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At least 325 records · Page 18Linked to original sources
PubMed2001

[Experiences with using a potentially temporary vena cava filter in multiple trauma patients].

INTRODUCTION: In Europe, there is little experience in the application of temporary cava filters in patients with multiple injuries. Especially patients with pelvic injuries, fractures of the spine, and the lower extremities are at high risk for thromboembolic events like thrombosis or pulmonary emboli. Moreover, in patients with severe head injuries, anticoagulation is contraindicated. METHOD: We present in this paper our experience with 24 consecutive patients with multiple injuries who were treated with a temporary cava filter. The insertion site was either the femoral (n = 20) or the jugular (n = 4) vein. The 24 patients revealed a mean ISS of 35.1 +/- 2.01 points. Nineteen patients had pelvic injuries and 17 patients suffered from severe head injury. In 17 patients the insertion of the filter was prophylactic, in 4 patients a thrombosis was present and in 3 patients a non-fatal pulmonary emboli was diagnosed before the application of a cava filter. RESULTS: No complication occurred due to insertion of the filter. In one patient a thrombosis of the cava was observed as the only overall complication (1 of 24 = 4.2%). CONCLUSION: The insertion of a cava filter in patients with multiple injuries with contraindication for anticoagulation is a safe and effective procedure to prevent fatal pulmonary emboli.

Adult↗
PubMed2000

[Acute acalculous cholecystitis following hepatic artery embolism in multiple trauma].

We have reported a case of acute acalculous cholecystitis occurring after hepatic artery embolization in a woman sustaining multiple traumatic injuries. Although many classical factors such as shock, sepsis, transfusion or narcotic administration may be involved in the genesis of gall-bladder necrosis, we have discussed the possible involvement of hepatic artery embolization in the ischaemic process. Indeed, this mechanism has already been reported in non traumatic patient following hepatic tumor chemoembolization.

Acute Disease↗
PubMed2005

[Pelvic fractures coexistent with multiple trauma--own diagnostic and therapeutic algorithm].

Pelvic fractures determine one from greatest diagnostic and therapeutic problems in complex of multiple injures. Pelvic fractures observes one-self at 20-30% patients with multiple injures of the body. These injuries are attended for prognostic factor of severity status in this to group of patients. Using at presence diagnostic and therapeutic methods appear continually insufficient. Testifies about this high mortality in these patients. Aim of study was presentation of own manner of diagnostic and therapeutic treatment at patients with pelvic fractures coexisting with multiple injuries, and confirmation of legitimacy early reposition of pelvic fracture and external stabilisation. Investigated group of patients embraced 201 ill with multiple injuries of the body attended in years 1999-2003. Pelvic fractures were recognised at 42 (20.9%) patients. Severity of injury according to Injury Severity Score carried out 54 points. Immediate closed reposition under X-ray inspection and anterior external stabilisation executed at 12 (28.5%) most heavy patients. In this group 5 (41.6%) of the patients survived. Diagnostics and treatment one passed according to settled by authors of algorithms in which one important criterium of conduct was state stability of the circulatory system. One turned also attention on necessity wider usages of angiographic investigations of pelvic blood vessels and their immobilisation. One acknowledged that conduct according to worked out algorithms arranges and makes easy process of diagnosis and treatments. One confirmed advantages early closed reposition of pelvic fractures and their external stabilisation at unstable patients, as intervention saving life.

Algorithms↗
PubMed1999

Functional outcome in children with multiple trauma without significant head injury.

OBJECTIVE: To assess functional outcome and describe disability at discharge in children who have had trauma without significant head injury. DESIGN: Retrospective cohort. SETTING: National Pediatric Trauma Registry, 1988-1994. PARTICIPANTS: Patients of ages 7 to 18 years with Glasgow Coma Scale (GCS) 13 to 15 without significant anatomic head inJury. RESULTS: Functional Independence Measure (FIM) at discharge was used to assess patient outcome. There were 13,649 children meeting study criteria who had sustained 34,254 injuries. Fractures constituted 30% of all injuries. As measured by FIM, 1,522 (11.2%) patients had mild disability at discharge; 1,983 (14.5%) had moderate disability. After adjustment for age and injury severity, children with lower extremity fractures were more likely to be discharged with functional limitations than those without (relative risk, 5.43; 95% confidence interval: 5.06, 5.84). Of children with moderate disability at discharge, less than 50% were referred for rehabilitation evaluation and less than 25% for physical therapy. CONCLUSION: Functional dependence is present in a large proportion of injured children, even without significant head injury. Rehabilitation and other services may be underused in this population. Further study is required to fully assess the degree and duration of disability in these patients.

