Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Oct 2008
Do C-reactive protein and body mass index predict duration of mechanical ventilation in critically ill trauma patients?
The predictive ability of body mass index (BMI) or C-reactive protein (CRP) as a simple, inexpensive, and dynamic marker of critical illness in patients requiring mechanical ventilation (MV) is unknown. This study was thus conducted to determine the incidence and presence of a relationship between the predictors of BMI or CRP and duration of MV in trauma patients admitted to the intensive care unit (ICU). ⋯ Both BMI and CRP, comparable with the SOFA score, can be used in estimating the risk of prolonged MV.
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Perioral electrical burns are rarely seen household injuries that cause both functional and aesthetic deformities requiring special consideration for reconstruction. The cause is usually a child younger than 3 years old biting an electrical cord. An eleven-month-old girl admitted to the emergency room with perioral electrical burn after biting an electrical cable of a television. ⋯ To reconstruct the lip defect, an inferior-based nasolabial flap from the lateral side was used. The mucosa of the flap was dissected and advanced to form the lower lip vermillion. With this case presentation, the principles and options for perioral electrical burns are presented.
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Prognostic factors affecting mortality and morbidity in thoracoabdominal injuries were evaluated. ⋯ It was determined that trauma-operation period >or=3 hours, number of injured organs >or=3, and increased number of blood transfusions increased both mortality and morbidity. However, presence of shock increased only mortality. On the other hand, application of closed thorax drainage within a reasonable time period was determined to decrease mortality and morbidity.
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Hemorrhage is the leading cause of trauma-related deaths. The early identification and surgical control of this hemorrhage is the crucial first step in the management of the injured patient; however, this objective remains challenging in the most critically ill trauma patients. As an adjunct to traditional methods of surgical hemorrhage control, several advanced hemostatic agents are currently available. ⋯ Materials such as Zeolite and Chitosan comprise the newest generation of local hemostatics and the efficacy and safety of these agents are currently under investigation. Recombinant factor VIIa has emerged recently as a promising systemic hemostatic adjunct for the treatment of intractable surgical bleeding; however, until completion of the ongoing multinational randomized control trial, the indications for its use in trauma patients and its safety profile are unclear. This article reviews the role of commercially available local and systemic hemostatic products in the trauma patient population; it also addresses the unique set of characteristics, indications, limitations and rationale for their use.
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Femoral neck fractures in young patients are the emergent injuries that require precise reduction and stable fixation. Despite all advances, nonunion and avascular necrosis (AVN) of the femoral head are the major complications necessitating salvage procedures. In this retrospective series, we evaluated the complications of internally fixed femoral neck fractures. ⋯ AVN is the most common complication of displaced femoral neck fractures. However, less than half of these cases require salvage procedures. Total hip replacement is the preferred treatment option for these cases.