Machine learning-based prediction models for accidental hypothermia patients.

Background: Accidental hypothermia is a critical condition with high risks of fatal arrhythmia, multiple organ failure, and mortality; however, there is no established model to predict the mortality. The present study aimed to develop and validate machine learning-based models for predicting in-hospital mortality using easily available data at hospital admission among the patients with accidental hypothermia.

Method: This study was secondary analysis of multi-center retrospective cohort study (J-point registry) including patients with accidental hypothermia.

Association of body temperature with in-hospital mortality among paediatric trauma patients: an analysis of a nationwide observational trauma database in Japan.

Objectives: To examine the association between body temperature (BT) on hospital arrival and in-hospital mortality among paediatric trauma patients.

Design: A retrospective cohort study.

Setting: Japan Trauma Data Bank (JTDB, which is a nationwide, prospective, observational trauma registry with data from 235 hospitals).

Body temperature and in-hospital mortality in trauma patients: analysis of a nationwide trauma database in Japan.

Purpose: Avoiding body temperature (BT) abnormalities has been emphasized in trauma care, and BT correction in the initial treatment period may improve patient outcome. However, the effect of hyperthermia at hospital arrival on mortality in trauma patients is unclear. This study aimed to identify the association between BT and in-hospital mortality among adult trauma patients.

Early treatment of progressive vertebral arteriovenous fistula caused by cervical penetrating injury.

Background: Penetrating injury of the vertebral artery (VA) is uncommon because it lies deep in the neck and is surrounded by a bony foramen. Vertebral-venous fistula is a rare vascular condition in which there is direct aberrant communication among the extracranial vertebral artery, its radicular or muscular branches, and adjacent venous structures.

Case Presentation: We report an asymptomatic patient of fistula from the vertebral artery to the paravertebral veins secondary to a cervical stab wound that increased in size and flow, as observed on the angiogram 10 days later, which was successfully treated by endovascular surgery.

Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study.

Background: Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have been established.

Drastic drop in blood flow of extracorporeal membrane oxygenation induced by an excessive increase in intra-abdominal pressure in an obese patient.

Obesity and conditions that increase intra-abdominal pressure (IAP) should be considered as risk factors for reduced extracorporeal membrane oxygenation (ECMO) blood flow (BF) drastically. For obese patients on ECMO, effective IAP control and risk factor assessment is necessary to prevent excessive IAP elevation and subsequent drop in ECMO BF.

Association between the Japan Coma Scale scores at the scene of injury and in-hospital outcomes in trauma patients: an analysis from the nationwide trauma database in Japan.

Objective: Japan Coma Scale (JCS) is a grading system used to evaluate disturbed consciousness in prehospital care settings. We aimed to identify the association between the JCS levels at the scene with in-hospital mortality, as well as the discrimination ability for the outcomes.

Design: A retrospective cohort study based on the nationwide trauma database in Japan.

Correction to: The development and validation of a "5A" severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data.

[This corrects the article DOI: 10.1186/s40560-019-0384-2.].

The development and validation of a "5A" severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data.

Background: Accidental hypothermia is a serious condition that requires immediate and accurate assessment to determine severity and treatment. Currently, accidental hypothermia is evaluated using the Swiss grading system which uses core body temperature and clinical findings; however, research has shown that core body temperature is not associated with in-hospital mortality in urban settings. Therefore, we developed and validated a severity scale for predicting in-hospital mortality among urban Japanese patients with accidental hypothermia.

Survival After Cardiac Arrest With Instantaneous Rigorlike Stiffness: A Case Report.

Instantaneous rigor is the immediate appearance of rigor mortis after cardiac arrest. To our knowledge, no previous reports exist on resuscitation of such patients. A young athlete suddenly collapsed with cardiac arrest during a marathon; his legs stiffened with instantaneous rigorlike stiffness.

Massive systemic arterial air embolism caused by an air shunt after blunt chest trauma: A case report.

Introduction: Systemic arterial air embolism (SAAE) is a rare but fatal condition, with only a few cases reported, and the detailed etiology underlying SAAE remains unknown. We report a first case of massive SAAE after blunt chest injury, wherein the presence of traumatic air shunt was confirmed by direct observation during surgery. We also summarize our experience with six other SAAE cases.

Late recovery from unconsciousness in a patient with severe posterior reversible encephalopathy syndrome.

This study describes a patient case presenting with severe posterior reversible encephalopathy syndrome (PRES) who needed 3 months to recover impaired consciousness. We discuss the protracted time course needed to deal with severe PRES cases. Positive prognoses can emerge from these situations if treatment is prompt and precise.

Prognostic factors for patients with accidental hypothermia: A multi-institutional retrospective cohort study.

Introduction: In cases of severe accidental hypothermia (AH) in urban areas, the prognostic factors are unknown. We identified factors associated with in-hospital mortality in patients with moderate-to-severe AH in urban areas of Japan.

Method: The J-Point registry database is a multi-institutional retrospective cohort study for AH in 12 Japanese emergency departments.

Treatment for unstable pulmonary sequestration injury in patient with severe blunt trauma: A case report.

Case: Pulmonary sequestration is a congenital malformation characterized by nonfunctioning tissue not communicating with the tracheobronchial tree. As the blood pressure in the artery feeding the sequestrated lung tissue is higher than that in the normal pulmonary artery, the risk of massive hemorrhage in pulmonary sequestration is high. We herein present the first case of a severe blunt trauma patient with unstable pulmonary sequestration injury.

Management of pediatric 'cannot intubate, cannot oxygenate'.

Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department.

Bloody Bronchial Cast Formation Due to Alveolar Hemorrhage Associated with H1N1 Influenza Infection.

A previously healthy 55-year-old man with H1N1 influenza A presented with severe respiratory failure and cardiac arrest. Following the return of spontaneous circulation, venovenous extracorporeal membrane oxygenation was required to maintain oxygenation. On day 2, bronchoscopy revealed a bloody bronchial cast obstructing the right main bronchus.

Anatomical landmarks for safely implementing resuscitative balloon occlusion of the aorta (REBOA) in zone 1 without fluoroscopy.

Background: Resuscitative balloon occlusion of the aorta (REBOA) can maintain hemodynamic stability during hemorrhagic shock after a following torso injury, although inappropriate balloon placement may induce brain or visceral organ ischemia. External anatomical landmarks [the suprasternal notch (SSN) and xiphoid process (Xi)] are empirically used to implement REBOA in zone 1. We aimed to confirm if these landmarks were useful for determining a balloon catheter length for safe implementation of REBOA in zone 1 without using fluoroscopy.

Lower limb ischemia caused by resuscitative balloon occlusion of aorta.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure to manage severe hemorrhagic shock from torso injury but can cause severe ischemia of the lower extremities. However, lower extremity ischemia occurring as a complication of REBOA has been rarely reported. We describe the severe lower extremity ischemia caused by REBOA with a 12-Fr sheath in a small-built patient.

Damage control management of innominate artery injury with tracheostomy.

Innominate artery injury is a rare, but catastrophic complication of tracheostomy. We present a case of severe hemorrhagic shock in a 79-year-old male with innominate artery injury that occurred during tracheostomy. Despite temporary innominate artery isolation, the regional forehead saturation was 60 % without laterality.