European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2024
Effects of anesthesia with sevoflurane on outcome parameters in murine experimental studies.
Multiple murine studies modelling the immuno-pathophysiological consequences of trauma, shock, burn or sepsis were performed during the last decades. Almost every animal model requires anesthesia for practical and ethical reasons. Furthermore, often, corresponding control groups involve untreated animals without or with a limited exposure to anesthetics. However, the influences of anesthetic drugs on immuno-pathophysiological reactions remain insufficiently investigated. Therefore, we aimed to closer characterize the anesthetic impact exemplified by sevoflurane on the organ performance in mice and thereby investigate the influence of anesthesia itself on major outcome parameters in animal studies. ⋯ As anesthesia with sevoflurane exhibited distinct effects in different organs, it is difficult to predict its specific impact on targets of interest in in vivo studies. Therefore, further studies are required to clarify the effects of different anesthetic drugs. Overall, the inclusion of a control group subjected to the same anesthesia protocol as the experimental groups of interest seems helpful to precisely define the inherent impact of the anesthetic when investigating immuno-pathophysiologic conditions in vivo.
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Eur J Trauma Emerg Surg · Dec 2024
Review Meta AnalysisContrast-enhanced CT scan (CECT) for the detection of hollow viscus and mesenteric injuries in blunt trauma - an updated systematic review of the literature and meta-analysis of diagnostic test accuracy.
Despite improved awareness of blunt traumatic hollow viscus and mesenteric injuries (THVMI), the accuracy of contrast-enhanced CT (CECT) varies considerably among studies. This systematic review and meta-analysis of test accuracy aims to explore the diagnostic performance of CECT in detecting THVMI in blunt trauma. ⋯ CECT has a fundamental role in identifying THVMI with high specificity but suboptimal sensitivity. Clinical criteria are still of paramount importance, especially in cases of ambiguous initial CECT images.
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Eur J Trauma Emerg Surg · Dec 2024
Review Meta Analysis Comparative StudyOperative versus non-operative treatment of ulnar styloid process base fractures: a systematic review and meta-analysis.
Ulnar styloid process (USP) fractures are present in 40-65% of all distal radius fractures (DRFs). USP base fractures can be associated with distal radioulnar joint (DRUJ) instability and ulnar sided wrist pain and are treated by conservative management and surgical fixation, without consensus. This systematic review and meta-analysis compares operative to non-operative treatment of concomitant ulnar styloid base fractures in patients with distal radius fractures. ⋯ Routinely fixating USP base fractures as standard of care is not indicated. Surgery may be considered in selective cases (e.g. persistent DRUJ instability during ballottement test after fixation of the radius).
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Eur J Trauma Emerg Surg · Dec 2024
ReviewCan "Stop The Bleed" training courses for laypersons improve hemorrhage control knowledge, skills, and attitudes? A systematic review.
In many regions of the world, most trauma deaths occur within 1-2 h of injury due to uncontrolled bleeding. For this reason, training lay first-person responders in trauma care, focusing on hemorrhage control, has been recommended. We hypothesized that STOP THE BLEED (STB) training courses that teach laypersons how to stop traumatic compressible bleeding immediately are needed to potentially prevent deaths due to hemorrhage. This systematic review will analyze the effect of the STB training course on the knowledge, skill, and attitudes of lay first-person responders for hemorrhage control. ⋯ STB courses for laypersons have demonstrated significant improvements in knowledge, skill, confidence, and willingness to intervene to stop traumatic exsanguination. The evaluation of clinically relevant patient outcomes, specifically their effect on preventable deaths from traumatic exsanguination, is needed to strengthen further the evidence behind the recommendations for more widespread teaching of "STB" courses.