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Moti Klein - One of the best experts on this subject based on the ideXlab platform.
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urine flow rate monitoring in hypovolemic Multiple Trauma patients
World Journal of Emergency Surgery, 2017Co-Authors: Evgeni Brotfain, Yoram Klein, Leonid Koyfman, Micha Y Shamir, Ronen Toledano, Dmitry Frank, Moti KleinAbstract:The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill Multiple Trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive Multiple Trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems. A total of 59 patients were included in the study. The patients were divided into two study groups. Group 1 consisted of 29 Multiple Trauma patients whose systolic blood pressure was greater than 90 mmHg on admission to the ICU and who were consequently deemed to be hemodynamically compromised. Group 2 consisted of 30 patients whose systolic blood pressure was less than 90 mmHg on admission to the ICU and who were therefore regarded as hemodynamically uncompromised. The urine output and urine flow rate variability during the first 6 h of the patients’ ICU stay was significantly lower in group 2 than in group 1 (p < 0.001 and 0.006 respectively). Statistical analysis by the Pearson method demonstrated a strong direct correlation between decreased urine flow rate variability and decreased urine output per hour (R = 0.17; P = 0.009), decreased mean arterial blood pressure (R = 0.24; p = 0.001), and increased heart rate (R = 0.205; p = 0.001). These findings suggest that minute-to-minute urine flow rate variability is a reliable incipient marker of hypovolemia and that it should therefore take its place among the parameters used to monitor the hemodynamic status of critically ill Multiple Trauma patients.
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Urine flow rate monitoring in hypovolemic Multiple Trauma patients.
World Journal of Emergency Surgery, 2017Co-Authors: Evgeni Brotfain, Yoram Klein, Leonid Koyfman, Micha Y Shamir, Ronen Toledano, Dmitry Frank, Moti KleinAbstract:The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill Multiple Trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive Multiple Trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems. A total of 59 patients were included in the study. The patients were divided into two study groups. Group 1 consisted of 29 Multiple Trauma patients whose systolic blood pressure was greater than 90 mmHg on admission to the ICU and who were consequently deemed to be hemodynamically compromised. Group 2 consisted of 30 patients whose systolic blood pressure was less than 90 mmHg on admission to the ICU and who were therefore regarded as hemodynamically uncompromised. The urine output and urine flow rate variability during the first 6 h of the patients’ ICU stay was significantly lower in group 2 than in group 1 (p
Ricardo Alfici - One of the best experts on this subject based on the ideXlab platform.
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is routine portable pelvic x ray in stable Multiple Trauma patients always justified in a high technology era
Injury-international Journal of The Care of The Injured, 2007Co-Authors: Boris Kessel, Roger Sevi, Igor Jeroukhimov, Alex Kalganov, Tawfik Khashan, Itamar Ashkenazi, Gabriel Bartal, Ariel Halevi, Ricardo AlficiAbstract:Introduction According to the Advanced Trauma Life Support, portable pelvis radiography (PXR) is mandatory in Multiple Trauma patients, and is performed following initial clinical evaluation. The purpose of an early PXR is to identify pelvic fractures that may have haemodynamic consequences. Today, ultrafast multi-detector CT scanners (MDCT) are readily available and widely used in the evaluation of stable Trauma patients. The objective of this study was to determine the impact of PXR in stable blunt Multiple Trauma patients, who required CT scan for full evaluation of the abdomen and pelvis. Methods A retrospective review of all stable blunt Trauma patients, suffering from pelvic fractures was performed from January 2001 until December 2004 at two high volume Trauma Centres. Patients’ demographics and Injury Severity Scores (ISS) were abstracted from our Trauma registry. Two certified radiologists and two certified orthopaedic surgeons retrospectively evaluated and compared PXR films and CT angiographies (CTA) of the abdomen and pelvis. We recorded each case when the management policy was altered due to the results of imaging and compared the clinical impact of both modalities. Results One hundred and twenty-nine stable blunt Multiple Trauma patients with pelvic fractures underwent CTA of the abdomen and pelvis during their initial evaluation. Mean ISS was 16.5. Average Glasgow Coma Scale on arrival was 13.2 (range 3–15). Compared to CTA, sensitivity and specificity of the PXR was 64.4 and 90.0%, respectively. CTA diagnosed 35.6% more pelvic fractures than PXR (p < 0.05). No changes in the therapeutic policy were observed following PXR results. In 19 (14.7%) patients, CTA findings led to pelvic angiography. Conclusions PXR in stable blunt Multiple Trauma patients did not change the therapeutic policy in our patients. CTA of the abdomen and pelvis is the imaging modality of choice in blunt Multiple Trauma, regardless of the findings of PXR. Benefit of routine PXR is questionable in hospitals where MDCT is available. Based on our results, we suggest re-evaluating the current practice of routine mandatory portable pelvis radiography.
