Articles: trauma.
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Scand J Trauma Resus · Jan 2014
Randomized Controlled TrialDose reduction in whole-body computed tomography of multiple injuries (DoReMI): protocol for a prospective cohort study.
Single-pass, contrast-enhanced whole body multidetector computed tomography (MDCT) emerged as the diagnostic standard for evaluating patients with major trauma. Modern iterative image algorithms showed high image quality at a much lower radiation dose in the non-trauma setting. This study aims at investigating whether the radiation dose can safely be reduced in trauma patients without compromising the diagnostic accuracy and image quality. ⋯ Although non-experimental, this study will generate first large-scale data on the utility of imaging-enhancing algorithms in whole-body MDCT for major blunt trauma.
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Scand J Trauma Resus · Jan 2014
Comparative StudyInterleukin-6 as inflammatory marker referring to multiple organ dysfunction syndrome in severely injured children.
Despite the suggestion that the inflammatory response in traumatized children is functionally unique, prognostic markers predicting pediatric multiple organ failure are lacking. We intended to verify whether Interleukin-6 (IL-6) displays a pivotal role in pediatric trauma similar to adults. ⋯ The presented prospective study is the first providing evidence for a correlation of IL-6 levels with injury severity and the incidence of MODS in traumatized children.
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Scand J Trauma Resus · Jan 2014
The impact of severe traumatic brain injury on a novel base deficit- based classification of hypovolemic shock.
Recently, our group has proposed a new classification of hypovolemic shock based on the physiological shock marker base deficit (BD). The classification consists of four groups of worsening BD and correlates with the extent of hypovolemic shock in severely injured patients. The aim of this study was to test the applicability of our recently proposed classification of hypovolemic shock in the context of severe traumatic brain injury (TBI). ⋯ The presence of TBI has no relevant impact on the applicability of the recently proposed BD-based classification of hypovolemic shock. This study underlines the role of BD as a relevant clinical indicator of hypovolaemic shock during the initial assessment in respect to haemostatic resuscitation and transfusion requirements.
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Scand J Trauma Resus · Jan 2014
Venoarterial extracorporeal life support in post-traumatic shock and cardiac arrest: lessons learned.
Venoarterial extracorporeal life support (VA-ECLS) is an effective support of acute hemodynamic collapse caused by miscellaneous diseases. However, using VA-ECLS for post-traumatic shock is controversial and may induce a disastrous hemorrhage. To investigate the feasibility of using VA-ECLS to treat post-traumatic shock or cardiac arrest (CA), a single-center experience of VA-ECLS in traumatology was reported. ⋯ Using VA-ECLS to treat post-traumatic shock/CA is challenging and requires multidisciplinary expertise.
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Periorbital ecchymosis (PE) is caused by blood tracking along tissue plains into periorbital tissues, causing discoloration in the upper and lower eyelids. This clinical feature is most commonly associated with basal skull fractures. Our objective is to present the first patient series describing the clinical features associated with traumatically induced PE. ⋯ Periorbital ecchymosis is a useful clinic sign that should alert the clinician to assess for skull fractures, intracranial haemorrhage, and cranial nerve injury. However, this series shows that PE can be associated with a variety of clinical features, is rarely accompanied by other classic signs of basal skull fracture, and most patients with PE do not have injuries severe enough to require surgical intervention or post-discharge rehabilitation.