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hypotensive trauma patients

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https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#1
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#2
Aidan Jc Burrell, David M Kaye, Mark C Fitzgerald, David J Cooper, James L Hare, Benedict T Costello, Andrew J Taylor
INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#3
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#4
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28258447/time-to-ct-and-surgery-for-hpb-trauma-in-scotland-prior-to-the-introduction-of-major-trauma-centres
#5
P S McKechnie, D A Kerslake, R W Parks
AIMS: To assess the time taken to CT and emergency surgery for trauma patients with an injury to liver, spleen or pancreas prior to the introduction of major trauma centres (MTCs) in Scotland. METHODS: A search was performed of the Scottish Trauma Audit Group database for any patient with relevant injuries over a 2-year period. Primary outcome measures were time to CT and emergency surgery. Patient demographics were also recorded. RESULTS: A total of 211 patients were identified of whom 23 had more than one organ affected...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#6
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension (SIH) syndrome results from spontaneous spinal CSF leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas. Two lumbar epidural blood patches were unsuccessful...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28246141/vasopressor-use-following-traumatic-injury-protocol-for-a-systematic-review
#7
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne-Julie Frenette, Frederick D'Aragon, Emilie Belley-Côté, Morten Hylander, François Lauzier, Reed Alexander Siemieniuk, Emmanuel Charbonney, Joey Kwong, Jon Henrik Laake, Gordon Guyatt, Per Olav Vandvik, Bram Rochwerg, Robert Green, Ian Ball, Damon Scales, Srinivas Murthy, Sandro Rizoli, Pierre Asfar, François Lamontagne
INTRODUCTION: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28243715/volume-replacement-during-trauma-resuscitation-a-brief-synopsis-of-current-guidelines-and-recommendations
#8
REVIEW
M Maegele, M Fröhlich, M Caspers, S Kaske
INTRODUCTION: Intravascular volume and fluid replacement are still cornerstones to correct fluid deficits during early trauma resuscitation, but optimum strategies remain under debate. METHODS: A synopsis of best current knowledge with reference to the following guidelines and recommendations is presented: (1) The European Guideline on Management of Major Bleeding and Coagulopathy following Trauma (fourth edition), (2) S3 Guideline on Treatment of Patients with Severe and Multiple Injuries [English Version of the German Guideline S3 Leitlinie Polytrauma/Schwerverletzten-Behandlung/AWMF Register-Nr...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28230626/resiliency-and-quality-of-life-trajectories-after-injury
#9
Ben L Zarzaur, Teresa M Bell, Stephen A Zanskas
BACKGROUND: Injury can greatly impact patients' long-term quality of life. Resilience refers to an individual's ability to positively adapt after facing stress or trauma. The objective of this study was to examine the relationship between pre-injury resiliency scores and quality of life after injury. METHODS: 225 adults admitted with an injury severity score > 10 but without neurological injury were included. The SF-36 was administered at the time of admission and repeated at 1, 2, 4 and 12 months after injury...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225738/pneumatosis-intestinalis-predictive-evaluation-study-a-multicenter-epidemiologic-study-of-the-american-association-for-the-surgery-of-trauma
#10
Paula Ferrada, Rachael Callcut, Graciela Bauza, Karen R O'Bosky, Xian Luo-Owen, Nicky J Mansfield, Kenji Inaba, Jason Pasley, Nikolay Bugaev, Bruno Pereira, Forrest O Moore, Jinfeng Han, Amelia Pasley, Joseph DuBose
BACKGROUND: Our group has previously published a retrospective review defining variables predictive of transmural bowel ischemia in the setting of pneumatosis intestinalis (PI). We hypothesize this prospective study will confirm the findings of the retrospective review, enhancing legitimacy to the predictive factors for pathologic PI previously highlighted. METHODS: Data were collected using the Research Electronic Data Capture. Forward logistic regression was utilized to identify independent predictors for pathologic PI...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#11
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28188356/brain-trauma-foundation-guidelines-for-intracranial-pressure-monitoring-compliance-and-effect-on-outcome
#12
Alberto Aiolfi, Elizabeth Benjamin, Desmond Khor, Kenji Inaba, Lydia Lam, Demetrios Demetriades
BACKGROUND: Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring in patients who sustained severe traumatic brain injury (TBI). Compliance to BTF guidelines is variable, and the effect of ICP monitoring on outcomes remains a controversial issue. The purpose of this study was to assess guidelines compliance in patients who sustain a severe TBI and to analyze the effect of ICP monitoring on outcomes. METHODS: Trauma Quality Improvement Program database study, which included patients with isolated severe blunt head trauma (head Abbreviated Injury Scale ≥3 with Glasgow Coma Scale <9)...
