Panamerican journal of trauma, critical care & emergency surgery最新文献

{"title":"Patient with Severe Traumatic Brain Injury and Malaria in a Middle Eastern Country","authors":"Vishwajit Verma, A. Alansari, S. Arumugam","doi":"10.5005/jp-journals-10030-1363","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1363","url":null,"abstract":"Patient is a 38-year-old male who recently travelled from Uganda to Qatar with history of fever, headache, and abdominal pain. Patient was feeling dizzy and fell down while trying to walk up to the toilet. His initial Glasgow Coma Score (GCS) reported to be 15/15 with bilaterally reactive pupils. Patient’s GCS dropped rapidly during the transport to trauma resuscitation unit. On arrival in trauma resuscitation unit patient developed anisocoria with a GCS of 3/15 and was intubated with rapid sequence intubation. An urgent trauma whole body CT scan revealed a large subdural haemato-hygroma causing mid-line shift of 16 mm and multiple frontal and temporal contusions with effacement of basal cisterns (Figs 1A and B). Admission CT also showed a subtle hypodensity in the posterior cerebral artery territory (Fig. 1C). Patient was taken for a lifesaving evacuation of subdural hematoma. In view of the history of travel, fever and low platelets on presentation, malaria screen was also performed in addition to routine BaC kg r o u n D","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76830527","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}

{"title":"Artery and Subclavia Vein Injury due to Blunt Trauma: A Case Report and Literature Review","authors":"Juliane Rocha Bertelli Cabral, Karina Cavalcante da Silva, Isabella Aurea Signorini, Danielle Gonçalves de Carvalho Pinheiro, A. A. Tenorio, Joao Victor Pinheiro Nunes, A. Teixeira, Paloma Oliveira de Vasconcelos, T. Campos","doi":"10.5005/jp-journals-10030-1350","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1350","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"2017 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82833995","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}

{"title":"Brain-lung Interaction in Neurotrauma in COVID-19 Patients","authors":"Tariq Janjua, L. Moscote-Salazar, William AF Perdomo","doi":"10.5005/jp-journals-10030-1353","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1353","url":null,"abstract":"The recently described coronavirus (SARS-CoV-2) has produced a series of pathological changes after infection of the human body. A significant percentage of infected critically ill patients with COVID-19 will require multiple intensive care strategies to give appropriate support to increase the possibility of favorable evolution. The new coronavirus could invade using the respiratory mucosa and to infect various cell types successively creating a severe inflammatory response. Patients with cerebral neurotrauma have elements associated with the primary and secondary lesions. Lung injury impact brain with hypoxia, hypercapnia, hypocapnia, mediators release, presence of neurotoxic factors, and endothelial activation. On the other hand, brain injury impacts lungs due to increase in intracranial pressure (ICP). There is development of neuroinflammatory phenomena, the activation of sympathetic nervous system, and the presence of intense dopaminergic activity through the hypothalamic-pituitary-adrenal axis. Studies have demonstrated injury at the ultrastructural level in type II pneumocytes after traumatic brain injury.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79214300","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}

{"title":"Successful Embolectomy of over 10 cm Clot in Acute Internal Carotid Artery","authors":"Tariq Janjua, L. Moscote-Salazar, Fotis G. Souslian, S. A. Meyer, J. Goddard","doi":"10.5005/jp-journals-10030-1355","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1355","url":null,"abstract":"Large vessel occlusion with acute embolic stroke (AES) is usually undergo embolectomy attempt within 24 hours on last known normal. Embolectomy leads to clots extraction and improvement of distal flow to minimize or complete reversal of AES. The size of clot extracted is usually in different fragments. One complete extraction of full occlusive clot is rare. The chance of extraction does down with extend of occlusion, duration, type of clot, and location. Here we describe a single pass extraction of over 10 cm clot which improved the distal flow with marked reduction is neurological weakness.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"313 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78383518","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}

