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https://www.readbyqxmd.com/read/27928254/diagnosing-myocardial-contusion-after-blunt-chest-trauma
#1
REVIEW
Zahra Alborzi, Vahid Zangouri, Shahram Paydar, Zahra Ghahramani, Masih Shafa, Bizhan Ziaeian, Mohammad Reza Radpey, Armin Amirian, Shahin Khodaei
A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs) and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27914759/fluid-management-in-patients-with-trauma-restrictive-versus-liberal-approach
#2
REVIEW
Lee Palmer
Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival...
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#3
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#4
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27904257/expression-of-p38-mitogen-activated-protein-kinases-glycogen-synthase-kinase-c-jun-nh2-terminal-kinase-extracellular-signal-regulated-kinase-signaling-can-it-be-used-as-molecular-markers-among-trauma-hemorrhagic-shock-patients
#5
Manoj Kumar, Keshava Sharma, Sanjeev Bhoi, Mahendra Kumar, Manjunath Maruti Pol
No abstract text is available yet for this article.
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27904256/what-s-new-in-emergencies-trauma-and-shock-calculating-costs-for-disaster-preparedness
#6
EDITORIAL
Venkataramanaiah Saddikuti
No abstract text is available yet for this article.
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27895945/congenital-renal-fusion-and-ectopia-in-the-trauma-patient
#7
Andrew A Rosenthal, Jordan J Ditchek, Seong K Lee, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare, Eddy H Carrillo
We present two separate cases of young male patients with congenital kidney anomalies (horseshoe and crossed fused renal ectopia) identified following blunt abdominal trauma. Despite being rare, ectopic and fusion anomalies of the kidneys are occasionally noted in a trauma patient during imaging or upon exploration of the abdomen. Incidental renal findings may influence the management of traumatic injuries to preserve and protect the patient's renal function. Renal anomalies may be asymptomatic or present with hematuria, flank or abdominal pain, hypotension, or shock, even following minor blunt trauma or low velocity impact...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27894499/resuscitative-endovascular-balloon-occlusion-of-the-aorta-indications-outcomes-and-training
#8
REVIEW
Lena M Napolitano
Exsanguinating torso hemorrhage is a leading killer of trauma patients. The most appropriate means of hemorrhage control must be used. Trauma surgeons should have expertise with all approaches for prompt hemorrhage control [laparotomy, thoracotomy, resuscitative endovascular balloon occlusion of the aorta (REBOA), and resuscitative thoracotomy]. REBOA is an exciting adjunct for hemorrhage control as it can be deployed quickly and placed percutaneously. Balloon inflation can vary dependent on patient physiology...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27893646/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#9
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. iNO lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure. METHODS: A hemorrhagic shock and pneumonectomy model was developed using sheep...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893619/substituting-systolic-blood-pressure-with-shock-index-in-the-national-trauma-triage-protocol
#10
Ansab A Haider, Asad Azim, Peter Rhee, Narong Kulvatunyou, Kareem Ibraheem, Andrew Tang, Terence O'Keeffe, Hajira Iftikhar, Gary Vercruysse, Bellal Joseph
INTRODUCTION: The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance. METHODS: A 2-year (2011-2012) retrospective analysis of all trauma patients 18 years or older in the National Trauma Databank was performed...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#11
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27887016/inferior-vena-caval-filter-strut-perforation-causing-intramural-duodenal-haematoma
#12
Zoheb Berry Williams, Nicole M Organ, Stephen Deane
We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#13
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27873292/icu-management-based-on-picco-parameters-reduces-duration-of-mechanical-ventilation-and-icu-length-of-stay-in-patients-with-severe-thoracic-trauma-and-acute-respiratory-distress-syndrome
#14
Zhong Yuanbo, Wang Jin, Shi Fei, Long Liangong, Liu Xunfa, Xu Shihai, Shan Aijun
BACKGROUND: This study aimed to assess whether a management algorithm using data obtained with a PiCCO system can improve clinical outcomes in critically ill patients with acute respiratory distress syndrome (ARDS). RESULTS: The PaO2/FiO2 ratio increased over time in both groups, with a sharper increase in the PiCCO group. There was no difference in 28-day mortality (3.2 vs. 3.6%, P = 0.841). Days on mechanical ventilation (3 vs. 5 days, P = 0.002) and ICU length of stay (6 vs...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27863917/pelvic-fracture-in-multiple-trauma-a-67-case-series
#15
M Caillot, E Hammad, M Le Baron, V Villes, M Leone, X Flecher
INTRODUCTION: Severe pelvic trauma remains associated with elevated mortality, largely due to hemorrhagic shock. OBJECTIVE: The main study objective was to test for correlation between fracture type and mortality. The secondary objective was to assess the efficacy in terms of mortality of multidisciplinary management following a decision-tree in multiple trauma victims admitted to a level 1 trauma center. MATERIAL AND METHODS: Between July 2011 and July 2013, 534 severe trauma patients were included in a single-center continuous prospective observational study...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27857892/arterial-ammonia-levels-prognostic-marker-in-traumatic-hemorrhage
#16
Anurag Singla, Satinder Kaur, Navjot Kaur, C S Gill
BACKGROUND: In blunt trauma, extent of hemorrhage cannot be determined by physical examination, and vital signs may also not give clear picture in all the patients, especially young healthy ones. Hemorrhagic shock has been reported to increase blood ammonia levels. Arterial ammonia was analyzed in blunt trauma abdomen patients and correlated with shock index (SI). Its predictive value was determined for timely decision of intervention. MATERIALS AND METHODS: Hundred blunt trauma abdomen patients presented in the emergency ward of tertiary care hospital were included in the study...
October 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27857504/impaired-hematopoietic-progenitor-cells-in-trauma-hemorrhagic-shock
#17
REVIEW
Manoj Kumar, Sanjeev Bhoi
Hemorrhagic shock (HS) is the major cause of death during trauma. Mortality due to HS is about 50%. Dysfunction of hematopoietic progenitor cells (HPCs) has been observed during severe trauma and HS. HS induces the elevation of cytokines, granulocyte-colony stimulating factor (G-CSF), peripheral blood HPCs, and circulating catecholamines, and decreases the expression of erythropoietin receptor connected with suppression of HPCs. Impaired HPCs may lead to persistent anemia and risk of susceptibility to infection, sepsis, and MOF...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#18
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27849815/172-enteral-protease-inhibition-in-trauma-hemorrhagic-shock-effects-on-biochemical-parameters
#19
Federico Aletti, Frank DeLano, Erik Kistler
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848054/incidence-and-predictive-risk-factors-of-postoperative-sepsis-in-orthopedic-trauma-patients
#20
Nikita Lakomkin, Vasanth Sathiyakumar, Brandon Wick, Michelle S Shen, A Alex Jahangir, Hassan Mir, William T Obremskey, Ashley C Dodd, Manish K Sethi
BACKGROUND: Postoperative sepsis is associated with high mortality and the national costs of septicemia exceed those of any other diagnosis. While numerous studies in the basic orthopedic science literature suggest that traumatic injuries facilitate the development of sepsis, it is currently unclear whether orthopedic trauma patients are at increased risk. The purpose of this study was thus to assess the incidence of sepsis and determine the risk factors that significantly predicted septicemia following orthopedic trauma surgery...
November 15, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
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