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https://www.readbyqxmd.com/read/29923133/what-raises-troponins-in-the-paediatric-population
#1
Debbra Chong, Yan Ting Chua, Shu-Ling Chong, Gene Yong-Kwang Ong
Troponin I is a cardiac enzyme that is released during myocardial injury. However, cardiac enzymes are non-specific and can occur in many cardiac and non-cardiac pathologies. We aim to (1) describe the range of acute conditions that were associated with raised troponins in the paediatric population in our institution and (2) quantify the extent of troponin elevation and correlate it with the underlying aetiology. We performed a retrospective observational study in a tertiary institution which included patients from 1 January 2009 to 31 December 2013...
June 19, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29914563/case-reports-of-atrial-and-pericardial-rupture-from-blunt-cardiac-trauma
#2
D Baldwin, K L Chow, H Mashbari, E Omi, J K Lee
BACKGROUND: Blunt cardiac trauma is diagnosed in less than 10% of trauma patients and covers the range of severity from clinically insignificant myocardial contusions to lethal multi-chamber cardiac rupture. The most common mechanisms of injury include: motor vehicle collisions (MVC), pedestrians struck by motor vehicles and falls from significant heights. A severe complication from blunt cardiac trauma is cardiac chamber rupture with pericardial tear. It is an exceedingly rare diagnosis...
June 19, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29909182/diffuse-axonal-injury-dai-in-moderate-to-severe-head-injured-patients-pure-dai-vs-non-pure-dai
#3
Moinay Kim, Jae Sung Ahn, Wonhyoung Park, Suk Kyung Hong, Sang Ryong Jeon, Sung Woo Roh, Seungjoo Lee
OBJECTIVE: Diffuse axonal injury (DAI) is known to be associated with poor outcome. DAI often associates with other intracranial injuries but their distinct features have not been established. In this retrospective cohort study, we compared clinical outcomes between pure and non-pure DAI patients. PATIENTS AND METHODS: Total of 1047 traumatic brain injury (TBI) patients visited our institute between 2011 and 2017. Age ranged between 15-85 years old and Glasgow coma scale (GCS) score less than 13 were included...
June 10, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29907210/nonoperative-management-of-penetrating-abdominal-solid-organ-injuries-in-children
#4
Reid Sakamoto, Kazuhide Matsushima, Amory de Roulet, Kristine Beetham, Aaron Strumwasser, Damon Clark, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Nonoperative management (NOM) of penetrating solid organ injuries (SOI) has not been well described in the pediatric population. The objective of this study was to characterize the epidemiology, injury patterns, and factors associated with trial and failure of NOM. METHODS: This is a retrospective cohort analysis of the National Trauma Data Bank for the period of 2007-2014. The study population included patients ≤18 y with penetrating injury to the liver, spleen, or kidney...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29849292/repeat-point-of-care-echocardiographic-evaluation-of-traumatic-cardiac-arrest-a-new-paradigm-for-the-emergency-physician
#5
Benjamin Thomas, Edward Durant, Sophie Barbant, Arun Nagdev
We report a case of a 52-year-old man who presented to the emergency department (ED) in extremis (hypotensive with an altered sensorium) with subsequent cardiac arrest after a motor vehicle collision. The initial trauma evaluation did not reveal a source of the hemodynamic compromise. A point-of-care ultrasound revealed severe mitral regurgitation secondary to an anterolateral papillary muscle rupture. Patient underwent successful emergent mitral valve replacement after initial resuscitative efforts and intraaortic balloon pump placement...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29848342/spontaneous-omental-bleeding-a-case-report-and-literature-review
#6
Yun-Xiao Lyu, Yun-Xiao Cheng, Ting Li
BACKGROUND: Spontaneous rupture of omental vessels is an infrequent medical condition possibly causing severe intra-abdominal hemorrhage. Omental bleeding results from trauma associated injury and irritation, neoplasia, arterial aneurysm rupture, and anticoagulant treatment. Idiopathic omental bleeding rarely causes acute abdominal bleeding which has been reported to occur in previous studies. Here we reported a case with idiopathic omental hemorrhage due to vascular malformation. A systematic review of literature is provided...