February 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28187248/emergency-department-telemedicine-is-used-for-more-severely-injured-rural-trauma-patients-but-does-not-decrease-transfer-a-cohort-study
#13
Nicholas M Mohr, Karisa K Harland, Elizabeth A Chrischilles, Amanda Bell, Dan M Shane, Marcia M Ward
OBJECTIVES: Traumatic injury is a leading cause of death in the United States, and rural populations are at increased risk of injury and death. Rural residents have limited access to trauma care, and telemedicine has been proposed as one strategy to improve the provision of trauma care locally. The objective of this study was to describe patient-level factors associated with telemedicine consultation in North Dakota critical-access hospital (CAH) emergency departments (EDs) and to measure the association between telemedicine consultation and interhospital transfer...
February 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28129264/management-of-pericardial-fluid-in-blunt-trauma-variability-in-practice-and-predictors-of-operative-outcome-in-patients-with-computed-tomography-evidence-of-pericardial-fluid
#14
Cordelie E Witt, Ken F Linnau, Ronald V Maier, Frederick P Rivara, Monica S Vavilala, Eileen M Bulger, Saman Arbabi
BACKGROUND: The objectives of this study were to assess current variability in management preferences for blunt trauma patients with pericardial fluid, and to identify characteristics associated with operative intervention for patients with pericardial fluid on admission computed tomography (CT) scan. METHODS: This was a mixed-methods study of blunt trauma patients with pericardial fluid. The first portion was a research survey of members of the Eastern Association for the Surgery of Trauma conducted in 2016, in which surgeons were presented with four clinical scenarios of blunt trauma patients with pericardial fluid...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099392/re-the-role-of-timely-emergency-care-for-hypotensive-trauma-patients-the-three-rs
#15
Jonathan P Meizoso, Kenneth G Proctor, Nicholas Namias
No abstract text is available yet for this article.
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099391/the-role-of-timely-emergency-care-for-hypotensive-trauma-patients
#16
Swathikan Chidambaram, En Lin Goh
No abstract text is available yet for this article.
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099181/adverse-events-and-risk-factors-during-emergency-intubation-in-a-tertiary-paediatric-emergency-department
#17
Ruth M C Löllgen, Jennifer Pontin, Matthew Gow, Mary E McCaskill
BACKGROUND: Rapid sequence intubation and emergency intubation in the emergency department (ED) can be life-saving procedures, but require the appropriate skills, experience and preparation to avoid complications ranging from simple trauma to life-threatening desaturation. Only scarce data exist in the published literature on complications following emergency intubation in children and most guidelines are extrapolated from the adult population. PATIENTS AND METHODS: We reviewed all emergency intubations of patients in our tertiary paediatric ED within a 2-year period to estimate the incidence of complications and to analyse the risk factors associated with this procedure...
January 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28033136/permissive-hypotension-and-trauma-can-fluid-restriction-reduce-the-incidence-of-ards
#18
Melissa Kolarik, Eric Roberts
Emergency care, including the resuscitation of patients involved in traumatic events, has evolved over the years. A prior practice of utilizing large volumes of crystalloids has been found to contribute to complications such as coagulopathy, fluid overload, and adult respiratory distress syndrome (ARDS). In contrast, permissive hypotension is a method of fluid restriction that allows for low blood pressure and mean arterial pressure during the resuscitation period. When permissive hypotension occurs and fluids are restricted in trauma patients, the incidence of ARDS can be reduced significantly with improvement in patient outcomes...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28031087/life-threatening-spontaneous-retroperitoneal-haemorrhage-role-of-multidetector-ct-angiography-for-the-emergency-management
#19
Zhi-Wei Wang, Hua-Dan Xue, Xiao-Guang Li, Jie Pan, Xiao-Bo Zhang, Zheng-Yu Jin
Objective To evaluate the role of multidetector computed tomography-angiography (MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage (SRH).Methods A retrospective analysis of the medical records of all SRH patients admitted to our hospital from January 1, 2005 to November 31, 2014 was performed. SRH was defined as unrelated to invasive procedures, surgery, trauma, abdominal tumor or aortic aneurysm. Life-threatening SRH was defined as hemodynamic instability with hypotension. Sixteen cases met the inclusive criteria...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28030494/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#20
Leah Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura B Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multi-center retrospective cohort study was performed across three Level I Trauma Centers encompassing traumatic colon injuries from January 2006 through June 2014...
December 23, 2016: Journal of Trauma and Acute Care Surgery
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