{"title":"“Neurotrauma Care”: A Challenge in the Americas","authors":"A. Rubiano, L. Moscote-Salazar, O. Alves","doi":"10.5005/jp-journals-10030-1362","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1362","url":null,"abstract":"organized care at least in the Pan-American region. Prevention, education, research, and social leadership are fundamental skills that all the trauma care providers from the region need to promote in order to improve neurotrauma care for the next generations.6,7 Trauma kills every day more people than COVID-19 but the resources allocated to both problems are totally different. Research in COVID-19 exponentially grows every day compared with The present special issue on neurotrauma care from the Pan-American Journal of Trauma, Critical Care, and Emergency Surgery, fills a critical gap in the understanding of the impact of neurotrauma care within the trauma surgery community in the Pan-American region. According to the World Health Organization data, the burden of injuries in the region represents the most important number of victims from 5–45 years, and the fatality is totally driven by neurotrauma, being present in near to 90% of the polytrauma deaths (Fig. 1).1 This special issue was requested urgently and fortunately, the Editor-in-Chief accepted the offer to open a call for neurotrauma-related articles from the region. Near to 90% of neurotrauma patients worldwide are in Latin America, Africa, and South-East Asia. Most of them are in middle and low developing indexed regions.2 Motor vehicle-related incidents are the leading mechanism, mostly associated with motorcycle accidents.3-5 The economic and social impact is neglected in most countries of these regions, reflected in the lack of organized trauma care systems defined by low engagement of these topics in the present and future political agendas. Multidisciplinary and multi-institutional action is required to fill these gaps for capacity building in trauma and neurotrauma 1Crítical Care Unit, Centro Policlínico del Olaya, (CPO) Bogota, Colombia 2Department of Neurosciences & Neurosurgery, Neurosciences Institute/Universidad El Bosque, Bogota, Colombia 3Head of Neurosurgery, Hospital Lusiadas Porto, Senior Consultant Centro Hospitalar Gaia e Espinho, Treasurer and Executive Board, Cervical Spine Research Society, CSRS-E Fulbright Fellow How to cite this article: Moscote-Salazar LR, Rubiano AM, Alves ÓL. Neurotrauma Care: A Challenge in the Americas. Panam J Trauma Crit Care Emerg Surg 2021;10(3):91–92. Source of support: Nil Conflict of interest: None Neurotrauma Care: A Challenge in the Americas Luis R Moscote-Salazar1, Andrés M Rubiano2, Óscar L Alves3","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83774315","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}

{"title":"Toracotomia Resucitativa Por Trauma Cardiaco Penetrante En Recien Nacido Reporte De Un Caso Excepcional","authors":"Napoleón Méndez, G. López","doi":"10.5005/jp-journals-10030-1354","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1354","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82548222","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}

{"title":"Comparison between Intraosseous and Central Venous Access in Adult Trauma Patients in the Emergency Room: A Systematic Review and Meta-analysis","authors":"Marcelo A. F. Ribeiro Jr, Larissa B Loureiro, A. C. Romeo","doi":"10.5005/jp-journals-10030-1360","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1360","url":null,"abstract":"Comparison between Intraosseous and Central Venous Access in Adult the Room: A Meta-analysis. Background: Obtaining an efficient vascular access in a short-time is fundamental for the patient with hypovolemic shock in the emergency room. In case of peripheral venous access failure, the second option is not yet well defined. Objective: Critically appraise the literature on the use of intraosseous access and central venous access comparing these two interventions with respect to time to complete each of them, rate of success, and complications. Methods: The electronic databases used were MEDLINE / PubMed, PubMed Central, CAPES Platform, The Cochrane Library, EuroPMC, and Virtual Health Library (VHL). Literature reviews, conference proceedings, case reports, case series, comments, and correspondence were excluded, as were studies with children under 18 and a small sample. For the meta-analysis which estimated success in the first attempt, the odds ratios for success, the Mantel-Haenszel method was used for fixed effects. For the analysis of the execution time between procedures, the inverse variation method for fixed results was used. Meta-analysis calculations were performed using the Reviewer Manager 5.3 software. Results: A total of 144 studies were found, four of which were selected for the review, totaling 167 patients. There was superiority of intraosseous access in relation to central venous access with respect to the success rate in the first attempt (9.93; 95% CI 5.08–19.40; 0.00,001) and duration of the procedure (1.94; 95% CI 2.02–1.13; 0.00,001). All four studies comparing access found better performance and less time to perform intraosseous access compared to the central venous catheter. Conclusion: It is possible to determine that intraosseous vascular access is a safe, reliable, and a faster option in trauma patients in shock in the emergency room with inaccessible peripheral veins.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84962240","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}

