J Trauma
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Multicenter Study
Percutaneous computed tomographic-controlled ventriculostomy in severe traumatic brain injury.
Percutaneous computed tomographic (CT)-controlled ventriculostomy (PCV) was introduced for the monitoring of intracranial pressure in patients with severe traumatic brain injury who did not require simultaneous decompressive trepanation. ⋯ Distinct time savings are the major advantages of PCV, allowing exact catheter positioning even with very narrow ventricles.
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It is essential to identify patients at high risk of death and complications for future studies of interventions to decrease reperfusion injury. ⋯ Hemorrhage-induced hypotension in trauma patients is predictive of high mortality (54%) and morbidity. The requirement for large volumes of crystalloid was associated with increased mortality.
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To study the viability, reliability, and validity of the Spanish version of the Burn-Specific Health Scale. ⋯ The Spanish version of the Burn-Specific Health Scale is a reliable and valid instrument for use in the Spanish population, and its results are perfectly comparable with those obtained in the original English version.
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Hemoglobin-based blood substitutes may cause vasoconstriction, which could limit organ perfusion during trauma resuscitation. We investigated the effect of two hemoglobin solutions on regional blood flow and mucosal perfusion in the gastrointestinal tract in a hemorrhagic shock model. ⋯ PHP was efficacious in restoring CI and small-bowel flow, but the pHi remained low, indicating possible continued mucosal ischemia. Alpha(alpha)Hb led to limited recovery of CI and small-bowel blood flow but restored pHi close to baseline. Shed blood was efficacious in restoration of pHi, gastrointestinal blood flows, and systemic hemodynamics.
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Changes in the management of torso gunshot wounds (TGSWs) have evolved in recent years as a result of differences between military and civilian injuries and increasing interest in avoiding nontherapeutic invasive procedures. The objective of this study was to establish the utility and accuracy of computed tomography (CT) in the evaluation of selected patients with TGSWs. ⋯ CT of selected TGSW patients is safe and may reduce the incidence of invasive diagnostic procedures. A prospective evaluation of CT for TGSW patients is warranted.