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Survival after trauma

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https://www.readbyqxmd.com/read/28442204/out-of-hospital-thoracotomy-for-cardiac-arrest-after-penetrating-thoracic-trauma
#1
Mark G Van Vledder, Oscar J F Van Waes, Fabian O Kooij, Joost H Peters, Esther M M Van Lieshout, Michael H J Verhofstad
INTRODUCTION: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated thoracotomy on the accident scene. The aim of this study was to determine the proportion of patients with return of spontaneous circulation and subsequent survival after out of hospital thoracotomy in the Netherlands...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#2
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#3
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424818/dose-requirements-for-idarucizumab-reversal-of-dabigatran-in-a-lethal-porcine-trauma-model-with-continuous-bleeding
#4
Markus Honickel, Henri M Spronk, Rolf Rossaint, Christian Stoppe, Joanne van Ryn, Hugo Ten Cate, Oliver Grottke
Idarucizumab is licensed for emergency reversal of dabigatran. A single 5 g dose is usually sufficient, but higher doses may sometimes be required and optimum dosing has not been defined. It was the aim of this study to investigate the effect of idarucizumab, given once or as a split dose, after double trauma in pigs anticoagulated with dabigatran. Dabigatran etexilate (30 mg/kg bid) was given to 18 male pigs orally for 3 days. On day 4, animals were randomised 1:1:1 to receive idarucizumab 60+0, 60+60 or 120+0 mg/kg...
April 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28421780/intestinal-dysfunction-in-the-critical-trauma-patients-an-early-and-frequent-event
#5
Beatriz Pinto Costa, Paulo Martins, Carla Verissimo, Marta Simões, Marisa Tomé, Manuela Grazina, Jorge Pimentel, Francisco Castro-Sousa
BACKGROUND: Small-bowel dysfunction exerts a relevant prognostic impact in the critically ill patients. Citrullinemia has been used in the evaluation of the intestinal function and it is considered an objective parameter of the functional enterocyte mass. Present study proposes to determine the intestinal dysfunction prevalence and the citrullinemia kinetic profile in severe trauma patients and to investigate its correlation with severity indicators and clinical outcome. METHODS: A prospective study including 23 critical trauma patients was performed...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28417338/accessibility-accountability-affordability-healthcare-policy-in-orthopedic-trauma
#6
REVIEW
Renee C Genova, Rachel L Box, James R Ficke
PURPOSE OF REVIEW: This review provides historical background on trauma care in the USA and summarizes contemporary trauma-related health policy issues. It is a primer for orthopedic surgeons who want to promote improvements in research, delivery, and cost reduction in trauma care. RECENT FINDINGS: As of 2010, funding for trauma research accounted for only 0.02% of all National Institutes of Health research funding. This is disproportionate to the societal burden of traumatic injury, which is the leading cause of death and disability among people aged 1 to 46 years in the USA...
April 18, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28416561/requirements-for-and-current-provision-of-rehabilitation-services-for-children-after-severe-acquired-brain-injury-in-the-uk-a-population-based-study
#7
Louise Hayes, Simon Shaw, Mark S Pearce, Rob J Forsyth
OBJECTIVES: Survival with brain injury is an outcome of severe illness that may be becoming more common. Provision for children in this situation has received little attention. We sought to estimate rates of severe paediatric acquired brain injury (ABI) requiring rehabilitation and to describe current provision of services for these children in the UK. METHODS: This study conducted an analysis of Hospital Episode Statistics data between April 2003 and March 2012, supplemented by a UK provider survey completed in 2015...