Evgeni Brotfain - One of the best experts on this subject based on the ideXlab platform.
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urine flow rate monitoring in hypovolemic Multiple Trauma patients
World Journal of Emergency Surgery, 2017Co-Authors: Evgeni Brotfain, Yoram Klein, Leonid Koyfman, Micha Y Shamir, Ronen Toledano, Dmitry Frank, Moti KleinAbstract:The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill Multiple Trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive Multiple Trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems. A total of 59 patients were included in the study. The patients were divided into two study groups. Group 1 consisted of 29 Multiple Trauma patients whose systolic blood pressure was greater than 90 mmHg on admission to the ICU and who were consequently deemed to be hemodynamically compromised. Group 2 consisted of 30 patients whose systolic blood pressure was less than 90 mmHg on admission to the ICU and who were therefore regarded as hemodynamically uncompromised. The urine output and urine flow rate variability during the first 6 h of the patients’ ICU stay was significantly lower in group 2 than in group 1 (p < 0.001 and 0.006 respectively). Statistical analysis by the Pearson method demonstrated a strong direct correlation between decreased urine flow rate variability and decreased urine output per hour (R = 0.17; P = 0.009), decreased mean arterial blood pressure (R = 0.24; p = 0.001), and increased heart rate (R = 0.205; p = 0.001). These findings suggest that minute-to-minute urine flow rate variability is a reliable incipient marker of hypovolemia and that it should therefore take its place among the parameters used to monitor the hemodynamic status of critically ill Multiple Trauma patients.
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Urine flow rate monitoring in hypovolemic Multiple Trauma patients.
World Journal of Emergency Surgery, 2017Co-Authors: Evgeni Brotfain, Yoram Klein, Leonid Koyfman, Micha Y Shamir, Ronen Toledano, Dmitry Frank, Moti KleinAbstract:The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill Multiple Trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive Multiple Trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems. A total of 59 patients were included in the study. The patients were divided into two study groups. Group 1 consisted of 29 Multiple Trauma patients whose systolic blood pressure was greater than 90 mmHg on admission to the ICU and who were consequently deemed to be hemodynamically compromised. Group 2 consisted of 30 patients whose systolic blood pressure was less than 90 mmHg on admission to the ICU and who were therefore regarded as hemodynamically uncompromised. The urine output and urine flow rate variability during the first 6 h of the patients’ ICU stay was significantly lower in group 2 than in group 1 (p
Axel R Fuglmeyer - One of the best experts on this subject based on the ideXlab platform.
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is sense of coherence stable after Multiple Trauma
Clinical Rehabilitation, 2003Co-Authors: Hildegun Snekkevik, Audny Anke, Johan K Stanghelle, Axel R FuglmeyerAbstract:Objectives: To explore whether sense of coherence (SOC) is stable over time after Multiple Trauma. The associations between SOC and satisfaction with life as a whole, as well as aspects of psychological well-being, were explored. Finally, an overriding aim was to assess whether SOC has long-term prognostic value for global life satisfaction or psychological well-being.Design: Prospective study.Setting: Sunnaas Rehabilitation Hospital.Subjects: Twenty-six subjects with severe Multiple Trauma, without neuropsychological deficits.Main outcome measures: Questionnaires that were answered at admission, at discharge and at follow-up 1–3 years after Trauma were: Sense of Coherence Scale 13 items (SOC-13), satisfaction with life as a whole, General Health Questionnaire 20 items (GHQ-20), Hospital Anxiety and Depression Scale (HAD).Results: While median SOC scores were fairly stable, individual scores were not stable over time, and for some subjects showed large variations. SOC score had neither long-term prognosti...
Lei Su - One of the best experts on this subject based on the ideXlab platform.
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Ten-year retrospective analysis of Multiple Trauma complicated by pulmonary contusion.
Military Medical Research, 2014Co-Authors: Hui Jin, You-qing Tang, Zhi Guo Pan, Qiang Wen, Liqun Tang, Na Peng, Lei SuAbstract:Background This study reports a 10-year retrospective analysis of Multiple Trauma complicated by pulmonary contusion. The purpose of this study is to ascertain the risk factors for mortality due to Trauma in patients with pulmonary contusion, the impact of various treatment options for prognosis, and the risk factors for concurrent Acute Respiratory Distress Syndrome (ARDS).