May 30, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29847536/outcomes-following-trauma-laparotomy-for-hypotensive-trauma-patients-a-uk-military-and-civilian-perspective
#7
Max Marsden, Rich Carden, Lalin Navaratne, Iain M Smith, Jowan G Penn-Barwell, Luke M Kraven, Karim Brohi, Nigel R M Tai, Douglas M Bowley
BACKGROUND: The management of trauma patients has changed radically in the last decade and studies have shown overall improvements in survival. However, reduction in mortality for the many may obscure a lack of progress in some high-risk patients. We sought to examine the outcomes for hypotensive patients requiring laparotomy in UK military and civilian cohorts. METHODS: We undertook a review of two prospectively maintained trauma databases; the UK Joint Theatre Trauma Registry (JTTR) for the military cohort (4th February 2003 to 21st September 2014), and the trauma registry of the Royal London Hospital MTC (1st January 2012 to 1st January 2017) for civilian patients...
May 25, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29802644/safety-profile-of-uncrossmatched-cold-stored-low-titer-group-o-whole-blood-in-civilian-trauma-patients
#8
Jansen N Seheult, Marshall Bahr, Vincent Anto, Louis H Alarcon, Alain Corcos, Jason L Sperry, Darrell J Triulzi, Mark H Yazer
BACKGROUND: The use of cold-stored low-titer group O whole blood (LTOWB) for civilian trauma patients is gaining popularity. However, hemolysis might occur among non-group O recipients. This study evaluated the serologic safety of transfusing up to 4 units of LTOWB. STUDY DESIGN AND METHODS: Hypotensive male and at least 50-year-old female trauma patients who received leukoreduced, uncrossmatched, group O+, low-titer (<50 anti-A and anti-B), platelet-replete whole blood during initial resuscitation were included in this prospective, observational study...
May 25, 2018: Transfusion
https://www.readbyqxmd.com/read/29799823/trauma-hemostasis-and-oxygenation-research-network-position-paper-on-the-role-of-hypotensive-resuscitation-as-part-of-remote-damage-control-resuscitation
#9
Thomas Woolley, Patrick Thompson, Emrys Kirkman, Richard Reed, Sylvain Ausset, Andrew Beckett, Christopher Bjerkvig, Andrew P Cap, Tim Coats, Mitchell Cohen, Marc Despasquale, Warren Dorlac, Heidi Doughty, Richard Dutton, Brian Eastridge, Elon Glassberg, Anthony Hudson, Donald Jenkins, Sean Keenan, Christophe Martinaud, Ethan Miles, Ernest Moore, Giles Nordmann, Nicolas Prat, Joseph Rappold, Michael C Reade, Paul Rees, Rory Rickard, Martin Schreiber, Stacy Shackelford, Håkon Skogran Eliassen, Jason Smith, Mike Smith, Philip Spinella, Geir Strandenes, Kevin Ward, Sarah Watts, Nathan White, Steve Williams
The Trauma Hemostasis and Oxygenation Research (THOR) Network has developed a consensus statement on the role of permissive hypotension in remote damage control resuscitation (RDCR). A summary of the evidence on permissive hypotension follows the THOR Network position on the topic. In RDCR, the burden of time in the care of the patients suffering from noncompressible hemorrhage affects outcomes. Despite the lack of published evidence, and based on clinical experience and expertise, it is the THOR Network's opinion that the increase in prehospital time leads to an increased burden of shock, which poses a greater risk to the patient than the risk of rebleeding due to slightly increased blood pressure, especially when blood products are available as part of prehospital resuscitation...
June 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29793813/umbilical-hernia-with-evisceration-two-cases-and-a-review-of-the-literature
#10
Eham Arora, Saurabh Gandhi, Ajay Bhandarwar, Abdul Haque M Quraishi, Amol Wagh, Amarjeet Tandur, Dhansagar Wakle
BACKGROUND: Evisceration of umbilical hernias is an uncommon occurrence whereby the hernial contents break through the skin overlying the sac and skin. Irrespective of cause, sudden evisceration of an umbilical hernia is associated with deterioration and a poor outcome. CASE REPORTS: Our first case was a 42-year-old woman who presented with sudden outpouring of fluid from the umbilicus with omental evisceration. Further evaluation revealed hepatic decompensation caused by hepatitis C infection belonging to Child-Turcotte-Pugh class C...
May 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#11
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/29785693/massive-transfusion-the-revised-assessment-of-bleeding-and-transfusion-rabt-score
#12
Bellal Joseph, Muhammad Khan, Michael Truitt, Faisal Jehan, Narong Kulvatunyou, Asad Azim, Arpana Jain, Muhammad Zeeshan, Andrew Tang, Terence O'Keeffe
BACKGROUND: Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures. METHODS: We performed a 2-year (2014-2015) analysis of all high-level trauma activations and excluded patients dead on arrival...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29784591/accuracy-and-outcome-of-rapid-ultrasound-in-shock-and-hypotension-rush-in-egyptian-polytrauma-patients
#13
Adel Hamed Elbaih, Ahmed Mohamed Housseini, Mohamed E M Khalifa
PURPOSE: "Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes...
