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Cardiac trauma

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https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#1
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#2
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#3
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27902668/pneumatosis-intestinalis-due-to-child-abuse
#4
Stephanie Anne Deutsch, Cindy W Christian
Pneumatosis intestinalis (PI) and the presence of portal venous gas (PVG) are commonly considered pathognomonic for necrotizing enterocolitis in the neonatal period; however, these 2 radiographic findings have been documented in all age groups in a variety of clinical settings and medical conditions including respiratory, cardiac, rheumatologic, gastrointestinal disorders, and traumatic injury. In children, intramural dissection of intestinal gas in the absence of clinical symptoms suggestive of necrotizing enterocolitis should raise concern for a traumatic etiology, including injuries sustained from child physical abuse...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27889903/a-case-report-hemothorax-caused-by-rupture-of-the-left-atrial-appendage
#5
Hiroaki Oizumi, Kenji Suzuki, Hironobu Hoshino, Takahiro Tatsumori, Hideomi Ichinokawa
Cardiac rupture is defined as a full-thickness myocardial tear; this injury after blunt chest trauma is rare, and is associated with high mortality. Blunt cardiac rupture typically presents with either cardiac tamponade or massive hemothorax, and is often unrecognized in the context of blunt chest trauma. It is a little known fact that pericardial effusions can decrease due to pericardial lacerations. Hence, cardiac rupture with pericardial lacerations may be easily overlooked especially by chest surgeons. We herein report a case of hemothorax caused by rupture of the left atrial appendage...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#6
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27879614/getting-a-better-look-outcomes-of-laparoscopic-versus-transdiaphragmatic-pericardial-window-for-penetrating-thoracoabdominal-trauma-at-a-level-i-trauma-center
#7
Jamie E Anderson, Edgardo S Salcedo, Kacie M Rounds, Joseph M Galante
BACKGROUND: In penetrating thoracoabdominal trauma, it is necessary to evaluate both the pericardial fluid and the diaphragm directly. Transdiaphragmatic pericardial windows (TDWs) provide direct access to the pericardium and diaphragm but expose the patient to the risks of laparotomy. We hypothesize that transabdominal laparoscopic pericardial windows (LPWs) are a safe and effective alternative to TDWs in stable patients. METHODS: This is a retrospective observational study of stable patients with thoracoabdominal penetrating trauma at a level I trauma center between January 2007 and June 2015, comparing outcomes after TDW versus LPW...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27875660/successful-use-of-targeted-temperature-management-after-repair-of-myocardial-rupture-from-blunt-chest-trauma-a-case-report
#8
Wook-Jin Choi, Yun Seok Kim, Jung Seok Hong, Jeong Won Kim
Targeted temperature management (TTM) improves survival and neurological outcome after nontraumatic cardiac arrest. However, TTM is not used widely after traumatic cardiac arrest because of concerns that it might exacerbate bleeding. We report the use of postarrest TTM after repair of blunt myocardial rupture. A 48-year-old man was admitted after being rescued from a major traffic accident by the local emergency service. Focused sonography showed pericardial fluid without cardiac tamponade. Computed tomography showed a large hematoma in the anterior mediastinum associated with hemopericardium...
November 22, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27871682/factors-affecting-mortality-after-penetrating-cardiac-injuries-10-year-experience-at-urban-level-i-trauma-center
#9
Michael J Mina, Rashi Jhunjhunwala, Rondi B Gelbard, Stacy D Dougherty, Jacquelyn S Carr, Christopher J Dente, Jeffrey M Nicholas, Amy D Wyrzykowski, Jeffrey P Salomone, Gary A Vercruysse, David V Feliciano, Bryan C Morse
BACKGROUND: Despite the lethality of injuries to the heart, optimizing factors that impact mortality for victims that do survive to reach the hospital is critical. METHODS: From 2003 to 2012, prehospital data, injury characteristics, and clinical patient factors were analyzed for victims with penetrating cardiac injuries (PCIs) at an urban, level I trauma center. RESULTS: Over the 10-year study, 80 PCI patients survived to reach the hospital...
