Injury
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Gallbladder trauma is a rare injury. This study aimed to describe the significance of these injuries and the appropriate management strategies. ⋯ Gallbladder injury is rare but when encountered implies a significant degree of trauma. Although cholecystectomy is usually definitive, there is an association with other occult extra-hepatic biliary tract injuries. The severity of the associated injuries usually determines patient outcomes.
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Rhabdomyolysis is a frequent complication in war wounded. Its complex pathophysiology suggests that it not only affects kidneys but also other organs such as the liver. The aim of this study was to evaluate the relationship between creatine kinase (CK) and liver enzymes in war wounded with rhabdomyolysis. ⋯ IV STUDY TYPE: Diagnostic.
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Alcohol withdrawal syndrome (AWS) is an uncommon occurrence in trauma victims. However, the syndrome can cause a prolonged hospital stay. Therefore, the purpose of this study is to develop and validate the risk factors of AWS so that interventions can be applied to high-risk patients. ⋯ Approximately 1.4% of the trauma victims developed AWS. Certain patient demographic and comorbidity characteristics, and head injury have a higher risk of developing of AWS.
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Mechanical ventilation of trauma patients is common, and many will require a higher than normal fraction of inspired oxygen (FiO2) to avoid hypoxaemia. The primary objective of this study was to assess the association between FiO2 and all-cause, one-year mortality in intubated trauma patients. ⋯ A fraction of inspired oxygen above 60% for more than 2 hours during the first 24 hours of admission was associated with increased mortality in intubated trauma patients in a duration-dependent manner. However, given the limitations of this retrospective study, the findings need to be confirmed in a larger, randomized set-up.
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Opiates are frequently used in the inpatient management of chest wall injury following blunt trauma. However, the daily sum of opiates used during acute care, and the impact that additional injuries or rib fracture displacement may have on daily opiate requirement is unknown. ⋯ This study has demonstrated the daily opioid requirement is maximal on day 2 post-admission following isolated major chest wall injury. The addition of a regional block resulted in a reduction of the average MME used each day over the first seven days post-admission, compared to ketamine when added to PCA. The presence of displaced rib fractures or clavicle/scapular fractures increased the MME used each day, changed the day of peak consumption and increased the average daily opioid requirement during acute hospitalisation.