European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2020
Observational StudyMinute-to-minute urine flow rate variability: a retrospective survey of its ability to provide early warning of acute hypotension in critically ill multiple trauma patients.
Dynamic changes in urine output and neurological status are the recognized clinical signs of hemodynamically significant hemorrhage. In the present study, we analyzed the dynamic minute-to-minute changes in the UFR and also the changes in its minute-to-minute variability in a group of critically ill multiple trauma patients whose blood pressures were normal on admission to the ICU but who subsequently developed hypotension within the first few hours of their ICU admission. ⋯ We found that changes in UFRV correlate strongly with systolic and mean arterial blood pressures. We feel that this parameter could potentially serve as an early signal of hemodynamic deterioration due to occult bleeding in critically ill trauma patients, and might also be able to identify the optimal end-point of hemodynamic resuscitative measures in these patients.
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Eur J Trauma Emerg Surg · Oct 2020
Limited value of the column concept in the operative management of posterior column tibial plateau fractures.
The three-column concept has been proposed as tool in surgical decision-making for treating tibial plateau fractures. Recent studies have underscored the negative effect of posterior column tibial plateau fractures on clinical outcome. The purpose of this study was to assess the value of the three-column concept and posterior plating in posterior column fractures. We hypothesized that treating patients according to the three-column concept improves functional outcome. ⋯ 3.
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Eur J Trauma Emerg Surg · Oct 2020
Review Practice GuidelineThe Bucharest ESTES consensus statement on peritonitis.
Peritonitis is still an important health problem associated with high morbidity and mortality. A multidisciplinary approach to the management of patients with peritonitis may be an important factor to reduce the risks for patients and improve efficiency, outcome, and the cost of care. ⋯ This document is an updated presentation of management of peritonitis and represents the summary of the final recommendations approved by a panel of experts.
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Eur J Trauma Emerg Surg · Oct 2020
ReviewMalnutrition and its effects in severely injured trauma patients.
In hospitalized patients, malnutrition is associated with adverse outcomes. However, the consequences of malnutrition in trauma patients are still poorly understood. This study aims to review the current knowledge about the pathophysiology, prevalence, and effects of malnutrition in severely injured patients. ⋯ Despite widespread belief about the importance of nutrition in severely injured patients, the quantity and quality of available evidence is surprisingly sparse, frequently of low-quality, and outdated. Based on the malnutrition-associated adverse outcomes, the nutritional status of trauma patients should be routinely and carefully monitored. Trials are required to better define the optimal nutritional treatment of trauma patients, but a standardized data dictionary and reasonable outcome measures are required for meaningful interpretation and application of results.