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Cardiac trauma

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https://www.readbyqxmd.com/read/29208736/pathophysiological-and-behavioral-deficits-in-developing-mice-following-rotational-acceleration-deceleration-traumatic-brain-injury
#1
Guoxiang Wang, Yi Ping Zhang, Zhongwen Gao, Lisa B E Shields, Fang Li, Tianci Chu, Huayi Lv, Thomas Moriarty, Xiao-Ming Xu, Xiaoyu Yang, Christopher B Shields, Jun Cai
Abusive head trauma (AHT) is the leading cause of death from trauma in infants and young children. An AHT animal model was developed on 12-day-old mice subjected to 90° head extension-flexion sagittal shaking repeated 30, 60, 80, and 100 times. The mortality and time until return of consciousness were dependent on the number of repeats and severity of the injury. Under 60 times of repeated head shakings, the pups demonstrated apnea and/or bradycardia immediately after injury. Acute oxygen desaturation was observed by pulse oximetry during respiratory and cardiac suppression...
November 30, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#2
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#3
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29203574/blunt-chest-trauma-a-clinical-chameleon
#4
REVIEW
Kaveh Eghbalzadeh, Anton Sabashnikov, Mohamed Zeriouh, Yeong-Hoon Choi, Alexander C Bunck, Navid Mader, Thorsten Wahlers
The incidence of blunt chest trauma (BCT) is greater than 15% of all trauma admissions to the emergency departments worldwide and is the second leading cause of death after head injury in motor vehicle accidents. The mortality due to BCT is inhomogeneously described ranging from 9% to 60%. BCT is commonly caused by a sudden high-speed deceleration trauma to the anterior chest, leading to a compression of the thorax. All thoracic structures might be injured as a result of the trauma. Complex cardiac arrhythmia, heart murmurs, hypotension, angina-like chest pain, respiratory insufficiency or distention of the jugular veins may indicate potential cardiac injury...
December 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29202259/bedside-lung-ultrasound-in-the-care-of-the-critically-ill
#5
Máté Rudas, Sam Orde, Marek Nalos
OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care. SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29201841/the-combined-use-of-cardiac-output-and-intracranial-pressure-monitoring-to-maintain-optimal-cerebral-perfusion-pressure-and-minimize-complications-for-severe-traumatic-brain-injury
#6
Jin Shup So, Jung-Ho Yun
Objective: To show the effect of dual monitoring including cardiac output (CO) and intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI) patiens. We hypothesized that meticulous treatment using dual monitoring is effective to sustain maintain minimal intensive care unit (ICU) complications and maintain optimal ICP and cerebral perfusion pressure (CPP) for severe TBI patiens. Methods: We included severe TBI, below Glasgow Coma Scale (GCS) 8 and head abbreviation injury scale (AIS) >4 and performed decompressive craniectomy at trauma ICU of our hospital...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29200065/cardiac-arrest-in-the-operating-room-part-2-special-situations-in-the-perioperative-period
#7
Matthew D McEvoy, Karl-Christian Thies, Sharon Einav, Kurt Ruetzler, Vivek K Moitra, Mark E Nunnally, Arna Banerjee, Guy Weinberg, Andrea Gabrielli, Gerald A Maccioli, Gregory Dobson, Michael F O'Connor
As noted in part 1 of this series, periprocedural cardiac arrest (PPCA) can differ greatly in etiology and treatment from what is described by the American Heart Association advanced cardiac life support algorithms, which were largely developed for use in out-of-hospital cardiac arrest and in-hospital cardiac arrest outside of the perioperative space. Specifically, there are several life-threatening causes of PPCA of which the management should be within the skill set of all anesthesiologists. However, previous research has demonstrated that continued review and training in the management of these scenarios is greatly needed and is also associated with improved delivery of care and outcomes during PPCA...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29195571/impact-of-discordant-views-in-the-management-of-descending-thoracic-aortic-aneurysm
#8
Peter Chiu, Anna-Margaretha Sailer, Michael Baiocchi, Andrew B Goldstone, Justin M Schaffer, Jeff Trojan, Dominik Fleischmann, R Scott Mitchell, D Craig Miller, Michael D Dake, Y Joseph Woo, Jason T Lee, Michael P Fischbein
Thoracic endovascular aortic repair has a lower perceived risk than open surgical repair and has become an increasingly popular alternative. Whether general consensus exists regarding candidacy for either operation among open and endovascular specialists is unknown. A retrospective review of isolated descending thoracic aortic aneurysm at our institution between January 2005 and October 2015 was performed, excluding trauma and dissection. Two cardiac surgeons, 2 cardiovascular surgeons, 1 vascular surgeon, and 1 interventional radiologist gave their preference for open vs endovascular repair...
