Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Observational StudyEasy method to determine fluid responsiveness in septic shock patients: end-tidal CO2 - a prospective observational study.
In critically ill patients, especially those with septic shock, fluid management can be a challenging aspect of clinical care. One of the primary steps in treating patients with hemodynamic instability is optimizing intravascular volume. The Passive Leg Raising (PLR) maneuver is a reliable test for assessing fluid responsiveness, as demonstrated by numerous studies and meta-analyses. However, its use requires the measurement of cardiac output, which is often complex and may necessitate clinician experience and specialized equipment. End-Tidal Carbon Dioxide (ETCO2) measurement is relatively easy and is generally stable under steady metabolic conditions. It depends on the body's CO2 production, diffusion of CO2 from the lungs into the bloodstream, and cardiac output. If the other two parameters (metabolic conditions and minute ventilation) are constant, ETCO2 can provide information about cardiac output. The aim of the present study is to investigate the sensitivity of ETCO2 measurement in demonstrating fluid responsiveness. ⋯ This study demonstrates that in septic patients, ETCO2 during the PLR test can indicate fluid responsiveness with high sensitivity and specificity and can be used as an alternative to cardiac output measurement.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Hollow viscus injury due to blunt abdominal trauma: a tertiary trauma center experience.
Hollow viscus injuries (HVIs) present less frequently than solid organ injuries in patients with blunt abdominal trauma, potentially leading to significantly increased morbidity and mortality rates. Modern imaging equipment, confidently used for diagnosing solid organ injuries, may fail to identify hollow viscus injuries. In this study, we aim to present our tertiary center's experience with this entity. ⋯ Nondeclining white blood cell (WBC) counts within 24 hours of admission, alongside any physical or radiological finding indicating an HVI, should prompt immediate surgical exploration.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Effects of lercanidipine on traumatic spinal cord injury: an experimental study.
Spinal cord injury is a devastating trauma that leaves survivors at risk for several medical complications throughout their lives. Lercanidipine, a third-generation calcium channel blocker, possesses anti-apoptotic, anti-inflammatory, and antioxidative properties. This study aimed to evaluate the neuroprotective effects of lercanidipine in an experimental spinal cord trauma model. ⋯ Lercanidipine, a third-generation calcium channel blocker, is effective against inflammatory responses induced in spinal cord injury. Further studies are required to determine its capability in preventing apoptosis or improving functional recovery. To the best of our knowledge, this study is the first in the literature to examine the neuroprotective effects of lercanidipine on spinal cord injury.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Evaluating the effectiveness of inflammatory markers in pediatric open globe injury using a modified pediatric ocular trauma score.
This study aims to assess pediatric patients with Open Globe Injury (OGI) using the Modified Pediatric Ocular Trauma Score (MPOTS) and to investigate the correlation between Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lympho-cyte ratio (PLR) parameters with the prognosis determined by MPOTS. ⋯ The Modified Pediatric Ocular Trauma Score is an effective and practical method for assessing the prognosis of pediatric patients with Open Globe Injury (OGI). Furthermore, there is evidence indicating a negative correlation between MPOTS and the increase in NLR and PLR values that often follows OGI in this patient population.
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Ulus Travma Acil Cerrahi Derg · Feb 2024
Observational StudyEvaluating emergency department visits for spontaneous and traumatic pneumomediastinum: a retrospective analysis.
Pneumomediastinum signifies the accumulation of air within the mediastinum. This condition can develop sponta-neously or as a secondary condition due to trauma or iatrogenic causes. Although rare, it is part of a wide differential diagnosis scale due to its most common presenting symptoms: chest pain and shortness of breath. ⋯ Upon examining the causes of pneumomediastinum cases, it was observed that patients with a history of trauma required thoracostomy tube insertion and surgical intervention more frequently. However, when classified as spontaneous or trau-matic, both groups exhibited similar clinical courses and outcomes. Both groups demonstrated favorable clinical outcomes.