Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2012
Comparative StudyComplications of high grade liver injuries: management and outcomewith focus on bile leaks.
Although liver injury scale does not predict need for surgical intervention, a high-grade complex liver injury should alert the physician to expect an increased risk of hepatic complications following trauma. The aim of the current study was to define hepatic related morbidity in patients sustaining high-grade hepatic injuries that could be safely managed non-operatively. ⋯ A high complication rate following high-grade liver injuries should be anticipated. In patients with clinical evidence of biliary complications, CT scan is a useful diagnostic and therapeutic tool. AE, ERCP and temporary internal stenting, together with percutaneous drainage of intra-abdominal or intrahepatic bile collections, represents a safe and effective strategy for the management of complications following both blunt and penetrating hepatic trauma.
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Scand J Trauma Resus · Jan 2012
Case ReportsPain-related somatosensory evoked potentials and functional brain magnetic resonance in the evaluation of neurologic recovery after cardiac arrest: a case study of three patients.
This case series investigates whether painful electrical stimulation increases the early prognostic value of both somatosensory-evoked potentials and functional magnetic resonance imaging in comatose patients after cardiac arrest. Three single cases with hypoxic-ischemic encephalopathy were considered. A neurophysiological evaluation with an electroencephalogram and somatosensory-evoked potentials during increased electrical stimulation in both median nerves was performed within five days of cardiac arrest. ⋯ These preliminary findings suggest that the pain-related somatosensory evoked potentials performed to increase the prognosis of comatose patients after cardiac arrest are associated with regional brain activity showed by functional magnetic resonance imaging during median nerves electrical stimulation. More importantly, this cases report also suggests that somatosensory evoked potentials and functional magnetic resonance imaging during painful electrical stimulation may be sensitive and complementary methods to predict the neurological outcome in the acute phase of coma. Thus, pain-related somatosensory-evoked potentials may be a reliable and a cost-effective tool for planning the early diagnostic evaluation of comatose patients.
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Scand J Trauma Resus · Jan 2012
Intramedullary nailing of femoral shaft fractures in polytraumatized patients. a longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses.
Early intramedullary nailing (IMN) of long bone fractures in severely injured patients has been evaluated as beneficial, but has also been associated with increased inflammation, multi organ failure (MOF) and morbidity. This study was initiated to evaluate the impact of primary femoral IMN on coagulation-, fibrinolysis-, inflammatory- and cardiopulmonary responses in polytraumatized patients. ⋯ In the polytraumatized patients with femoral shaft fractures operated with primary IMN we observed a substantial response related to the initial trauma. We could not demonstrate any major additional IMN-related impact on the inflammatory responses or on the cardiopulmonary function parameters. These results have to be interpreted carefully due to the relatively few patients included.
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Scand J Trauma Resus · Jan 2012
Randomized Controlled Trial Multicenter StudyThe development of simple survival prediction models for blunt trauma victims treated at Asian emergency centers.
For real-time assessment of the probability of survival (Ps) of blunt trauma victims at emergency centers, this study aimed to establish regression models for estimating Ps using simplified coefficients. ⋯ These equations allow physicians to perform real-time assessments of survival by easy mental calculations at Asian emergency centers, which are overcrowded with blunt injury victims of traffic accidents.
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Scand J Trauma Resus · Jan 2012
ReviewPortable bedside ultrasound: the visual stethoscope of the 21st century.
Over the past decade technological advances in the realm of ultrasound have allowed what was once a cumbersome and large machine to become essentially hand-held. This coupled with a greater understanding of lung sonography has revolutionized our bedside assessment of patients. Using ultrasound not as a diagnostic test, but instead as a component of the physical exam, may allow it to become the stethoscope of the 21st century.