Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · Jan 2009
[Total body CT scan as the primary diagnostic modality in multi-trauma patients].
Radiological imaging is highly protocolized during initial assessment of severely injured trauma patients. After an initial examination, radiography and ultrasound are performed. Imaging is frequently supplemented by CT scan of selective body areas. ⋯ Recent research on TBCT in multi-trauma patients shows promising results and several large European trauma centers have already protocolized this strategy. These studies lack a good study design, so more prospective research on clinical outcomes, cost effectiveness and radiation exposure is necessary. As part of a pilot study in preparation for a randomized multicenter study, the University Medical Centre in Amsterdam in the Netherlands is performing TBCT in severely injured trauma patients.
-
Since its introduction in 1984, selective decontamination of the digestive tract has had clear supporters and opponents. De Smet et al. conducted a large national study in 13 Dutch intensive care units, investigating the effects of the following 3 regimens on mortality: standard treatment, selective decontamination of the digestive tract and selective oropharyngeal decontamination. The results showed decontamination to have a clear benefit in terms of reducing mortality. Based on these results, decontamination should be used in all intensive care patients.