Articles: trauma.
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Traumatic tracheal injury via blunt or penetrating mechanism comes with a grave prognosis. Cricotracheal separation is a rare entity among these injuries and even more infrequent by means of penetrating trauma. Resultant airway discontinuity subsequent to these insults causes immense global hypoxia and tends to be uniformly fatal. ⋯ Emergent management and stabilization of the airway is critical to survival in the context of trauma involving the neck and airway structures.
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Guidelines for evaluating the cervical spine in pediatric trauma patients recommend cervical spine CT (CSCT) when plain radiographs suggest an injury. Our objective was to compare usage of CSCT between a pediatric trauma center (PTC) and referral general emergency departments (GEDs). ⋯ Despite a stable rate of CSI, rate of CSCT increased significantly over time, especially among patients initially evaluated at a GED.
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Case Reports
Massive cerebrovascular air embolism during posttraumatic cardiopulmonary resuscitation.
Air embolism is known to be a complicating factor in several clinical settings, including thoracic, cardiovascular, and neurosurgical operations; central line placement; and penetrating thoracic and cranial trauma. There are, however, only few case descriptions for cardiopulmonary resuscitation massive cerebral air embolism, and the frequency of this supposedly rare complication is unknown. Computed tomography is useful for showing cerebral air embolism. In this report, we present a 16-year-old adolescent girl with cerebrovascular air embolism on computed tomographic examination after a posttraumatic cardiopulmonary resuscitation and discuss the reasonable mechanisms of cerebrovascular air embolism.
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Comparative Study
Midterm effects of fluid resuscitation strategies in an experimental model of lung contusion and hemorrhagic shock.
This study compared three different fluid resuscitation strategies in terms of respiratory tolerance and hemodynamic efficacy in a pig model of blunt chest trauma with lung contusion and controlled hemorrhagic shock. We hypothesized that the choice of fluid resuscitation strategy (type and amount of fluids) may impact differently contused lungs in terms of extravascular lung water (EVLW) 20 h after trauma. ⋯ This study demonstrated the impact of fluid resuscitation on contused lungs. Twenty hours after the trauma, all three resuscitation approaches showed modest clinical consequences, with moderate lung edema and reduced compliance in response to the infused volume.
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To reduce the high rate of soft tissue complications in the treatment of displaced intra-articular fractures of the calcaneus, several minimally invasive techniques have been developed. Little evidence exists on the clinical outcome of these techniques. ⋯ Level IV, retrospective case series.