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https://www.readbyqxmd.com/read/29922874/flail-chest-less-deadly-than-originally-thought
#1
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Flail chest is considered a highly morbid condition with reported mortality ranging from 10 to 20%. It is often associated with other severe injuries, which may complicate management and interpretation of outcomes. The physiologic impact and prognosis of isolated flail chest injury is poorly defined. METHODS: This is a National Trauma Databank study. All patients from 1/2007 to 12/2014 admitted with flail chest were extracted. Patients with head or abdominal AIS ≥3, dead on arrival, or transferred, were excluded...
June 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29807546/surgical-plate-fixation-of-multiple-rib-fractures-a-case-report
#2
Konstantin Mitev, Dashurie Neziri, Emil Stoicovski, Zan Mitrev
BACKGROUND: The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit...
May 29, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#3
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29776439/concurrence-of-symmetrical-peripheral-gangrene-and-venous-limb-gangrene-following-polytrauma-a-case-report
#4
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29774196/common-carotid-artery-dissection-in-multiple-extracranial-injury-a-case-report
#5
Jin Sang Kil, Mi Kyung Lee, Ki Seong Eom
Traumatic common carotid artery dissection (CCAD) is rare. To our knowledge, only 14 case reports have described traumatic CCAD previously. Here, we report a case of CCAD in a patient with severe trauma. A 50-year-old man was lying on the road after drinking alcohol when a car drove over him. Computed tomography (CT) revealed multiple rib fractures with hemopneumothorax, lung contusion, flail chest, large amount of hematoma with bladder rupture, and fractures on the C6 spinous process, sacral ala, iliac bone, and pubic ramus...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29697089/lung-contusion
#6
Padmanabhan Arjun, Akbar Abdul Najeeb, Rahul Ramachandran
Lung contusion usually follows blunt trauma to the chest. If not properly diagnosed and adequately treated, it could at times be fatal as well. This case is being presented to highlight the radiological findings of this condition.
May 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29593715/comparative-analysis-of-the-regulatory-t-cells-dynamics-in-peripheral-blood-in-human-and-porcine-polytrauma
#7
Rafael Serve, Ramona Sturm, Lukas Schimunek, Philipp Störmann, David Heftrig, Michel P J Teuben, Elsie Oppermann, Klemens Horst, Roman Pfeifer, Tim P Simon, Yannik Kalbas, Hans-Christoph Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
Background: Severely injured patients experience substantial immunological stress in the aftermath of traumatic insult, which often results in systemic immune dysregulation. Regulatory T cells (Treg) play a key role in the suppression of the immune response and in the maintenance of immunological homeostasis. Little is known about their presence and dynamics in blood after trauma, and nothing is known about Treg in the porcine polytrauma model. Here, we assessed different subsets of Treg in trauma patients (TP) and compared those to either healthy volunteers (HV) or data from porcine polytrauma...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29584488/functional-outcomes-of-thoracic-injuries-in-pediatric-and-adult-occupants
#8
Ashley A Weaver, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, Joel D Stitzel, Mark R Zonfrillo
OBJECTIVE: To develop a disability metric for motor vehicle crash (MVC) thoracic injuries and compare functional outcomes between pediatric and adult populations. METHODS: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank (NTDB) for the top 95% most frequently occurring AIS 2, 3, 4, and 5 thoracic injuries in NASS-CDS 2000-2011. The NTDB contains a truncated form of the FIM score, including three items (self-feed, locomotion, and verbal expression), each graded from full functional dependence to full functional independence...
February 28, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29582175/exogenous-surfactant-as-a-bridge-to-prolonged-total-lung-rest-in-severely-injured-patient-during-extracorporeal-membrane-oxygenation
#9
Peter Sklienka, Jan Maca, Filip Bursa, Jan Neiser, Roman Kula, Marcela Kanova, Tomas Danek, Pavel Sevcik
We report a case of a 20-year-old male patient suffering from motorcycle accident complicated by rapid development of severe refractory hypoxemia and hypercapnia due to serious bilateral lung contusions and lacerations. Positive pressure mechanical ventilation induced pressure-dependent massive air leak from disrupted pulmonary tissue. Simultaneous implementation of veno-venous extracorporeal membrane oxygenation together with surfactant application allowed prolonged disconnection of patient from mechanical ventilation ("total lung rest" mode)...
March 27, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29514343/imaging-of-combat-related-thoracic-trauma-blunt-trauma-and-blast-lung-injury
#10
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma (CRTT) is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries are the most common mechanisms of trauma to the chest. Imaging plays a key role in the battlefield management of CRTT casualties. This work discusses the imaging manifestations of thoracic injuries from blunt trauma and blast injury, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29479940/cpr-related-thoracic-injuries-comparison-of-cpr-guidelines-between-2010-and-2015
#11
Kaan Yusufoğlu, Mehmet Özgür Erdoğan, İsmail Tayfur, Mustafa Ahmet Afacan, Şahin Çolak
Background/aim: This study aimed to evaluate traumatic thorax complications in post-CPR patients and to investigate whether or not there has been a decrease in these complications since the adoption of current chest compression recommendations. Materials and methods: Post-CPR patients with return of spontaneous circulation (ROSC) were admitted between January 2014 and January 2016 were analyzed retrospectively. Patients admitted to the ED in 2014 were resuscitated according to 2010 AHA CPR guidelines, while those admitted to the ED in 2015 were resuscitated according to current ERC CPR guidelines...
February 23, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29466280/persistent-injury-associated-anemia-and-aging-novel-insights
#12
Tyler J Loftus, Kolenkode B Kannan, Christy S Carter, Jessica M Plazas, Juan C Mira, Scott C Brakenridge, Christiaan Leeuwenburgh, Philip A Efron, Alicia M Mohr
BACKGROUND: Hypercatecholaminemia and bone marrow dysfunction have been implicated in the pathophysiology of persistent injury-associated anemia. The elderly may be more vulnerable to bone marrow dysfunction due to high basal and peak catecholamine levels and impaired hematopoietic progenitor growth. We hypothesized that aging would adversely affect persistent injury-associated anemia. METHODS: Male Sprague-Dawley rats aged 8 to 9 weeks and F344-BN rats aged 25 months were randomized to naive controls, lung contusion plus hemorrhagic shock (LCHS), and LCHS plus daily chronic restraint stress (LCHS/CS)...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29434806/extracorporeal-membrane-oxygenation-support-for-a-multitrauma-patient-with-ards-a-case-report-and-literature-review
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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