83.2 per cent. Younger dogs sustained more frequently lung contusions and limb fractures, while larger dogs more frequently suffered limb fractures, and smaller dogs and older ones sustained more frequently pelvic fractures and sacroiliac luxation (P<0...
December 19, 2017: Veterinary Record
https://www.readbyqxmd.com/read/29237485/resuscitative-endovascular-balloon-occlusion-of-the-aorta-may-increase-the-bleeding-of-minor-thoracic-injury-in-severe-multiple-trauma-patients-a-case-report
#8
Takaaki Maruhashi, Hiroaki Minehara, Ichiro Takeuchi, Yuichi Kataoka, Yasushi Asari
BACKGROUND: The resuscitative endovascular balloon occlusion of the aorta, because of its efficacy and feasibility, has been widely used in treating patients with severe torso trauma. However, complications developing around the site proximal to the occlusion by resuscitative endovascular balloon occlusion of the aorta have almost never been studied. CASE PRESENTATION: A 50-year-old Japanese woman fell from a height of approximately 10 m. At initial arrival, her respiratory rate was 24 breaths/minute, her blood oxygen saturation was 95% under 10 L/minute oxygenation, her pulse rate was 90 beats per minute, and her blood pressure was 180/120 mmHg...
December 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29227981/gamma-secretase-inhibitors-attenuate-neurotrauma-and-neurogenic-acute-lung-injury-in-rats-by-rescuing-the-accumulation-of-hypertrophic-microglia
#9
Hung-Jung Lin, Chien-Chin Hsu, Chung-Ching Chio, Yu-Feng Tian, Mao-Tsun Lin, Ting-Wei Lin, Chih-Hsien Chang, Ching-Ping Chang
BACKGROUND/AIMS: In response to traumatic brain injury (TBI), activated microglia exhibit changes in their morphology from the resting ramified phenotype toward the activated hypertrophic or amoeboid phenotype. Here, we provide the first description of the mechanism underlying the neuroprotective effects of γ-secretase inhibitors on TBI outcomes in rats. METHODS: The neuroprotective effects of γ-secretase inhibitors such as LY411575 or CHF5074 on TBI-induced neurotoxicity were analysed using a neurological motor function evaluation, cerebral contusion assay, immunohistochemical staining for microglia phenotypes, lung injury score and Evans Blue dye extravasation assay of brain and lung oedema...
December 6, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29185785/functional-outcomes-of-motor-vehicle-crash-thoracic-injuries-in-pediatric-and-adult-occupants
#10
Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, Gretchen Baker, Joel D Stitzel, Mark R Zonfrillo
OBJECTIVE: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs), and compare the functional outcomes between the pediatric and adult populations. METHODS: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2-5 thoracic injuries...
November 29, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29157219/a-new-multiple-trauma-model-of-the-mouse
#11
Stefanie Fitschen-Oestern, Sebastian Lippross, Tim Klueter, Matthias Weuster, Deike Varoga, Mersedeh Tohidnezhad, Thomas Pufe, Stefan Rose-John, Hagen Andruszkow, Frank Hildebrand, Nadine Steubesand, Andreas Seekamp, Claudia Neunaber
BACKGROUND: Blunt trauma is the most frequent mechanism of injury in multiple trauma, commonly resulting from road traffic collisions or falls. Two of the most frequent injuries in patients with multiple trauma are chest trauma and extremity fracture. Several trauma mouse models combine chest trauma and head injury, but no trauma mouse model to date includes the combination of long bone fractures and chest trauma. Outcome is essentially determined by the combination of these injuries...
November 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29156155/leukotriene-b4-indicates-lung-injury-and-on-going-inflammatory-changes-after-severe-trauma-in-a-porcine-long-term-model
#12
Philipp Störmann, Birgit Auner, Lukas Schimunek, Rafael Serve, Klemens Horst, Tim-P Simon, Roman Pfeifer, Kernt Köhler, Frank Hildebrand, Sebastian Wutzler, Hans-Christoph Pape, Ingo Marzi, Borna Relja
BACKGROUND: Recognizing patients at risk for pulmonary complications (PC) is of high clinical relevance. Migration of polymorphonuclear leukocytes (PMN) to inflammatory sites plays an important role in PC, and is tightly regulated by specific chemokines including interleukin (IL)-8 and other mediators such as leukotriene (LT)B4. Previously, we have reported that LTB4 indicated early patients at risk for PC after trauma. Here, the relevance of LTB4 to indicating lung integrity in a newly established long-term porcine severe trauma model (polytrauma, PT) was explored...
December 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#13
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29124026/risk-factors-for-pneumonia-in-ventilated-trauma-patients-with-multiple-rib-fractures
#14
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#15
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29064302/study-of-chest-injuries-to-3yo-child-occupants-seated-in-impact-shield-and-5-point-harness-crss
#16
Yong Han, Di Pan, Jun Ouyang, Lei Qian, Koji Mizuno, Anguo Cang
OBJECTIVE: To investigate whether the 5-point harness or the impact shield CRS or both has the potential to cause chest injuries to children. This is determined by examining whether the loading to the chest reaches the internal organ injury threshold for children. METHOD: The chest injury risk to a child occupant in a child restraint system (CRS) was investigated using Q3 dummy tests, finite element (FE) simulations (Q3 dummy and human models) and animal tests. The investigation was done for two types of CRSs (i...
October 24, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29052820/evaluation-of-different-treatment-protocols-for-combined-injury-induced-lung-injury-in-rabbits
#17
Xiao Bing Li
BACKGROUND: This study aims to evaluate the effectiveness of different treatment regimens on combined injury-induced lung injury. METHODS: Rabbits were subjected to non-lethal closed-chest bilateral lung contusion followed by a 30% total body surface area scald burn. The rabbits were randomly assigned to resuscitation groups that maintained a minimum mean arterial blood pressure of 70 mmHg using one of the following three methods: normal saline plus polygeline injection in a ratio of 1:1 (1:1G), normal saline plus polygeline injection in a ratio of 1:2 (1:2G), and normal saline plus polygeline injection in a ratio of 1:3 (1:3G), After injury, lung injury was assessed using lung wet-to-dry (W/D) weight ratio, enzyme-linked immunosorbent assay, and real-time PCR...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29042090/the-natural-history-of-flail-chest-injuries
#18
Kamil Naidoo, Layth Hanbali, Peter Bates
PURPOSE: Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre (MTC)...
October 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28962220/clinical-study-on-the-changes-of-lung-specific-proteins-cc16-after-lung-contusion
#19
Meng-Ni Wen, Gang Zhao, Jia-Ying Zhang, Yong-Hong Zhao
The aim of the present study was to examine the clinical value of continuously monitoring serum CC16 levels in diagnosing pulmonary contusion, estimating its severity degree and predicting disease progression. Thirty-one acute trauma patients with lung contusion diagnosed by chest computed tomography (CT) were included, and chest CT was re-examined on day 1, 3 and 7 after injury. Calculating all the contusion volume by the Siemens syngo volume calculation program, complications such as pleural effusion or atelectasis were observed and recorded...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu%C3%A2
#20
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU®), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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