Scand J Trauma Resus
-
Scand J Trauma Resus · Jan 2010
Systemic central venous oxygen saturation is associated with clot strength during traumatic hemorrhagic shock: A preclinical observational model.
Clot strength by Thrombelastography (TEG) is associated with mortality during trauma and has been linked to severity of tissue hypoperfusion. However, the optimal method for monitoring this important relationship remains undefined. We hypothesize that oxygen transport measurements will be associated with clot strength during traumatic shock, and test this hypothesis using a swine model of controlled traumatic shock. ⋯ Among multiple measurements of oxygen transport, only ScvO₂ was found to retain a significant association with TEG-MA during shock after adjusting for multiple covariates. ScvO₂ should be further studied for its utility as a clinical marker of both tissue hypoxia and clot formation during traumatic shock.
-
Scand J Trauma Resus · Jan 2010
Comparative StudyCuff overinflation and endotracheal tube obstruction: case report and experimental study.
Initiated by a clinical case of critical endotracheal tube (ETT) obstruction, we aimed to determine factors that potentially contribute to the development of endotracheal tube obstruction by its inflated cuff. Prehospital climate and storage conditions were simulated. ⋯ We could not demonstrate a critical obstruction of an ETT by its inflated cuff, neither when the cuff was over-inflated to a pressure of 12 kPa or higher, nor in ETTs that had been exposed to unfavorable storage conditions and significant mechanical stress.
-
Scand J Trauma Resus · Jan 2010
A first city-wide early defibrillation project in a German city: 5-year results of the Bochum against sudden cardiac arrest study.
Immediate defibrillation is the decisive determinant of prognosis in patients suffering from cardiac/circulatory arrest caused by ventricular fibrillation (VF). Therefore, various national and international associations recommend that first responders use defibrillators as soon as possible and also recommend public access to early defibrillation programmes. Here we report the results of the first city-wide early defibrillation project in a large German urban area. ⋯ Consistent with other reports, our findings show that the organisation of a city-wide initiative by a project office combining public access and first-responder defibrillation programmes can be safe, feasible and successful. Our experiences confirm that strategic planning of AED placement is a prerequisite for successful, cost-effective resuscitation.
-
Scand J Trauma Resus · Jan 2010
Blood product ratio in acute traumatic coagulopathy--effect on mortality in a Scandinavian level 1 trauma centre.
Trauma is the leading cause of loss of life expectancy worldwide. In the most seriously injured patients, coagulopathy is often present on admission. Therefore, transfusion strategies to increase the ratio of plasma (FFP) and platelets (PLT) to red blood cells (RBC), simulating whole blood, have been introduced. Several studies report that higher ratios improve survival in massively bleeding patients. Here, the aim was to investigate the potential effect of increased FFP and PLT to RBC on mortality in trauma patients. ⋯ Aggressive administration of FFP and PLT did not influence mortality in the present trauma population.
-
Scand J Trauma Resus · Jan 2010
Time needed to achieve completeness and accuracy in bedside lung ultrasound reporting in intensive care unit.
The use of lung ultrasound (LUS) in ICU is increasing but ultrasonographic patterns of lung are often difficult to quantify by different operators. The aim of this study was to evaluate the accuracy and quality of LUS reporting after the introduction of a standardized electronic recording sheet. ⋯ The uniformity in teaching programme and examinations reporting system permits to improve the level of completeness and accuracy of LUS reporting, helping physicians in following lung pathology evolution.