European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2020
Contributing factors in the development of acute lung injury in a murine double hit model.
Blunt chest (thoracic) trauma (TxT) is known to contribute to the development of secondary pulmonary complications. Of these, acute lung injury (ALI) is common especially in multiply injured patients and might not only be due to the direct trauma itself, but seems to be caused by ongoing and multifactorial inflammatory changes. Nevertheless, the exact mechanisms and contributing factors of the development of ALI following blunt chest trauma are still elusive. ⋯ Early observed lung injury with moderate inflammatory changes after blunt chest trauma recovered quickly, and therefore, may be caused by mechanical lung injury. In contrast, lung injury in the ALI group did not undergo recovery and is closely associated with significant changes of inflammatory mediators. This model may be used for further examinations of contributing factors and therapeutic strategies to prevent ALI.
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Eur J Trauma Emerg Surg · Dec 2019
Observational StudyNon-invasive cardiac output monitoring device "ICON" in trauma patients: a feasibility study.
Assessment of hemodynamics is crucial for the evaluation of major trauma patients. Cardiac output (CO) monitoring provides additional information and may improve volume resuscitation. The goal of this prospective pilot study was to evaluate the feasibility of a new non-invasive CO monitoring (NICOM) device in the emergency department (ED). ⋯ Non-invasive CO monitoring proved to be feasible and safe for the initial hemodynamic evaluation of trauma patients. Problems with the NICOM device were detachment of electrodes and temporary signal loss. Due to the small sample size and relatively low injury burden of the patients included in this study, further prospective investigation is warranted.
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Eur J Trauma Emerg Surg · Dec 2019
Mid-term outcomes of endovascular repair for traumatic thoracic aortic injury: a single-center experience.
Thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury (TTAI) reports short-term benefits. However, long-term durability and the need of reintervention remain unclear. Here, we determined mid-term outcome of TEVAR for TTAI and investigated the influence of the length of proximal landing zone on aorta. ⋯ In selective TTAI patients for TEVAR, the length of proximal landing zone did not considerably influence the aorta size or needed further reintervention.
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Eur J Trauma Emerg Surg · Dec 2019
ReviewSelective non-operative management for penetrating splenic trauma: a systematic review.
The treatment of abdominal solid organ injuries has shifted towards non-operative management (NOM). However, the feasibility of NOM for penetrating splenic trauma is unclear and outcome is believed to be worse than NOM for penetrating liver and kidney injuries. Hence, the aim of the current systematic review was to evaluate the feasibility of selective NOM in penetrating splenic injury. ⋯ This review demonstrates that non-operative management for penetrating splenic trauma in highly selected patients has been utilized in several well-equipped and experienced trauma centers. NOM of penetrating splenic injury in selected patients is not associated with increased morbidity nor mortality. Data on the less well-equipped and experienced trauma centers are not available. More prospective studies are required to further define exact selection criteria for non-operative management in splenic trauma.
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Eur J Trauma Emerg Surg · Dec 2019
Efficacy and safety of TEVAR with debranching technique for blunt traumatic aortic injury in patients with severe multiple trauma.
Blunt traumatic aortic injury (BTAI) patients are severely ill, with high mortality and morbidity. As 60% of BTAIs occur in the distal arch, left subclavian artery (LSCA) management is determined without knowing posterior cerebral or left arm circulation in emergent cases. Because we perform thoracic endovascular aortic repair (TEVAR) + debranching technique for thoracic BTAI, we assessed efficacy and safety of debranching TEVAR in BTAI patients. ⋯ Despite debranching TEVAR taking approximately 60 min longer than simple TEVAR, short-term results indicated it to be acceptable for BTAI in multiple trauma patients to avoid LSCA complications unless we fail to stop bleeding first.