J Trauma
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Continuous renal replacement therapy (CRRT) is the preferred mode of renal replacement therapy in patients with acute brain injury (ABI). There are limited data available describing the effects of CRRT on intracranial pressure (ICP). This study aims to evaluate changes in ICP during CRRT in patients after ABI. ⋯ CRRT may have beneficial effects in patients with RIH. Given the high mortality rate and poor neurological outcome associated with RIH, further research may be warranted.
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Because of an increasing life expectancy of patients and the rising number of joint replacements, peri- and interprosthetic femoral fractures are a common occurrence in most trauma centers. This study was designed to answer two primary questions. First, whether the fracture risk increases with two intramedullary implants in one femur; and second, whether a compression plate osteosynthesis is sufficient for stabilizing an interprosthetic fracture. ⋯ Two intramedullary implants reduce the fracture strength significantly. If an interprosthetic fracture occurs, sufficient stability can be achieved by a lateral compression plate. Because two intramedullary implants in the femur may decrease the fracture strength, the treatment of supracondylar femoral fractures with a retrograde nail in cases with preexisting ipsilateral hip prosthesis should be reconsidered.
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The purpose of this study was to determine whether trauma patients who are intubated because of combativeness, and not because of medical necessity, have more complications resulting in longer lengths of stay. ⋯ The results from this study indicate that trauma patients who are intubated because of combativeness, and not because of medical necessity, have longer lengths of stay, increased incidence of pneumonia, and poorer discharge status when compared with matched controls. The outcomes of this group are similar to that of patients who are intubated because of medical necessity.
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Ultrasonography has been widely applied in clinical settings, and its role in the assessment of trauma has been approved. However, there are very few reports about its role in the management of mass casualties. ⋯ In our hospital, ultrasonography was widely used in the triage of earthquake victims, bedside examination of severe cases, and interventional treatments. The advantages of ultrasonography such as convenience, noninvasiveness, high accuracy, and repeatability have been sufficiently demonstrated in this mass casualty, where ultrasonography played a great role in the rescue of victims of Wenchuan earthquake.
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The purpose of this study was to determine the percentage of amputee soldiers who sustained their injury during the current conflicts in Afghanistan and Iraq and have returned to duty. In addition, the authors plan to identify the factors that influence the amputee's likelihood to return to duty. ⋯ During the 1980s, 11 of 469 amputees returned to active duty (2.3%). The number of amputees returning to duty has increased significantly, from 2.3% to 16.5%, due to advancements in combat casualty care and the establishment of centralized amputee centers.