Adolescent↗
PubMed1992

[Pneumothorax in multiple trauma. Radiologic and CT study].

This study was aimed at evaluating the necessity to perform chest Computerized Tomography (CT) in multiple traumatized patients to diagnose pleuropulmonary lesions and, particularly, pneumothorax: the correct identification of this condition, although minimal, is important especially in prevision of long anesthesias and/or positive end-expiratory pressure (PEEP) therapy. This assisted respiratory technique improves arterial oxygenation but causes a barotrauma which may cause some complications; particularly, a small undetected pneumothorax can suddenly increase so as to cause pulmonary collapse with sometimes dramatic symptoms. Chest X-ray films and CT scans, performed in rapid succession on patient's admission in Emergency Ward, were compared in 21 subjects. CT is indispensable in case of severe chest parietal lesions which can mask the radiological evidence of pulmonary or pleural conditions, as it occurred in 3 of our cases. Moreover, CT resulted more reliable than chest X-rays (18 versus 10 correct diagnoses) especially in the detection of small antero-inferior pneumothorax flaps, in which direct radiological signs cannot be identified, in default of radio-geometrical assumptions. Indirect radiological signs of pneumothorax must be recognized but critically considered in order to avoid over-staging.

Adolescent↗
PubMed1991

[Treatment of diaphyseal femoral fractures in patients with associated and multiple traumas].

There has been analysed an outcome of treatment of diaphysial fractures of femur in 124 victims with associated and multiple damages. The analysed group of victims has been urgently subjected to intramedullary nailing osteosynthesis by means of a rod of our construction. Developed and officially approved method of nailing osteosynthesis not only eliminates application of bulky plaster bandages, skeletal traction systems, but ensures mobility, possibility of carrying out the repeated diagnostic and treatment--and--prophylactic measures and, in the indicated cases, repeated operative intervention. Clinical approval of the method of nailing osteosynthesis by means of the rod of our construction allowed to reduce the term of treatment, number of complications, temporary invalidity and invalidism as compared with the group of patients, subjected to conservative treatment.

Adult↗
PubMed1989

[Treatment of the patient with multiple trauma and prognostic assessment of the follow-up course].

After a short view of literature demands of treatment of multiple seriously injured patients, some ideas to optimize their attending are discussed. A practicable method of prognostication for critical injured patients is presented in 40 cases. It could be reached a real rating, nobody who survived was classified in the group with unfavourable prognosis. Existing problems of gradation are explained.

Adolescent↗
PubMed1997

Estimation of condensed pulmonary parenchyma from gas exchange parameters in patients with multiple trauma and blunt chest trauma.

Pulmonary gas exchange in correlation with condensed lung volume was prospectively studied in 10 patients with multiple injuries and blunt chest trauma. The purpose was to find nomograms that allow the estimation of the extent of pulmonary density from gas exchange parameters. The condensed lung volume was determined planimetrically from serial transverse sections of chest computed tomographic scans. There was no correlation between condensed lung volume and mean pulmonary artery pressure, pulmonary vascular resistance, systemic vascular resistance, or cardiac index and a week negative correlation to the oxygenation index (PaO2/FIO2) (r2 = 0.46) and to the total static lung compliance (r2 = 0.29). A strong correlation between pulmonary density and intrapulmonary shunt fraction (Qs/Qt) (r2 = 0.95) as well as alveoloarterial PO2 difference (P[A-a]O2) (r2 = 0.86) was evident. By using linear regression equations (linear regression line with 95% confidence interval), nomograms were calculated. The extent of pulmonary density can easily be obtained from these nomograms by measuring Qs/Qt or P(A-a)O2. The presented nomograms may be helpful in monitoring the effect of treatment in patients with blunt chest trauma.

Adolescent↗