Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2013
Head Computed Tomographic measurement as an early predictor of outcome in hypoxic-ischemic brain damage patients treated with hypothermia therapy.
Neurological abnormalities are a key factor in the prognosis of patients with post-cardiac arrest syndrome. In this study, we evaluated whether differences in CT measurements expressed in Hounsfield units (HUs) of the cerebral cortex and white matter can be used as early predictors of neurological outcome in patients treated with hypothermia therapy after hypoxic-ischemic brain damage. ⋯ This study showed that DCW values may be used for the prediction of neurological outcome of patients with post-cardiac arrest syndrome in the very early phase following the return of spontaneous circulation. Especially, a cut-off value for DCW of less than 5.5 may indicate poor neurological outcome.
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Scand J Trauma Resus · Jan 2013
Predictors of cardiopulmonary arrest outcome in a comprehensive cancer center intensive care unit.
Some comprehensive cancer centers in industrialized countries have reported improved outcomes in their cardiopulmonary arrest (CPA) patients. Little is known about the outcomes and predictors of CPA in cancer centers in other parts of the world. The objective of this study was to examine the predictors of CPA outcome in a comprehensive cancer center closed medical-surgical intensive care unit (ICU) located in Amman, Jordan. ⋯ Survival among cancer patients who develop CPA in the ICU continues to be poor. Once cancer patients suffered a CPA in the ICU multiple factors predicted resuscitation failure but CPR duration was the only factor that predicted resuscitation failure and ICU as well as hospital mortality.
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Scand J Trauma Resus · Jan 2013
Comparative StudyHospital out-lying through lack of beds and its impact on care and patient outcome.
When medical wards become saturated, the common practice is to resort to outlying patients in another ward until a bed becomes free. ⋯ O patients had a worse prognosis than NO patients.
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Scand J Trauma Resus · Jan 2013
Exclusion of context knowledge in the development of prehospital guidelines: results produced by realistic evaluation.
Prehospital work is accomplished using guidelines and protocols, but there is evidence suggesting that compliance with guidelines is sometimes low in the prehospital setting. The reason for the poor compliance is not known. The objective of this study was to describe how guidelines and protocols are used in the prehospital context. ⋯ The personnel take a positive view of the use of guidelines and protocols in prehospital work. The main obstacle to the use of guidelines and protocols in this organization is the format, due to the exclusion of context knowledge in the development process.
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Scand J Trauma Resus · Jan 2013
Observational StudyTime course of soluble P-selectin and von Willebrand factor levels in trauma patients: a prospective observational study.
Coagulopathy often develops in patients with serious trauma and is correlated with the clinical outcome. The contribution of platelet activity and endothelial dysfunction to trauma-induced coagulopathy remain to be defined. The purpose of this study was to investigate the time courses of soluble P-selectin (sPsel, an index of platelet activation) and von Willebrand factor (VWF, an index of endothelial dysfunction) in trauma patients and elucidate their relationship to coagulation parameter levels, the presence of coagulopathy, and patient outcome. ⋯ In severely injured trauma patients in the ICU, lower levels of sPsel and VWF on admission were associated with the presence of coagulopathy and might not predict a better outcome. An increase in the VWF level at the end of the first week after admission to ICU was associated with increased 30-day mortality.