Journal of Acute Care Surgery最新文献_第2页

Case Report of an Appendiceal Mucinous Neoplasm: A Rare Etiology for Appendicitis 阑尾粘液瘤病例报告：阑尾炎的罕见病因

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.131

Olivia Boden, Y. Pillay

引用次数: 0

Surgical Techniques for Severe Liver Injury: A Comprehensive Review of Current Approaches and Advancements 严重肝损伤的外科技术：当前方法和进展的全面回顾

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.95

Dong Hun Kim

{"title":"Surgical Techniques for Severe Liver Injury: A Comprehensive Review of Current Approaches and Advancements","authors":"Dong Hun Kim","doi":"10.17479/jacs.2023.13.3.95","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.3.95","url":null,"abstract":"In abdominal trauma, the liver is the most injured organ and treatment is usually determined by hemodynamics. Severe liver injury with extensive parenchymal injury and uncontrollable bleeding may rapidly evolve into the lethal triad of death (acidosis, hypothermia, and coagulopathy), requiring damage control surgery (DCS). Damage control resuscitation for trauma treatment reduces the need for DCS by enabling rapid control of massive bleeding. Thus, definitive surgery can be completed in one operation. Despite the systematic application of damage control resuscitation, definitive surgery cannot be achieved in severe, and extensive liver injuries. Therefore, understanding, and acquiring damage control surgical techniques is necessary to achieve DCS for severe liver injury. The Western Trauma Association and the World Society of Emergency Surgery have proposed algorithms for the nonoperative and operative management of blunt hepatic trauma. The algorithms list several surgical skills, including electrocautery or argon beam, manual compression, perihepatic packing, the Pringle maneuver, liver suture, omental packing, selective hepatic artery ligation, balloon tamponade, hepatic vascular isolation, and the shunt operation. These techniques require a multidisciplinary approach and individual honing of skills by the surgeon. Trauma surgeons, even hepatobiliary surgeons, must practice damage control techniques in severe liver injury models (animals or cadavers).","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"316 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139204180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tissue Perfusion and the Braden Scale as Predictors of Pressure Injury Risk in the Intensive Care Unit Patient 组织灌注和布莱登量表作为重症监护病房患者压力损伤风险的预测指标

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.112

Eileen Wong, Shirley Visperas, So Yung Choi, Mahealani Suapaia

{"title":"Tissue Perfusion and the Braden Scale as Predictors of Pressure Injury Risk in the Intensive Care Unit Patient","authors":"Eileen Wong, Shirley Visperas, So Yung Choi, Mahealani Suapaia","doi":"10.17479/jacs.2023.13.3.112","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.3.112","url":null,"abstract":"Purpose: The national rate of pressure injury (PI) in the intensive care unit (ICU) 2016-2018 was 5.97%, while at one hospital in Honolulu, Hawaii it averaged 13%. The Braden scale is the gold standard PI risk assessment tool. Researchers have reported the Braden scale has limited value in the ICU setting and consider tissue perfusion to be the better indicator. The aim was to determine if tissue perfusion, as measured by noninvasive transcutaneous tissue oxygen levels, was a predictor of PI risk development.Methods: Electronic medical records of 161 patients admitted from January 1, 2017 to June 30, 2019 were retrospectively reviewed. Patients’ characteristics were summarized using descriptive statistics. Bivariate associations with the development of PI were examined using Fisher’s exact test for the categorical variables, and Wilcoxon rank-sum test for the continuous variables. A multivariable logistic model was fitted for the development of PI with adjustments for potential confounders.Results: Of 161 patients, 125 met the inclusion criteria. Length of stay, Acute Physiology and Chronic Health Evaluation II score, use of vasopressors, and the Braden score were statistically significant predictors of PI risk development; tissue perfusion was not significant.Conclusion: ICU patients have a higher mortality and severity of illness. The Braden score guides implementation of PI preventative measures. The relationship between tissue perfusion and PI development may warrant further research. A broader clinical picture to incorporate the Braden scale and other risk factors in PI development such as Acute Physiology and Chronic Health Evaluation II score and use of vasopressors should be considered.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Functional, Psychological and Economic Impacts 6 Months Post Major Trauma 重大创伤后 6 个月的功能、心理和经济影响