2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29194652/outcomes-of-red-blood-cell-transfusions-prescribed-in-organ-donors-by-the-digital-intern-an-electronic-decision-support-algorithm
#9
Joseph P Connor, Thomas Raife, Joshua E Medow
BACKGROUND: The Digital Intern (DI) is an electronic decision support tool for the management of organ donors. One algorithm determines the dose, in units of red blood cells to be transfused, based on hematocrit (Hct) thresholds and targets. The effectiveness of the transfusion dose calculated by the DI in terms of achieving the selected Hct target and the duration of the targeted dose is not known. STUDY DESIGN AND METHODS: This was a retrospective study to describe the outcomes of transfusions prescribed by the DI...
December 1, 2017: Transfusion
https://www.readbyqxmd.com/read/29194011/rapid-source-control-laparotomy-is-there-a-mortality-benefit-in-septic-shock
#10
James Vogler, Leslie Hart, Sharon Holmes, Jason Sciaretta, John Mihran Davis
BACKGROUND: In the 1990s, damage control laparotomy (DCL) became a proved approach to treat intra-abdominal injuries caused by trauma. In the ensuing two decades, this approach has been applied to non-traumatic abdominal processes as well. Although the benefits of DCL are clear, the benefit of rapid source-control laparotomy (RSCL) for non-traumatic abdominal diseases is much less clear. However, two recent cohort analyses identified significant increases in the mortality rate with RCSL compared with primary fascial closure (PFC)...
December 1, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29177620/revisiting-traumatic-cardiac-arrest-should-cpr-be-initiated
#11
Katie L Konesky, Weidun Alan Guo
OBJECTIVES: Traumatic cardiac arrest (TCA) represents a unique problem, and poses difficult challenges in the care of trauma patients. Although the literature has suggested that attempted resuscitation from TCA in trauma is futile and consumptive of medical and human resources, studies have recently demonstrated that the outcome of TCA is comparable cardiac arrest secondary to non-traumatic events. The objective of this study was to determine the incidence, predictors, and outcomes following TCA...
November 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29174327/a-case-of-cardiac-arrest-associated-with-aortic-valve-regurgitation
#12
Hyun Suk Chai, Suk Woo Lee, Jung Soo Park, Sang Chul Kim, Ji Han Lee, Hoon Kim
Blunt chest trauma can cause not only damage to the thoracic cage, but can also injure intracardiac structures including the papillary muscles, chordae tendineae, and valve leaflets. Aortic valve (AV) injury secondary to blunt chest trauma is a rare occurrence. Clinically, AV injury may be missed during the initial post-trauma assessment due to the lack of suspicion of cardiac involvement. Thus, the diagnosis of AV injury is often delayed or missed for a time interval of days to months. As a consequence, the traumatic AV regurgitation can rapidly or progressively lead to congestive heart failure unless surgically corrected...
