European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2021
Review Meta AnalysisThe effect of postoperative respiratory and mobilization interventions on postoperative complications following abdominal surgery: a systematic review and meta-analysis.
Up to 30% of patients undergoing abdominal surgery suffer from postoperative pulmonary complications. The purpose of this systematic review and meta-analyses was to investigate whether postoperative respiratory interventions and mobilization interventions compared with usual care can prevent postoperative complications following abdominal surgery. ⋯ The use of postoperative expiratory resistance modalities (CPAP, EPAP, BiPAP, NIV) after abdominal surgery might prevent pulmonary complications and it seems the preventive abilities were largely driven by postoperative treatment with CPAP.
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Eur J Trauma Emerg Surg · Aug 2021
Meta AnalysisDiagnostic approach for myocardial contusion: a retrospective evaluation of patient data and review of the literature.
Myocardial contusion can be a life-threatening condition in patients who sustained blunt thoracic trauma. The diagnostic approach remains a subject of debate. The aim of this study was to determine the sensitivity and specificity of echocardiography, electrocardiography, troponins T and I (TnT and TnI), and creatine kinase muscle/brain (CK-MB) for identifying patients with a myocardial contusion following blunt thoracic trauma. ⋯ The best diagnostic approach for myocardial contusion is a combination of electrocardiography and measurement of cardiac biomarkers. If abnormalities are found, telemonitoring is necessary for the early detection of life-threatening arrhythmias. Chest X-ray and CT scan may show other thoracic injuries but provide no information on myocardial contusion.
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Eur J Trauma Emerg Surg · Aug 2021
ReviewCurrent treatment and outcomes of traumatic sternovertebral fractures: a systematic review.
Combined sternal and spinal fractures are rare traumatic injuries with significant risk of spinal and thoracic wall instability. Controversy remains with regard to treatment strategies and the biomechanical need for sternal fixation to achieve spinal healing. The present study aimed to assess outcomes of sternovertebral fracture treatment. ⋯ Literature on traumatic sternovertebral fracture treatment is sparse. Findings indicate that in most patients, sternal fixation is not required to achieve sternal and spinal stability. However, results of the current review should be cautiously interpreted, since most included studies were of poor quality.
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Eur J Trauma Emerg Surg · Aug 2021
Meta AnalysisInternal fixation or primary arthrodesis for Lisfranc complex joint injuries? A meta-analysis of comparative studies.
Though uncommon, Lisfranc complex joint injuries constitute a therapeutic challenge. Two surgical methods are commonly used to treat such injuries: open reduction and internal fixation (ORIF) and primary arthrodesis (PA). The aim of this meta-analysis is to look for significant differences in the outcomes between these two techniques. ⋯ This meta-analysis demonstrated that even with a similar union rate, PA could be a better option in treating Lisfranc complex joint injuries when compared to ORIF. There is a need for larger controlled sampled studies to research on this type of injuries.
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Eur J Trauma Emerg Surg · Aug 2021
ReviewProne ventilation as treatment of acute respiratory distress syndrome related to COVID-19.
Prone ventilation refers to the delivery of mechanical ventilation with the patient lying in the prone position. The improvement of oxygenation during prone ventilation is multifactorial, but occurs mainly by reducing lung compression and improving lung perfusion. ⋯ In view of different roles, we surgeons had to take during the COVID-19 pandemic, it is of importance to learn how to implement this therapeutic measure, especially in a surgical critical care unit setting. As such, this article aims to review the physiological principles and effects of the prone ventilation, positioning, as well as its contraindications and complications.