{"title":"Head Trauma: Challenges in the Americas","authors":"J. I. Suárez","doi":"10.5005/jp-journals-10030-1261","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1261","url":null,"abstract":"Traumatic injuries are a common public health problem all over the world. Available data suggest that about 3.8 million people die from a traumatic injury each year, which is 32% more deaths from injuries than several common infectious diseases including malaria, tuberculosis, and acquired immunodeficiency syndrome.1–4 Such alarming statistics is compounded by the fact that more than 90% of these injury-related deaths occur in low-to-middle-income countries (LMICs).4 Traumatic brain injury (TBI) accounts for a substantial number of those deaths (up to an estimated 1.5 million) and is the leading cause of disability in young adults.5,6 Despite the lack of robust research in Latin America regarding the burden and causes of TBI, the available data suggest that factors that may contribute to such disproportionate higher numbers may include unsafe vehicles, lack of appropriate road infrastructure, and the predominance of vulnerable road users. In addition, systems of care for TBI patients vary across Latin America with some countries having very clear paths similar to high-income countries, whereas others have none at all.7 A recent study analyzing data from the Benchmark Evidence from South American Trials: Treatment of Intracranial Pressure (BEST TRIP) study suggested that even though mortality from severe TBI is higher in Latin American LMICs compared to high-income countries, the rate of favorable recovery is similar.8,9 However, demographic factors such as race and geographic location play a very important role in predicting outcome.8 Most likely, socioeconomic status and cultural differences between regions in Latin America may influence these differences. For example, family resources and purchasing power may dictate in large part the type of posthospital care patients receive. In addition, the prehospital care patients receive may depend on the robustness of the organization of the healthcare system of a particular geographic location. In this issue of the Panamerican Journal of Trauma, Critical Care, and Emergency Surgery, Drs Luis R Moscote-Salazar and Sandro Rizoli (guest editors) have assembled a group of authors from Argentina, Brazil, Canada, Colombia, Cuba, and Nicaragua to address important areas of care of severe TBI patients in Latin America. The discussions encompass the gamut of relevant issues such as epidemiology, pathophysiological aspects, prehospital care, emergency department evaluation, neurocritical care management, multimodality monitoring, osmotherapy, neuroprotection, biomarkers, and neurosurgical treatments. Such reviews are important as they can serve to highlight what aspects of the continuum of care of severe TBI patients may be missing across Latin America. Many challenges need to be overcome for the implementation of reliable and efficient systems of care for TBI. The Galapagos Neurocritical Care Summit Investigators7 have provided recommendations to improve specific areas to impact upon outcome of neurocritically ","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89662205","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}

{"title":"Traumatismo Toracoabdominal Penetrante: Que Cavidad Operar Primero?","authors":"Celeste Echavarria, Sofia Bou, Favio Guzman, Cristian Assell, Juliana Nazaretto, Andrea Potes, Guillermo Barillaro","doi":"10.5005/JP-JOURNALS-10030-1318","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10030-1318","url":null,"abstract":"mortalidad. En el grupo II predominaron las HAF transfixiantes de la línea media. En 8 casos se registró un error al abordar primero la cavidad con lesiones menos graves (en 4 casos el tórax y en 4 casos el abdomen), falleciendo 7 de los mismos y determinando una mortalidad de 25,8% para el grupo II. El análisis del error en esos 8 casos hallo que en 5 fue potencialmente prevenible y que estuvo relacionado con resultados erróneos de la ecografía y/o subestimación del débito del drenaje pleural y de la radiografía de tórax post-drenaje pleural. Conclusione: Los pacientes con TTAP y hemodinámicamente compensados presentaron predominio de HCP del lado izquierdo y no tuvieron errores en el manejo secuencial de cavidades ni mortalidad. En cambio en aquellos con TTAP y shock, predominaron las HAF y los trayectos transfixiantes de la línea media, y este grupo fue el que tuvo exclusivamente los errores de manejo y la mortalidad. La mayoría de los errores en el manejo fueron considerados potencialmente prevenibles dado que se relacionaron con resultados falsos de la ecografía y con subestimación del débito del drenaje pleural y de la radiografía de tórax post–drenaje pleural. Characteristics of patients with PTAT with a sequence of combined surgical interventions. • Characteristics of the error due to inappropriate sequence of said operative procedures. • Relationship of these previous factors with mortality. Design: Observational retrospective. Materials and methods: Review of the medical records of the patients assisted in our institution between January 2005 and December 2018, with PTAT that required operative procedures both in the chest (pleural drainage or thoracotomy) and in the abdomen (laparotomy or laparoscopy). Results: Seventy-nine patients with PTAT, 48 with normal hemodynamics (group I) and 31 with hypovolemic shock (group II) were assisted. In group I, SW (40) predominated over GSW (8), and lesions on the left side (42) (87.5%). In this group, there were no errors in sequential surgical management and no mortality was recorded. In group II, transfixing GSW of the midline predominated. In eight cases, an error was recorded when first approaching the cavity with less serious injuries (in four cases the thorax and in four cases the abdomen), seven of them died and determining mortality of 25.8% for group II. The analysis of the error in these eight cases found that in five it was potentially preventable and that it was related to erroneous results of the ultrasound and/or underestimation of the output of the pleural drainage and of the post-pleural drainage chest radiograph. Conclusion: Patients with PTAT and hemodynamically compensated presented a predominance of left-sided SW and had no errors in the sequential management of cavities or mortality. On the other hand, in those with PTAT and shock, GSW and transfixing paths of the midline predominated, and this group was the one that had exclusively the handling errors and mortality. Most of th","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"55 1","pages":"71-77"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84874554","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}

{"title":"Airway Management of Massive Hemoptysis in a Tracheostomized Patient: A Clinical Approach","authors":"Tariq Janjua, F. Bangash, L. Moscote-Salazar","doi":"10.5005/jp-journals-10030-1320","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1320","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86321774","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}