Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Observational StudyEasy method to determine fluid responsiveness in septic shock patients: end-tidal CO2 - a prospective observational study.
In critically ill patients, especially those with septic shock, fluid management can be a challenging aspect of clinical care. One of the primary steps in treating patients with hemodynamic instability is optimizing intravascular volume. The Passive Leg Raising (PLR) maneuver is a reliable test for assessing fluid responsiveness, as demonstrated by numerous studies and meta-analyses. However, its use requires the measurement of cardiac output, which is often complex and may necessitate clinician experience and specialized equipment. End-Tidal Carbon Dioxide (ETCO2) measurement is relatively easy and is generally stable under steady metabolic conditions. It depends on the body's CO2 production, diffusion of CO2 from the lungs into the bloodstream, and cardiac output. If the other two parameters (metabolic conditions and minute ventilation) are constant, ETCO2 can provide information about cardiac output. The aim of the present study is to investigate the sensitivity of ETCO2 measurement in demonstrating fluid responsiveness. ⋯ This study demonstrates that in septic patients, ETCO2 during the PLR test can indicate fluid responsiveness with high sensitivity and specificity and can be used as an alternative to cardiac output measurement.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Analysis of increased motorcycle accidents during the COVID-19 pandemic: a single-center study from Türkiye.
The Coronavirus Disease 2019 (COVID-19) pandemic has led to a unique set of circumstances, straining health-care systems and affecting the way of life in societies around the world. Measures such as social isolation, travel restrictions, and workplace closures have led to an increase in motorcycle use. Consequently, motorcycle accidents have become a significant problem during this period. This study presents detailed research conducted to examine motorcycle accidents during the COVID-19 pandemic and to understand the causes and consequences of the increase in these accidents. ⋯ This clinical study's findings demonstrate that the measures implemented during the pandemic to limit society's mobility have led to an increase in motorcycle accidents. Notably, there has been a significant rise in the number of accidents, particularly involving individual motorcycle use and motorcycle courier services.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Identification of complicated and non-complicated appendicitis: a new alvarado-based scoring system.
In the presence of non-complicated appendicitis, treatment typically involves a simple appendectomy and can even be managed medically. However, in cases of complicated appendicitis, surgery becomes more difficult, and the morbidity and mortality rates increase. This study aims to develop a method for recognizing complicated acute appendicitis operatively. ⋯ It is critical to identify perioperative and postoperative complications, provide appropriate patient counseling, and consider medical treatment when appropriate to diagnose acute complex appendicitis effectively. The new scoring system is an effective method for recognizing acute complicated appendicitis.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Case ReportsA case of seatbelt-induced mesenteric injury and delayed colon ischemia after a car accident.
Trauma is the sixth leading cause of death globally and the leading cause of morbidity and mortality in young patients. Blunt bowel and mesenteric injuries are rare, occuring in only 1-5% of blunt abdominal traumas, and are associated with high morbidity and mortality. In this report, we present a case of a patient with sigmoid colon perforation due to ischemia caused by mesenteric injury, who was admitted to the hospital with abdominal pain two days after a car accident. ⋯ He was discharged in good health after a 20-day hospital stay. Thorough clinical examination and radiological evaluation can aid in detecting visceral injuries in trauma patients. Early recognition and repair of intestinal damage can prevent severe complications.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Hollow viscus injury due to blunt abdominal trauma: a tertiary trauma center experience.
Hollow viscus injuries (HVIs) present less frequently than solid organ injuries in patients with blunt abdominal trauma, potentially leading to significantly increased morbidity and mortality rates. Modern imaging equipment, confidently used for diagnosing solid organ injuries, may fail to identify hollow viscus injuries. In this study, we aim to present our tertiary center's experience with this entity. ⋯ Nondeclining white blood cell (WBC) counts within 24 hours of admission, alongside any physical or radiological finding indicating an HVI, should prompt immediate surgical exploration.