October 15, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27866692/does-the-number-of-emergency-medical-technicians-affect-the-neurological-outcome-of-patients-with-out-of-hospital-cardiac-arrest
#10
Shuichi Hagiwara, Kiyohiro Oshima, Makoto Aoki, Dai Miyazaki, Atsushi Sakurai, Yoshio Tahara, Ken Nagao, Naohiro Yonemoto, Arino Yaguchi, Naoto Morimura
BACKGROUND: It is unclear whether the number of paramedics in an ambulance improves the outcome of patients with out-of-hospital cardiac arrest (OHCA) or not. METHODS AND RESULTS: This study was a prospective, observational study conducted on patients with OHCA. Patients were divided into the One-paramedic group (Group O) and the Two-or-more-paramedic group (Group T) and we analyzed the differences. Patients who were treated with only basic life support during transportation, and whose cause of cardiac arrest were extrinsic cause such as trauma and poisoning were excluded...
November 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27855275/epidemiology-and-aetiology-of-traumatic-cardiac-arrest-in-england-and-wales-a-retrospective-database-analysis
#11
Ed Barnard, David Yates, Antoinette Edwards, Marisol Fragoso-Iñiguez, Tom Jenks, Jason E Smith
BACKGROUND: Historically, reported survival from traumatic cardiac arrest (TCA) was extremely low. More recent publications have recorded survival to discharge of up to 8%. This improvement is likely to be multi-factorial; however, there are currently no published data describing the epidemiology or aetiology of TCA in England and Wales to guide future practice improvement. METHODS: Population-based analysis of 2009-2015 Trauma Audit and Research Network (TARN) data...
November 14, 2016: Resuscitation
https://www.readbyqxmd.com/read/27826118/medical-versus-non-medical-etiology-in-out-of-hospital-cardiac-arrest-changes-in-outcome-in-relation-to-the-revised-utstein-template
#12
A Claesson, T Djarv, P Nordberg, M Ringh, J Hollenberg, C Axelsson, A Ravn-Fischer, A Stromsoe
INTRODUCTION: The Utstein-style recommendations for reporting etiology and outcome in out-of-hospital cardiac arrest (OHCA) from 2004 have recently been revised. Among other etiologies a medical category is now introduced, replacing the cardiac category from Utstein template 2004. AIM: The aim of this study is to describe characteristics and temporal trends from reporting OHCA etiology according to the revised Utstein template 2014 in regards to patient characteristics and 30-day survival rates...
November 5, 2016: Resuscitation
https://www.readbyqxmd.com/read/27824672/the-feasibility-of-dual-energy-computed-tomography-in-cardiac-contusion-imaging-for-mildest-blunt-cardiac-injury
#13
Recep Sade, Mecit Kantarci, Hayri Ogul, Ummugulsum Bayraktutan, Mustafa Uzkeser, Sahin Aslan, Enbiya Aksakal, Necip Becit
PURPOSE: The purpose of this study was to evaluate the efficiency and feasibility of dual-energy computed tomography (DECT) used in the diagnosis of cardiac contusion with the mildest blunt cardiac injury. MATERIAL AND METHODS: This study was performed between February 2014 and September 2015; a total of 17 consecutive patients (10 men and 7 women; median age, 51 years [range: 20-78]) were enrolled in the study. The DECT was performed within 48 hours of the trauma and a subsequent follow-up DECT was performed a little less than 1 year after the first examination...
November 7, 2016: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/27822948/delayed-high-output-heart-failure-due-to-arteriovenous-fistula-complicated-with-herniated-disc-surgery
#14
Taeshik Park, Sang Ho Park, Alok Arora
A 36-year-old male presented with progressive exertional dyspnea over months. Physical examination showed jugular venous distension, lung crecipitations, femoral bruit and pitting pedal edema. Echocardiogram showed a dilated right ventricle with severe pulmonary hypertension and a non collapsing inferior vena cava (IVC). On right heart catheterization, IVC oxygen saturation was noted at 92% suggesting arterial mixing; a computed tomography of the abdomen showed a fistula between the right common iliac artery to the right common iliac vein at L4 level and a massive IVC; this was linked to trauma from a disectomy done 16 years ago at L4-L5 level...
