European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2014
Contrast enhanced ultrasound (CEUS) reliably detects critical perfusion changes in compartmental muscle: a model in healthy volunteers.
The purpose of this study was to assess the utility of contrast enhanced ultrasound (CEUS) in the differentiation between physiological and simulated pathophysiological lower limb muscle perfusion pressures in healthy volunteers. ⋯ CEUS provides a reliable non-invasive imaging modality for the assessment of lower limb muscle perfusion pressures. This may be of clinical use in the assessment of a developing compartment syndrome. Further clinical studies are required to further define its accuracy and reproducibility.
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Eur J Trauma Emerg Surg · Oct 2014
Risk factors for liver abscess formation in patients with blunt hepatic injury after non-operative management.
To identify risk factors for liver abscess formation in patients with blunt hepatic injury who underwent non-operative management (NOM). ⋯ TAE, high-grade hepatic injury, and a high GPT level are independent risk factors for liver abscess formation.
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Multiple studies have demonstrated a linear association between advancing age and mortality after injury. An inflection point, or an age at which outcomes begin to differ, has not been previously described. We hypothesized that the relationship between age and mortality after injury is non-linear and an inflection point exists. ⋯ The risk of death after injury varies linearly with age until 84 years. After 84 years of age, the mortality rates decline. These findings may reflect the varying severity of comorbidities and differences in baseline functional status in elderly trauma patients. Specifically, a proportion of our injured patient population less than 84 years old may be more frail, contributing to increased mortality after trauma, whereas a larger proportion of our injured patients over 84 years old, by virtue of reaching this advanced age, may, in fact, be less frail, contributing to less risk of death.
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Eur J Trauma Emerg Surg · Oct 2014
The role of non-invasive ventilation in blunt chest trauma: systematic review and meta-analysis.
Respiratory support is the mainstay for the management of patients with pulmonary contusion following blunt chest trauma. In patients not requiring immediate intubation and ventilation, the optimal respiratory management strategy is not clear. This systematic review and meta-analysis aimed to determine the efficacy of non-invasive ventilation (NIV), as compared to traditional respiratory support strategies (i.e., high-flow facemask oxygen or pre-emptive intubation and ventilation), in adult patients with blunt chest trauma. ⋯ This meta-analysis suggests that NIV is superior to both high-flow facemask oxygen or pre-emptive intubation and ventilation in patients with blunt chest trauma who have no contraindication to NIV.
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Eur J Trauma Emerg Surg · Oct 2014
Adherence to protocol in pregnant trauma patients? A 12-year retrospective study.
We investigated whether the standard (ATLS) trauma protocol was adhered to in cases of suspected multi-traumatized pregnant patients and if serious injuries were overlooked. We hypothesized that radiographic studies would be less frequent in pregnant trauma patients. ⋯ Adherence to the ATLS protocol in pregnant trauma patients was low in relation to radiographic studies but, in spite of this, no known significant injuries were missed. We found that a pelvic fracture seems to be predictive of a high risk of obstetric complications, such as intrauterine death or the need for cesarean section, but we were not able to relate trauma in general to a higher risk of cesarean section or premature birth.