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.105

YL Linn, Haowen Jiang, Norhayati Mohd Jainodin, Pei Leng Chong, Sock Teng Chin, Sachin Mathur

{"title":"The Functional, Psychological and Economic Impacts 6 Months Post Major Trauma","authors":"YL Linn, Haowen Jiang, Norhayati Mohd Jainodin, Pei Leng Chong, Sock Teng Chin, Sachin Mathur","doi":"10.17479/jacs.2023.13.3.105","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.3.105","url":null,"abstract":"Purpose: The consequences of severe traumatic injury extend beyond hospital admission and have the potential for long-term functional, psychological, and economic sequalae. This study investigated patient outcomes 6 months following major trauma.Methods: Using the National Trauma Registry, database of patients who were admitted between 2016-18 in a tertiary trauma hospital for major trauma [Injury Severity Score (ISS) ≥ 16] a review was performed on 6-month outcomes [including functional outcomes, self-reported state of health and outcome scores (EuroQol-5 Dimension score and Glasgow Outcome Scale Extended)].Result: There were 637 patients who were treated for major trauma (ISS ≥ 16); the median age was 64 years (range 16-100) and 435 (68.3%) patients were male. The most common injury mechanisms included falling from height (56.5%) and motor vehicle accident (27.0%). The median ISS was 24 (range 16-75). After 6 months, 87.6% of responders were living at home, 25.0% were back to work, and 55.1% were ambulating independently. The median self-rated state of health was 73 at baseline and 64 at 6 months. Age and length of stay were independent predictors of return to ambulation using multivariate analysis. Age, Abbreviated Injury Scale external, Glasgow Coma Scale on Emergency Department arrival, heart rate, and need for transfusion were independent predictors of failure to return to work at 6 months using multivariate analysis. Charlson Comorbidity Index, Glasgow Coma Scale on arrival, temperature, pain and need for inpatient rehabilitation were independent predictors of mortality at 6 months.Conclusion: Recovery from major trauma is multi-faceted and requires a team-based approach well beyond discharge.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139202277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Paralytic Ileus as a Presentation of Antiphospholipid Syndrome in a Patient with Renal Angiomyolipoma: A Case Report 一名肾血管肌脂肪瘤患者因抗磷脂综合征而出现麻痹性回肠炎：病例报告

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.141

Jacinda Risha Oktaviani, Nicholas Andrian Singgih, Raden Honggo Pranowo Sampurno Secodiningrat, Budiawan Atmadja, E. Manuputty

引用次数: 0

Tranexamic Acid in Trauma Management: A Review of Evidence 氨甲环酸在创伤治疗中的应用：证据综述

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.85

Namryeol Kim

{"title":"Tranexamic Acid in Trauma Management: A Review of Evidence","authors":"Namryeol Kim","doi":"10.17479/jacs.2023.13.3.85","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.3.85","url":null,"abstract":"Hemorrhage is the leading cause of death in trauma patients and trauma induced coagulopathy (TIC) is a major contributor to bleeding mortality. TIC has a diverse pathophysiology triggered by injury and hypoperfusion, including platelet dysfunction, endotheliopathy, fibrinogen or thrombin abnormalities, and dysregulated fibrinolysis. Early fluid resuscitation, appropriate blood transfusion, and definitive control of bleeding are essential components of initial management for TIC. Additionally, tranexamic acid (TXA), an antifibrinolytic agent, has emerged as a potential adjunctive therapy following the 2010 landmark trial that demonstrated the benefit of early administration of TXA in reducing trauma patient mortality (CRASH-2). This review provides an analysis of the current literature on the use of TXA in trauma patients. It critically evaluates the evidence on the effect of TXA on TIC and other clinical outcomes, emphasizing the time-sensitive nature of TXA administration and the variation of its effect depending on the severity and location of injury. It also discusses the optimal dosage, timing, and safety of TXA, as well as the challenges and limitations of existing studies. Furthermore, it highlights the importance of individualized treatment approaches based on the fibrinolysis status of TIC and the value of goal-directed therapy guided by viscoelastic hemostatic assays for the appropriate use of TXA.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preventable Death Rate of Trauma Patients in a Non-Regional Trauma Center 非区域性创伤中心创伤患者的可预防死亡率

