J Trauma
-
Multicenter Study Comparative Study
Blunt traumatic occult pneumothorax: is observation safe?--results of a prospective, AAST multicenter study.
An occult pneumothorax (OPTX) is found incidentally in 2% to 10% of all blunt trauma patients. Indications for intervention remain controversial. We sought to determine which factors predicted failed observation in blunt trauma patients. ⋯ Most blunt trauma patients with OPTX can be carefully monitored without tube thoracostomy; however, OPTX progression and respiratory distress are independently associated with observation failure.
-
Multicenter Study Comparative Study
Routine follow-up imaging of kidney injuries may not be justified.
The purpose of this investigation was to determine the yield of repeat follow-up imaging in patients sustaining renal trauma. ⋯ Selective reimaging of renal injuries based on clinical and laboratory criteria seems to be safe regardless of injury mechanism or management. High-grade penetrating injuries undergoing operative intervention should carry the highest degree of vigilance and lowest threshold for repeat imaging.
-
Case Reports
Clinical application of the flap based on the distal cutaneous branch of the ulnar artery.
To introduce our experiences of using the flap based on the distal cutaneous branch of the ulnar artery. ⋯ Because the flap does not compromise the dominant hand arteries and provides a reliable blood supply, it is a good choice for soft tissue reconstruction of defects in the dorsal and palmar aspects of the hand.
-
Comparative Study Controlled Clinical Trial
Mortality and regional oxygen saturation index in septic shock patients: a pilot study.
Peripheral muscle tissue oxygenation determined noninvasively using near-infrared spectroscopy may help to identify tissue hypoperfusion in septic patients. The aim of this study was to investigate regional oxygen saturation index (rSO2) in the brachioradialis (forearm) muscle by comparing measurements in healthy subjects and in intensive care unit (ICU) septic shock patients, and determine whether brachioradialis muscle rSO2 is associated with poor outcome in ICU septic shock patients. ⋯ We observed that septic shock patients with forearm skeletal muscle rSO2≤60% throughout first 24 hours after ICU admission had significantly greater mortality rate than patients with forearm skeletal muscle rSO2>60% throughout this critical time.
-
Comparative Study
Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications.
The objective was to clarify the role of hepatic arterial embolization (AE) in the management of blunt hepatic trauma. ⋯ AE is a key element in modern management of high-grade liver injuries. Two principal indications exist in the acute postinjury phase: primary hemostatic control in hemodynamically stable or stabilized patients with radiologic computed tomography evidence of active arterial bleeding and adjunctive hemostatic control in patients with uncontrolled suspected arterial bleeding despite emergency laparotomy. Successful management of injuries of grade III upward often entails a combined angiographic and surgical approach. Awareness of the ischemic complications due to angioembolization is important.