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At least 289 records · Page 16Linked to original sources
PubMed1997

[Hemolysis and multiple trauma. A clinical case report].

A patient is described who presented hemolysis after a chest and head trauma. We checked out every possible cause of anemia and our conclusion is that trauma itself was the cause of hemolysis. As an explanation, we suggest that red blood cells were broken in lung capillaries because of endothelial damage due to pulmonary injury.

Accidents, Traffic↗
PubMed1993

Medical consultation in the patient with multiple trauma.

Medical consultation is frequently requested to assist the trauma team in the management of the patient with multiple traumatic injuries. Four areas are commonly encountered as problems for management in this patient population. In this article, myocardial contusion, stress ulceration, seizure prophylaxis, and deep vein thrombosis prevention are addressed with respect to incidence, assessment, and management.

Contusions↗
PubMed1994

Mortality in multiple trauma patients with fractures.

A multicentered study was performed to determine the mortality rate of patients with multiple injuries with major pelvic and long bone fractures who have early total care of their injuries. A 2-year review of patients with ISSs > or = 18 with major fractures treated at the trauma centers in Buffalo, New York, Camden, New Jersey, Nashville, Tennessee, Baltimore, Maryland, Tampa, Florida, and Seattle, Washington was performed. This group of 676 patients was compared with a similar group of 906 patients from the American College of Surgeons' Multiple Trauma Outcome Study. Mortality was significantly reduced in the patients who had early total care of all their injuries including fracture stabilization for patients less than 50 years of age and those 50 years and older. In a subgroup of patients less than 50 years of age and an ISS of 18-34 and 35-45 there was a mortality reduction from 11.8% to 5.1% and from 25.8% to 11.5%, respectively, when the fractures were managed acutely. Similar reductions in mortality were found in the patients 50 years of age and older with early fracture stabilization with a reduction from 26.4% to 8% in patients with ISSs of 18-24 and a reduction from 42.3% to 18.4% in the patients with ISSs of 35-45. This study clearly shows the additional benefit of early fracture stabilization in reducing mortality rates in the patient with multiple injuries.

Adult↗
PubMedDate not supplied

[The effect of pain caused by multiple trauma on gamma-aminobutyric acid metabolism and the functional condition of animals].

Multiple injury to the bone tissue in rats caused changes of gamma-aminobutyric acid (GABA) metabolism manifested first by activation of its synthesis and then by inhibition of enzymatic inactivation and increase in GABA content in the brain. The initial reaction of the GABA system was attended by a loss of total body and thymus weight, increase in adrenal weight, and bicocculin- and picrotoxin-sensitive hypoalgesia in the tail-flick test. The subsequent changes of GABA-ergic transmission developed during restoration of the animals' functional condition but body weight loss persisted. It is suggested that activation of the GABA system is a defence reaction tending to intensify the inhibition processes and increase the activity of the brain antinociceptive systems.

Animals↗
PubMed1990

[Organ failure in patients with multiple trauma. The effect of early osteosynthesis of fractures on complications].

The course of 225 multiple traumatized patients in our ICU with a mean age of 35 +/- 16.8 years, a mean ISS of 30 +/- 8.3 and an overall mortality of 18.2% was evaluated retrospectively. For comparable ISS the mortality was higher in patients over 65 years, and increased further with age. The most common causes of death were MOF (41.5%), severe head injury (34.1%), and acute respiratory failure (ARF) (19.5%). The mortality increased when two or more organ failures were present. 105 patients had fractures of the long bones; in 28 of these all fractures were stabilized primarily (during the first 24 hours). Organ failure was seen less frequently in these patients compared to those with secondary stabilization: ARF 10.7% vs. 51.9% (p less than 0.0004), acute renal failure 3.6% vs. 11.7%, liver failure 3.6% vs. 11.7%, sepsis 14.3% vs. 29.9%. Mortality was significantly lower in the patient with primarily stabilized fractures (7.1% vs. 24.7%, p less than 0.05). The study demonstrates that early stabilization of long bone fractures results in a more favourable course, and that this should be carried out whenever feasible.

Adolescent↗
PubMedDate not supplied

[Intensive antibacterial therapy of multiple trauma].

Septic complications are considered among the main causes of death in patients with multiple injuries. In intensive care units their incidence is 33% of all cases. A total of 655 samples of sputum, blood, and urine from 224 patients were examined. The principal agents of septic infections were gram negative aerobic bacilli Pseudomonas aeruginosa and Proteus. The spectrum of activity of penicillins and aminoglycosides has appreciably changed. A decrease of contamination may be attained by arranging a special "cleansing" intensive care unit with continuous exchange of air free of bacteria, a regimen of an operative room, and use of solely cephalosporines combined with fluoroquinolones.

Adolescent↗
PubMedDate not supplied

[Abdominal compartment syndrome in multiple trauma patients with concomitant abdominal and head lesions --mechanisms and therapeutical aspects].

The acute and persistent increase of the intra-abdominal pressure (IAP) above 25 cm H2O represents a pathologic entity called the abdominal compartment syndrome (ACS). This intra-abdominal high pressure is responsible of dysfunctions in cardiovascular, respiratory and renal systems and also dysfunctions in brain and abdomen. In polytrauma patients with combined head and abdominal lesions, increases of IAP are transmitted via thorax and superior venous caval system to brain generating intracranial hypertension, reducing cerebral blood flow (CBF) and cerebral perfusion pressure (CPP) thus worsening neurological status and increasing mortality. A better prognosis for this polytrauma patients is possible only by elucidating the mechanisms which produces the dysfunctions in ACS and by promoting an aggressive therapeutical surgical approach.

Abdominal Injuries↗
PubMed1994

Increased gut permeability after multiple trauma.

Gut permeability was studied in multiply injured patients with respect to the development of multiple organ failure (MOF). Two groups were defined according to MOF score (threshold 10 points) as to whether MOF developed (group 1; n = 11, four deaths) or did not (group 2; n = 21, no death). Gut permeability was determined from the ratio of urinary excretion of enterally administered lactulose and mannitol. Serum elastase concentrations were also determined. Mean(s.e.m.) gut permeability was abnormal during the entire study (day 1: group 1--5.1(2.1) versus group 2--10.6(4.1) (P not significant; P < 0.001 versus normal volunteers, 0.56(0.24)). An increase on days 3 and 5 correlated with serum elastase levels only in patients in group 1 (rs = 0.71, P < 0.01). Severe injury leads to increased intestinal permeability, which is related to a systemic inflammatory response.

Adult↗
PubMed1992

[Abdominal visceral lesions in patients with multiple trauma].

The paper describes a series of 385 cases of multiple injuries which were treated between 1987 and 1991 at the Emergency Unit of the Fatebenefratelli Hospital in Milan. Special attention was paid to abdominal trauma and visceral injuries in terms of both diagnosis and treatment.

Abdominal Injuries↗
PubMed1995

Generating penetration path hypotheses for decision support in multiple trauma.

We present a 3D graphical system that allows users to visualize different penetration path hypotheses for (multiple) gunshot or stab wounds, using a 3D graphical model of a human body with appropriate anatomical structures. The system also identifies the anatomical structures associated with each hypothesis. The various penetration path hypotheses follow from a combinatorial analysis of the set of surface wounds. The affected structures are determined by performing a detailed interpenetration analysis between 3D models of a penetration path and each anatomical structure within the body.

Computer Simulation↗