April 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28409131/hip-disarticulation-case-series-analysis-and-literature-review
#8
Diogo Lino Moura, António Garruço
OBJECTIVE: To present a retrospective study of 16 patients submitted to hip disarticulation. METHODS: During the period of 16 years, 16 patients who underwent hip disarticulation were identified. All of them were studied based on clinical records regarding the gender, age at surgery, disarticulation cause, postoperative complications, mortality rates and functional status after hip disarticulation. RESULTS: Hip disarticulation was performed electively in most cases and urgently in only three cases...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28408792/thrombopoietin-receptor-agonist-mitigates-hematopoietic-radiation-syndrome-and-improves-survival-after-whole-body-ionizing-irradiation-followed-by-wound-trauma
#9
Juliann G Kiang, Min Zhai, Pei-Jun Liao, Connie Ho, Nikolai V Gorbunov, Thomas B Elliott
Ionizing radiation combined with trauma tissue injury (combined injury, CI) results in greater mortality and H-ARS than radiation alone (radiation injury, RI), which includes thrombocytopenia. The aim of this study was to determine whether increases in numbers of thrombocytes would improve survival and mitigate H-ARS after CI. We observed in mice that WBC and platelets remained very low in surviving RI animals that were given 9.5 Gy (60)Co-γ-photon radiation, whereas only lymphocytes and basophils remained low in surviving CI mice that were irradiated and then given skin wounds...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28408366/acute-brain-trauma-lung-injury-and-pneumonia-more-than-just-altered-mental-status-and-decreased-airway-protection
#10
Parker J Hu, Jean-Francois Pittet, Jeffrey D Kerby, Patrick L Bosarge, Brant M Wagener
Traumatic brain injury (TBI) is a major cause of mortality and morbidity worldwide. Even when patients survive the initial insult, there is significant morbidity and mortality secondary to subsequent pulmonary edema, acute lung injury and nosocomial pneumonia. While the relationship between TBI and secondary pulmonary complications is recognized, little is known about the mechanistic interplay of the two phenomena. Changes in mental status secondary to acute brain injury certainly impair airway- and lung-protective mechanisms...
April 13, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28408294/resilience-and-cross-network-connectivity-a-neural-model-for-post-trauma-survival
#11
Marcella Brunetti, Laura Marzetti, Gianna Sepede, Filippo Zappasodi, Vittorio Pizzella, Fabiola Sarchione, Federica Vellante, Giovanni Martinotti, Massimo Di Giannantonio
Literature on the neurobiological bases of Post-Traumatic Stress Disorder (PTSD) considers medial Prefrontal cortex (mPFC), a core region of the Default Mode Network (DMN), as a region involved in response regulation to stressors. Disrupted functioning of the DMN has been recognized at the basis of the pathophysiology of a number of mental disorders. Furthermore, in the evaluation of the protective factors to trauma consequence, an important role has been assigned to resilience. Our aim was to investigate the specific relation of resilience and PTSD symptoms severity with resting state brain connectivity in a traumatized population using magnetoencephalography (MEG), a non-invasive imaging technique with high temporal resolution and documented advantages in clinical applications...