March 26, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29761676/planned-re-laparotomy-in-a-non-trauma-setting-a-single-center-experience
#14
Yehuda Hershkovitz, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov
BACKGROUND: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. OBJECTIVES: To evaluate our experience with planned re-laparotomy (PRL) in non-trauma patients and compare it to other reports. METHODS: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29760839/severely-elevated-blood-pressure-and-early-mortality-in-children-with-traumatic-brain-injuries-the-neglected-end-of-the-spectrum
#15
M Austin Johnson, Matthew A Borgman, Jeremy W Cannon, Nathan Kuppermann, Lucas P Neff
Introduction: In adults with traumatic brain injuries (TBI), hypotension and hypertension at presentation are associated with mortality. The effect of age-adjusted blood pressure in children with TBI has been insufficiently studied. We sought to determine if age-adjusted hypertension in children with severe TBI is associated with mortality. Methods: This was a retrospective analysis of the Department of Defense Trauma Registry (DoDTR) between 2001 and 2013. We included for analysis patients <18 years with severe TBI defined as Abbreviated Injury Severity (AIS) scores of the head ≥3...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29747958/emergency-department-intubation-success-with-succinylcholine-versus-rocuronium-a-national-emergency-airway-registry-study
#16
Michael D April, Allyson Arana, Daniel J Pallin, Steven G Schauer, Andrea Fantegrossi, Jessie Fernandez, Joseph K Maddry, Shane M Summers, Mark A Antonacci, Calvin A Brown
STUDY OBJECTIVE: Although both succinylcholine and rocuronium are used to facilitate emergency department (ED) rapid sequence intubation, the difference in intubation success rate between them is unknown. We compare first-pass intubation success between ED rapid sequence intubation facilitated by succinylcholine versus rocuronium. METHODS: We analyzed prospectively collected data from the National Emergency Airway Registry, a multicenter registry collecting data on all intubations performed in 22 EDs...
May 7, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29729820/tachycardic-and-non-tachycardic-responses-in-trauma-patients-with-haemorrhagic-injuries
#17
Andrew T Reisner, Shwetha Edla, Jianbo Liu, Jiankun Liu, Maxim Y Khitrov, Jaques Reifman
BACKGROUND: Analyses of large databases have demonstrated that the association between heart rate (HR) and blood loss is weaker than what is taught by Advanced Trauma Life Support training. However, those studies had limited ability to generate a more descriptive paradigm, because they only examined a single HR value per patient. METHODS: In a comparative, retrospective analysis, we studied the temporal characteristics of HR through time in adult trauma patients with haemorrhage, based on documented injuries and transfusion of ≥3 units of red blood cells (RBCs)...
April 30, 2018: Injury
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#18
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29692755/prehospital-intubation-and-outcome-in-traumatic-brain-injury-assessing-intervention-efficacy-in-a-modern-trauma-cohort
#19
Rebecka Rubenson Wahlin, David W Nelson, Bo-Michael Bellander, Mikael Svensson, Adel Helmy, Eric Peter Thelin
Background: Prehospital intubation in traumatic brain injury (TBI) focuses on limiting the effects of secondary insults such as hypoxia, but no indisputable evidence has been presented that it is beneficial for outcome. The aim of this study was to explore the characteristics of patients who undergo prehospital intubation and, in turn, if these parameters affect outcome. Material and methods: Patients ≥15 years admitted to the Department of Neurosurgery, Stockholm, Sweden with TBI from 2008 through 2014 were included...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29664830/transcatheter-arterial-embolization-in-the-treatment-of-maxillofacial-fractures-with-life-threatening-hemorrhage
#20
Shokei Matsumoto, Taku Akashi, Kei Hayashida, Kazuhiko Sekine, Tomohiko Orita, Tomohiro Funabiki, Mitsuhide Kitano
INTRODUCTION: Transcatheter arterial embolization (TAE) has gained importance in the management of maxillofacial fractures with life-threating hemorrhage (MFH). However, clinical evidence supporting the use of TAE has not been clearly established in the literature. Therefore, we evaluated the effectiveness of TAE for MFH, based on data obtained from the Japan Trauma Data Bank. METHODS: Patients were identified from Japan Trauma Data Bank entries for the years 2004 to 2014...
June 2018: Annals of Plastic Surgery
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