European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2017
Controlled Clinical TrialInhalational Ciclesonide found beneficial in prevention of fat embolism syndrome and improvement of hypoxia in isolated skeletal trauma victims.
Many studies have established intravenous corticosteroid as an effective prophylactic therapy in fat embolism syndrome (FES). However, its use is limited among surgeons because of systemic side effects. Inhalational steroids have least systemic effects and are widely used for several chest conditions (i.e., asthma), but their effectiveness in FES has not been established. ⋯ Level III, therapeutic study.
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Eur J Trauma Emerg Surg · Jun 2017
Low serum albumin may predict the need for gastric resection in patients with perforated peptic ulcer.
Perforated peptic ulcer (PPU) is a common surgical emergency and treatment involves omental patch repair (PR). Gastric resection (GR) is reserved for difficult pathologies. We audit the outcomes of GR at our institution and evaluate the pre-operative factors predicting the need for GR. ⋯ GR is needed in one in ten cases of PPU. Low serum albumin predicted the need for GR on multivariate analysis. Morbidity and mortality of GR remains high.
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Eur J Trauma Emerg Surg · Jun 2017
Minimally traumatic submental intubation: a novel dilational technique.
Submental intubation is widely accepted as a safe and effective alternative to nasal intubation or tracheostomy in head and neck surgery patients. Forceful or careless technique can cause significant bleeding and trauma to the soft tissues at this point, increasing the likelihood of troublesome sublingual haematoma. ⋯ Patients will sometimes require a protected airway that allows surgeons unrestricted and simultaneous access to the dental occlusion, oral cavity, midface, and nose. In our case, this simple, easy, and quick adaptation of an established technique using a tracheostomy dilator is an excellent alternative to the traditional blunt dissection used to achieve submental intubation.
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Eur J Trauma Emerg Surg · Jun 2017
Multicenter Study Comparative StudyScoring severity in trauma: comparison of prehospital scoring systems in trauma ICU patients.
We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard. ⋯ Both MGAP and GAP scores performed better than the T-RTS in the prediction of hospital mortality in Spanish trauma ICU patients. Since these are easy-to-perform scores, they should be incorporated in clinical practice as a triaging tool.
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Eur J Trauma Emerg Surg · Jun 2017
30-Day, 90-day and 1-year mortality after emergency colonic surgery.
Emergency surgery is an independent risk factor in colonic surgery resulting in high 30-day mortality. The primary aim of this study was to report 30-day, 90-day and 1-year mortality rates after emergency colonic surgery, and to report factors associated with 30-day, 90-day and 1-year mortality. Second, the aim was to report 30-day postoperative complications and their relation to in-hospital mortality. ⋯ Mortality and complication rates after emergency colonic surgery are high and associated with patient related risk factors that cannot be modified, but also treatment related outcomes that are modifiable. An increased focus on medical and other preventive measures should be explored in the future.