Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Jun 2013
Gastrointestinal tract access for enteral nutrition in critically ill and trauma patients: indications, techniques, and complications.
Enteral nutrition (EN) is a widely used, standard-of-care technique for nutrition support in critically ill and trauma patients. ⋯ In critically ill and trauma patients, early EN through the stomach should be instituted whenever feasible. Other approaches can be used according to patient needs, available expertise, and institutional guidelines. More research is needed in order to ensure the safe use of surgical tubes in the open abdomen.
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Eur J Trauma Emerg S · Jun 2013
Contralateral extraaxial hematomas after urgent neurosurgery of a mass lesion in patients with traumatic brain injury.
The development of a contralateral extraaxial hematoma has repeatedly been described in small series and descriptive studies. However, the evidence available to date is limited. ⋯ Contralateral extraaxial hematoma is a rare entity, although it has a high mortality rate. Therefore, it requires a high index of suspicion, especially in patients with severe TBI, with minimal contralateral injury and mainly with contralateral skull fracture on the initial CT scan.
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Eur J Trauma Emerg S · Jun 2013
Serum cleaved tau protein and traumatic mild head injury: a preliminary study in the Thai population.
To determine the correlation between serum cleaved tau protein and traumatic mild head injury (MHI) (GCS 13-15). ⋯ As it was uncorrelated with traumatic MHI, serum cleaved tau protein proved to be an unreliable biomarker to use in the early detection of and decision-making for traumatic MHI patients at the emergency department.
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Eur J Trauma Emerg S · Jun 2013
Nutritional support in patients following damage control laparotomy with an open abdomen.
Damage control laparotomy (DCL) and the open abdomen have been well accepted following either severe abdominal trauma or emergency surgical disease. As DCL is increasingly utilized as a therapeutic option, appropriate management of the post-DCL patient is important. Early caloric support by enteral nutrition (EN) in the critically ill patient improves wound healing and decreases septic complications, lung injury, and multi-system organ failure. However, following DCL, nutritional strategies can be challenging and, at times, even daunting. ⋯ Even though limited data exist, the use of early EN following DCL seems safe, provided that the patient is not undergoing active resuscitation or the bowel is not in discontinuity. It is unknown as to whether EN in the open abdomen reduces septic complications, prevents enterocutaneous fistula (ECF), or alters the timing of definitive abdominal wall closure. Future investigation in a prospective manner may help elucidate these important questions.
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Eur J Trauma Emerg S · Jun 2013
Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment.
Serial rib fractures and flail chest injury can be treated by positive-pressure ventilation. Operative techniques reduce intensive care unit (ICU) stay, overall costs, mortality and morbidity, as well as pain. The aim of this study was to evaluate the benefit of surgical rib stabilisation in comparison to non-operative treatment in patients with severe trauma of the chest wall. ⋯ Operative rib stabilisation with plates is a safe therapy option for severe trauma of the chest wall. Provided that the duration of preoperative mechanical ventilation and time spent in the ICU is minimised due to early operation, our data suggest that the stabilisation of serial rib fractures and flail chest may lead to a reduced time of mechanical ventilation, time in the ICU and mortality.