December 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27816127/surgical-critical-care-for-the-trauma-patient-with-cardiac-disease
#15
REVIEW
Michael M Woll, Linda L Maerz
The elderly population is rapidly increasing in number. Therefore, geriatric trauma is becoming more prevalent. All practitioners caring for geriatric trauma patients should be familiar with the structural and functional changes naturally occurring in the aging heart, as well as common preexisting cardiac diseases in the geriatric population. Identification of the shock state related to cardiac dysfunction and targeted assessment of perfusion and resuscitation are important when managing elderly patients. Finally, management of cardiac dysfunction in the trauma patient includes an appreciation of the inherent effects of trauma on cardiac function...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27802176/complex-effects-of-apoplexy-secondary-to-pituitary-adenoma
#16
Rui-Cheng Zhang, Ying-Feng Mu, Jing Dong, Xiao-Qian Lin, De-Qin Geng
Pituitary adenoma apoplexy is a well-known clinical syndrome induced by insulin infusion, cardiac surgery, trauma, and hypothalamic releasing factors. Pituitary apoplexy can cause secondary cerebral infarct and internal carotid artery occlusion. With blockade of tumor perfusion, apoplexy triggers a sudden onset of headache, visual impairment, cranial nerve palsy, disturbances of consciousness, eyelid ptosis, and hemiparesis. However, pituitary adenoma cells with high metabolic demand cannot survive with deficient blood supply and glucose concentrations...
October 29, 2016: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/27797869/long-term-prognosis-after-out-of-hospital-resuscitation-of-cardiac-arrest-in-trauma-patients-prehospital-trauma-associated-cardiac-arrest
#17
François-Xavier Duchateau, Sophie Hamada, Mathieu Raux, Matthieu Gay, Jean Mantz, Catherine Paugam Burtz, Tobias Gauss
BACKGROUND: Although prehospital cardiac arrest (CA) remains associated with poor long-term outcome, recent studies show an improvement in the survival rate after prehospital trauma associated CA (TCA). However, data on the long-term neurological outcome of TCA, particularly from physician-staffed Emergency Medical Service (EMS), are scarce, and results reported have been inconsistent. The objective of this pilot study was to evaluate the long-term outcome of patients admitted to several trauma centres after a TCA...
October 26, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27793208/myocardial-function-at-the-early-phase-of-traumatic-brain-injury-a-prospective-controlled-study
#18
Adrien Cuisinier, Claire Maufrais, Jean-François Payen, Stephane Nottin, Guillaume Walther, Pierre Bouzat
BACKGROUND: The concept of brain-heart interaction has been described in several brain injuries. Traumatic brain injury (TBI) may also lead to cardiac dysfunction but evidences are mainly based upon experimental and clinical retrospective studies. METHODS: We conducted a prospective case-control study in a level I trauma center. Twenty consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. The control group included adult patients undergoing a general anesthesia for a peripheral trauma surgery...
October 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27787569/-cardiopulmonary-resuscitation-in-cardiac-arrest-following-trauma
#19
B A Leidel, K-G Kanz
For decades, survival rates of cardiac arrest following trauma were reported between 0 and 2 %. Since 2005, survival rates have increased with a wide range up to 39 % and good neurological recovery in every second person injured for unknown reasons. Especially in children, high survival rates with good neurologic outcomes are published. Resuscitation following traumatic cardiac arrest differs significantly from nontraumatic causes. Paramount is treatment of reversible causes, which include massive bleeding, hypoxia, tension pneumothorax, and pericardial tamponade...
October 27, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27787437/outcome-of-suicidal-hanging-patients-and-the-role-of-targeted-temperature-management-in-hanging-induced-cardiac-arrest
#20
Cindy H Hsu, Bryce Haac, Karen A McQuillan, Samuel A Tisherman, Thomas M Scalea, Deborah M Stein
BACKGROUND: No specific treatment is available for hanging-induced cardiac arrest (CA). We hypothesized that targeted temperature management (TTM) may improve the outcome of hanging-induced CA patients at hospital discharge. METHODS: A retrospective chart review of our trauma registry from January 1999 to September 2015 was conducted to identify patients ≥18 years with hanging as their injury type. All TTM was performed to achieve 32-34°C for 24 hours. The survival and Cerebral Performance Category (CPC) scores at hospital discharge were determined...
October 25, 2016: Journal of Trauma and Acute Care Surgery
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