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

{"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}

{"title":"Social Distancing for Patients and Doctors? A New Post-COVID World","authors":"S. Rizoli","doi":"10.5005/jp-journals-10030-1325","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1325","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88447997","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":"Fostering Knowledge Transfer to Strengthen the Surgical Workforce in LMIC: Lessons Learned from an International Observership Program","authors":"Michel B. Aboutanos, E. Rodas, Nancy Valencia-Rojas","doi":"10.5005/JP-JOURNALS-10030-1324","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10030-1324","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"21 1","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83257340","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":"Early Traumatic Hepatothorax: An Underdiagnose Complication of High Energy Blunt Trauma","authors":"O. Neto, Luiz ER Moutinho, L. Costa","doi":"10.5005/jp-journals-10030-1321","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1321","url":null,"abstract":"Aim and objective: This paper reports a case of early traumatic hepatothorax and discusses diagnosis and treatment according to an updated literature review. Background: Hepatothorax is the abnormal displacement of the liver to the chest. It is a rare condition, which may be challenging to diagnose, and is associated with high energy blunt trauma. Hepatothorax may evolve in different phases: initial, latent, and obstructive; and lead to significant complications and death. Case description: This paper reports the case of a female patient, 35-year-old, diagnosed with hepatothorax due to a car crash causing a high- energy thoracoabdominal trauma. Due to poor clinical progress after chest drainage, a subsequent helical computerized tomography was done and diagnosed a right diaphragmatic injury and hepatic herniation to the chest. The patient underwent early surgical correction of the diaphragmatic injury and she was later successfully discharged home without complications after a 1-year follow-up. Conclusion: The literature reports numerous underdiagnosed cases and later surgical correction of traumatic hepatothorax. In this case, persistent dyspnea, despite chest drainage, following a high-energy trauma led to the search and identification of the hepatothorax. Clinical significance: Physicians should have a high index of suspicion for traumatic hepatothorax in high-energy blunt thoracoabdominal trauma and consider early surgical repair, which is associated with lower morbidity and mortality in this type of injury.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90587717","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":"Talk and Die Syndrome: A Narrative Review","authors":"A. A. Chacón-Aponte, É. A. Durán-Vargas, J. A. Arévalo-Carrillo, A. Agrawal, I. Lozada‐Martínez, Tariq Janjua, L. Moscote-Salazar, V. Maurya, Rakesh Mishra, Mohammed Maan Al-Salihi, Moshiur Rahman","doi":"10.5005/jp-journals-10030-1322","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1322","url":null,"abstract":"The level of consciousness following head trauma generally correlates with the overall prognosis of an individual. It is a consensus that following a head injury, patients able to talk (Glasgow coma scale verbal of 3 or 4) perform well over time. However, there is a subset of patients who suddenly deteriorates and succumb despite talking after trauma. Such an event was labeled as “talk and die”. This review aims to summarize the published literature on talk and die syndrome, considering the relevance of this condition, especially in Latin America and the Caribbean, where there are high rates of traumatic brain injury.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88349256","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":"Coronavirus Disease (SARS-CoV-2) and Neurocritical Care: Challenges for Neurosurgeons","authors":"A. Agrawal, L. Moscote-Salazar, Md Moshiur Rahman","doi":"10.5005/JP-JOURNALS-10030-1317","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10030-1317","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"110 1","pages":"89-90"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77454005","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":"Trauma Outcomes in Methamphetamine-positive Patients vs Matched Methamphetamine-negative Controls in a Central Valley California Trauma Center","authors":"Jacob Kirkorowicz, N. Atherton, Yueqi Yan","doi":"10.5005/jp-journals-10030-1323","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1323","url":null,"abstract":"Aim and objective: Our objective was to determine whether patients presenting as activated traumas to a trauma center serving a high methamphetamine (meth) prevalence region differed in outcomes based on whether they tested positive vs negative for methamphetamine at the time of presentation. Materials and methods: A case-control design was used to examine the trauma outcomes among patients who tested meth-positive vs matched controls. The trauma outcomes evaluated were needed for laparotomy, rate of inpatient admission, rate of ICU admission, hospital length of stay, ICU length of stay, ventilation status, ventilation time, injury severity score, and mortality. Propensity score matching was used to match meth-positive cases and comparison cases on sex, age (in years), race, primary financial resources to pay for the visit, presentation time, and the county where s/he lived at the time of presentation. Results: Meth-positive patients and matched comparison cases did not differ in the need for laparotomy. Meth-positive patients experienced a longer hospital stay ( p = 0.011), longer duration of ventilator use ( p = 0.05), and a higher injury severity score ( p < 0.001). Positive cases were more likely than matched comparison cases to be admitted to the ICU ( p < 0.001) and to be placed on mechanical ventilation ( p < 0.001). Meth- positive patients had a marginally significantly higher rate of inpatient admission ( p = 0.066). No significant difference was found between the two groups in mortality rate at discharge and length of ICU stays. Conclusion: Meth positivity is notably associated with an increased injury severity score on presentation. If meth use is known or suspected before arrival, trauma resources should be mobilized appropriately to prepare for a severe traumatic injury. The fact that meth positivity increases the likelihood of ICU admission and ventilator use, with increased hospital length of stay and increased ventilator time, indicates that meth positivity in trauma patients places a large burden on hospital staffing and resources.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85067596","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":"Una Extranjera en el Extranjero","authors":"Amber N Himmler","doi":"10.5005/JP-JOURNALS-10030-1319","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10030-1319","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"9 1","pages":"87-88"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90606195","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":"Body Packer: An Experience in a Reference Hospital","authors":"Carlos A Lozano De Avila, Giovanna M Rivas Zuñiga, Katty C Square Nieves, N. D. J. Z. Medrano, Jaime M Iglesias Medrano","doi":"10.5005/JP-JOURNALS-10030-1309","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10030-1309","url":null,"abstract":"The term body packer refers to the carrying of illegals in the body of a person with the aim of contraband. It is estimated that around 5% of the world’s adult population used illicit drugs at least once in 2015. While most body packers are asymptomatic, a small percentage requires a surgical intervention due to complications such as intestinal obstruction. In the current report, we will present the case of a patient admitted with this complication to the emergency unit of a hospital in the city of Cartagena.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"204 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72961540","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}