Journal of Acute Care Surgery Pub Date : 2023-11-30 DOI: 10.17479/jacs.2023.13.3.118

K. Park, Wooram Choi, Sung-Bae Lee, K. Lee, Dongbeen Choi, Han-Gil Yoon, Ji Young Jang

{"title":"Preventable Death Rate of Trauma Patients in a Non-Regional Trauma Center","authors":"K. Park, Wooram Choi, Sung-Bae Lee, K. Lee, Dongbeen Choi, Han-Gil Yoon, Ji Young Jang","doi":"10.17479/jacs.2023.13.3.118","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.3.118","url":null,"abstract":"Purpose: A nationwide study (2012-2017) of preventable trauma death rates (PTDR) showed a 15.3% decrease after Regional Trauma centers were initiated. However, in non-trauma centers with an Emergency Department there is limited data of preventable mortality in trauma patients. Therefore, the purpose of this retrospective study was to investigate preventable mortality in trauma patients in a nonregional trauma center and determine the effect of initiating a Trauma Team.Methods: There were 46 deaths of trauma patients recorded in the National Health Insurance service Ilsan Hospital (NHISIH) in South Korea from January 2019 to December 2021. These patients’ preventable deaths were analyzed by an expert panel review considering the implementation of the Trauma Team in April 2020.Results: All deaths were attributable to blunt trauma with an average Injury Severity Score of 26.0 ± 19.2, Revised Trauma Score of 5.05 ± 3.20 and Trauma and Injury Score of 56.6 ± 41.3. The most frequent cause of death was traumatic brain injury followed by respiratory arrest. The most frequent error was delayed transfusion followed by delayed treatment of bleeding. Treatment errors occurred the most in the Emergency Room followed by the Intensive Care Unit. The PTDR of patients before the involvement of a Trauma Team (January 2019 to March 2020) and after the Trauma Team was initiated in April 2020 decreased from 27.27% to 4.27%, respectively (p = 0.021).Conclusion: The introduction of a dedicated Trauma Team in a non-regional trauma center significantly reduced the overall PTDR in trauma patients.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"134 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139202895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Difficult Weaning in ICU ICU困难脱机

Journal of Acute Care Surgery Pub Date : 2023-08-23 DOI: 10.5005/jp-journals-10089-0062

Raghunath Aladakatti, Aishwarya Sadashivamurthy

引用次数: 0

A Rare Case of Primary Ventriculitis Secondary to Community-acquired Extended-spectrum β-lactamase Escherichia coli Meningitis 原发性脑室炎继发于社区获得性广谱β-内酰胺酶大肠杆菌脑膜炎1例

Journal of Acute Care Surgery Pub Date : 2023-08-23 DOI: 10.5005/jp-journals-10089-0060

Mahesha Padyana, V. Krishnamurthy, PC Narendra, Raghavendra Goudar, Gururaj V Gunda

引用次数: 0

A Rare Case of Artery of Percheron Infarction 少见的动脉梗死1例

Journal of Acute Care Surgery Pub Date : 2023-08-23 DOI: 10.5005/jp-journals-10089-0065

G. Chandan, Spoorthy Holla, Km Ganesh

引用次数: 0