Arch Surg Chicago
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A critical evaluation of monitoring in critical illness must recognize first that there are many different types of monitoring that may take place, and that each type of monitor may be evaluated appropriately by different standards. Monitoring may occur with imaging devices, analyzers that require the permanent removal of tissue or fluid for analysis, or monitors that observe physiology with either invasive or noninvasive methods without requiring an ex vivo sample.
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To identify computed tomographic (CT) findings in children who have experienced blunt trauma and who have known intestinal injuries and to correlate these findings with the findings of the initial physical examination. ⋯ The initial physical examination findings and CT evaluation can independently identify the presence of intestinal injury in approximately 25% of cases. In the remainder of cases, the awareness of the more subtle findings of bowel injury on a CT scan can complement the physical examination findings and potentially lead to a more timely intervention for bowel injury.
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To determine if blood transfusion is a consistent risk factor for postinjury multiple organ failure (MOF), independent of other shock indexes. ⋯ Blood transfusion is an early consistent risk factor for postinjury MOF, independent of other indexes of shock.
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To measure the effect of prehospital endotracheal intubation on outcome in patients with severe head injury and the percentage of these patients intubated in the field under existing protocol. ⋯ Prehospital endotracheal intubation was associated with improved survival in patients with blunt injury and scene Glasgow Coma Score of 8 or less, especially those with severe head injury by anatomic criteria. Broadening indications for intubation by paramedical personnel has great potential to improve outcome in patients with severe head injury.
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To determine the relationship between gastrointestinal intramucosal pH and myocardial oxygenation during isovolemic hemodilution in dogs with critical coronary artery stenoses. ⋯ Myocardium compromised by coronary stenosis is more sensitive to normovolemic hemodilution-induced ischemia than the normally perfused gut mucosa. This limits the potential utilization of the measurement of gastrointestinal intramucosal pH as a guide to tolerable levels of anemia in critically ill patients.