April 10, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28403103/primary-bone-lymphoma-of-radius-and-tibia-a-case-report-and-review-of-literature
#12
Yanmei Huan, Yiwei Qi, Weisheng Zhang, Jianguo Chu
RATIONALE: Primary bone lymphoma (PBL) is a rare malignant entity. There is a better survival of PBL than any other malignant bone tumors and extranodal lymphomas. PATIENT CONCERNS: We report a rare case of PBL involving radius and tibia. The patient was a 14-year-old girl with left forearm pain and swelling after trauma. Six months later after the last chemotherapy and radiotherapy, pain and swelling of left knee was presented. DIAGNOSES: Radiological imaging revealed a lytic destruction, periosteal reaction, and pathological fracture of radius and tibia with soft tissue mass...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#13
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28392701/evaluation-of-the-clinical-effect-of-small-volume-resuscitation-on-uncontrolled-hemorrhagic-shock-in-emergency
#14
Gang Zhao, Wei Wu, Qi-Ming Feng, Jian Sun
OBJECTIVE: The objective of the present study was to explore the resuscitative effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency. METHODS: In this study, the resuscitative effects in 200 trauma patients with uncontrolled hemorrhagic shock in emergency were studied. Half of these patients were infused with hypertonic/hyperoncotic fluid (small-volume resuscitation group, n=100), whereas the rest were infused with Hespan and lactated Ringer's solution (conventional fluid resuscitation group, n=100)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#15
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28384927/inflammation-and-outcome-in-traumatic-brain-injury-does-gender-effect-on-survival-and-prognosis
#16
Taraneh Naghibi, Mina Mohajeri, Faramarz Dobakhti
INTRODUCTION: Traumatic Brain Injury (TBI) accounts for the majority of trauma deaths and there has been increased interest in the understanding the role of prognostic factors. C-Reactive Protein (CRP) level increases rapidly in response to trauma. AIM: Aim of the present study was to indicate the role of CRP as a predictor of outcome in TBI patients based on their gender category. MATERIALS AND METHODS: A prospective cohort study in a surgical Intensive Care Unit (ICU) in one of the Zanjan University of Medical Science hospital was designed...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28384898/primary-management-and-outcome-open-laryngotracheal-trauma
#17
Santosh Uttarkar Pandurangarao, Prashanth Basavaraj, Supriya Baswaraj Yempalle, Lavanya Karnam
Acute external injury to the larynx is both life threatening and a potential long term management challenge. As Otorhinolaryngologist we must be prepared and well versed to manage these patients. In our study seven patients of open laryngeal traumas were managed by primary closure. In five patients nature of injury was known in other two patients exact nature of injury was not known. After primary closure five patients with known injury survived and two patients with unknown injury died. As per our experience, we recommend primary closure, if the exact nature of injury is known as the outcome is definitely favourable...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383476/multicenter-observational-prehospital-resuscitation-on-helicopter-study-prohs
#18
John B Holcomb, Michael D Swartz, Stacia M DeSantis, Thomas J Greene, Erin E Fox, Deborah M Stein, Eileen M Bulger, Jeffrey D Kerby, Michael Goodman, Martin A Schreiber, Martin D Zielinski, Terence O'Keeffe, Kenji Inaba, Jeffrey S Tomasek, Jeanette M Podbielski, Savitri Appana, Misung Yi, Charles E Wade
BACKGROUND: Earlier use of in-hospital plasma, platelets and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). We hypothesized that PHT of plasma and/or RBCs would result in improved survival after injury in patients transported by helicopter. METHODS: Adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers were prospectively observed from Jan-Nov 2015...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28382256/prognostication-of-traumatic-brain-injury-outcomes-in-older-trauma-patients-a-novel-risk-assessment-tool-based-on-initial-cranial-ct-findings
#19
Stanislaw P Stawicki, Thomas R Wojda, John D Nuschke, Ronnie N Mubang, James Cipolla, William S Hoff, Brian A Hoey, Peter G Thomas, Joan Sweeney, Daniel Ackerman, Jonathan Hosey, Steven Falowski
INTRODUCTION: Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28380043/club-cell-protein-16-and-cytokeratin-fragment-21-1-as-early-predictors-of-pulmonary-complications-in-polytraumatized-patients-with-severe-chest-trauma
#20
Lukas L Negrin, Gabriel Halat, Stephan Kettner, Markus Gregori, Robin Ristl, Stefan Hajdu, Thomas Heinz
BACKGROUND: Acute respiratory distress syndrome (ARDS) and pneumonia have a great impact on the treatment regimen of polytraumatized patients with severe chest trauma. The objective of our study was to determine whether biomarker levels assessed shortly after multiple trauma may predict the occurrence of these conditions. METHODS AND FINDINGS: Our patient population included 71 men and 30 women (mean age, 40.3 ± 15.8 years) with an Injury Severity Score that ranged from 17 to 59 and an Abbreviated Injury Scale Thorax of at least 3...
2017: PloS One
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