November 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29173678/blunt-cardiac-trauma-review
#13
REVIEW
Maite A Huis In 't Veld, Colin A Craft, Robert E Hood
Patients suffering blunt cardiac trauma vary widely in the severity of their condition on presentation. Although some may present with mild sternal bruising, others may present with acute valvular rupture or malignant arrhythmia. Disposition for these patients ranges from discharge home to admission for urgent cardiac surgery. This article discusses some of the common types of blunt cardiac trauma and reviews the current literature and guidelines for their triage and initial management.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29170351/54%C3%A2-paediatric-traumatic-cardiac-arrest-in-england-and-wales-a-10-year-epidemiological-study
#14
James Vassallo, Melanie Webster, Edward Barnard, Marisol Fragoso Iniguez, Mark Lyttle, Jason Smith
INTRODUCTION: Traumatic cardiac arrest (TCA) has traditionally been described as futile, with poor outcomes. Reported survival rates vary widely, with higher rates observed from mechanisms leading to a respiratory cause of traumatic cardiac arrest (e.g., drowning and hanging). Currently there is little evidence regarding outcomes following TCA in children. The primary aim of our study was to describe 30 day survival following TCA. Secondary aims were to provide an analysis of injury patterns (severe haemorrhage or traumatic brain injury), describe the functional outcome at discharge and to report the association between survival and interventions performed...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170346/49%C3%A2-paediatric-traumatic-cardiac-arrest-the-development-of-a-treatment-algorithm
#15
James Vassallo, Tim Nutbeam, Annette Rickard, Mark Lyttle, Jason Smith
INTRODUCTION: Paediatric Traumatic Cardiac Arrest (TCA) is a high acuity, low frequency event with fewer than 15 cases reported per year to the Trauma Audit Research Network (TARN). Traditionally survival from TCA has been reported as low, with some believing resuscitation is futile. Within the adult population there is growing evidence to suggest that with early and aggressive correction of reversible causes, survival from TCA may be comparable to that seen from medical out-of-hospital cardiac arrests...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29167615/vocal-cord-paralysis-and-laryngeal-trauma-in-cardiac-surgery
#16
Yung-Yuan Chen, Yeo-Yee Chia, Pa-Chun Wang, Hsiu-Yen Lin, Chiu-Ling Tsai, Shaw-Min Hou
Background: Cardiac surgery - associated iatrogenic laryngeal trauma is often overlooked. We investigated the risk factors of vocal cord paralysis in cardiac surgery. Methods: Medical records were reviewed from 169 patients who underwent elective or emergency cardiac surgeries. Patients had transesophageal echocardiography (TEE) placed either under video fiberscopic image guidance (guided group) or blind placement (blind group). Routine postoperative otolaryngologist consultation with video laryngoscopic recording were performed...
November 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29150890/suspended-animation-the-past-present-and-future-of-major-cardiothoracic-trauma
#17
REVIEW
Syed Mohiyaddin, Prakash Nanjaiah, Ahmed O Saad, Metesh N Acharya, Tanveer A Khan, Rhodri H Davies, Saeed Ashraf
About 50% of the trauma victims die at the scene mostly because of exsanguinating haemorrhage. Most trials of resuscitation fail in face of the ongoing bleeding. Ongoing research/studies to save these victims by inducing rapid hypothermia using cardiopulmonary bypass as an emergency initial measure along with delayed resuscitation show improved outcomes. A comprehensive review of this research and analysis of studies showed that rapid induction of hypothermia within 5 min of cardiac arrest is associated with better survival and improved neurological outcome...
November 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#18
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29150222/retrospective-study-of-thoracotomy-performed-in-a-french-level-1-trauma-center
#19
A Mancini, A Bonne, A Pirvu, P Porcu, P Bouzat, J Abba, C Arvieux
OBJECTIVE: Resuscitative thoracotomy, a potentially life-saving procedure, is used exceptionally, and essentially for penetrating trauma. Most of the available literature is American while reports from Europe are sparse. We report our experience in a French level 1-trauma center. MATERIAL AND METHODS: Patient records (patient age, gender, mechanism of injury, indication for emergency thoracotomy, anatomic injuries, interventions and survival) for all patients who underwent emergency thoracotomy between January 2005 and December 2015 were analyzed...
November 14, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29149974/liver-transplantation-with-old-grafts-a-ten-year-experience
#20
S Roullet, M Defaye, A Quinart, J-P Adam, L Chiche, C Laurent, M Neau-Cransac
BACKGROUND: The persistent scarcity of donors has prompted liver transplantation teams to find solutions for increasing graft availability. We report our experience of liver transplantations performed with grafts from older donors, specifically over 70 and 80 years old. PATIENTS AND METHODS: We analyzed our prospectively maintained single-center database from January 1, 2005, to December 31, 2014, with 380 liver transplantations performed in 354 patients. Six groups were composed according to donor age: <40 (n = 84), 40 to 49 (n = 67), from 50 to 59 (n = 62), from 60 to 69 (n = 76), from 70 to 79 (n = 64), and ≥80 years (n = 27)...
November 2017: Transplantation Proceedings
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