J Trauma
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To evaluate the functional outcome and return to work after suture of upper extremity nerves after low-velocity missile injury. ⋯ Nerve suture between the wrist and axilla and supplemental techniques achieve functional recovery in the majority of patients after missile injury with good expectations for return to work, except in combined median and ulnar nerve injuries.
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Review Case Reports
Seat belt-related injury to the common iliac artery: case report and review of the literature.
Blunt trauma to the common iliac artery is a rare phenomenon. Although seat belt injuries to the abdominal aorta and the carotid artery have been reported, there is only one previous report in the literature of seat belt injury to the common iliac artery. We report a case of common iliac arterial injury directly related to use of the lap belt and not associated with pelvic or lumbar fractures. The literature related to blunt trauma of the common iliac artery is reviewed.
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Randomized Controlled Trial Clinical Trial
Hemodynamic and ventilatory effects associated with increasing inverse inspiratory-expiratory ventilation.
Increasing the percentage of inspiratory time during mechanical ventilation (i.e., inverse inspiratory-expiratory (I:E) ventilation) is frequently used to improve oxygenation in patients with acute respiratory distress syndrome; however, an optimal I:E ratio is unknown. ⋯ These findings demonstrate the effectiveness of increasing inspiratory time to improve oxygenation, yet to the detriment of ventilation. This suggests that within the parameter confines of this study, the preferential I:E ratio is a balance between oxygen demands and ventilatory requirements.
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In 1987, the article "The Demographics of Trauma in 1995" (DT95) attempted to predict the future needs of trauma centers based on changing population distributions. This article foresaw a relative increase in the number of injuries to the elderly and a relative decrease in total injuries. Based on these predictions, the paper recommended increasing the capabilities of existing trauma centers rather than developing new facilities. We compared these predictions to actual experience to validate this use of demographic data in trauma system planning. ⋯ Demographic projections assist in predicting the number and type of future injuries. Sociologic and economic factors also need to be considered in any predictive determinations of the true demand for trauma centers.
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Comparative Study
Cardiopulmonary function after pulmonary contusion and partial liquid ventilation.
To compare the effects of mechanical ventilation with either positive end-expiratory pressure (PEEP) or partial liquid ventilation (PLV) on cardiopulmonary function after severe pulmonary contusion. ⋯ Both PEEP and PLV improved pulmonary function after severe unilateral pulmonary contusion, but negative hemodynamic and histologic changes were associated with PEEP and not with PLV. These data suggest that PLV is a promising novel ventilatory strategy for unilateral pulmonary contusion that might ameliorate secondary injury in the contralateral uninjured lung.