Routine follow-up cranial computed tomography for deeply sedated, intubated, and ventilated multiple trauma patients with suspected severe head injury.

Background: Missed or delayed detection of progressive neuronal damage after traumatic brain injury (TBI) may have negative impact on the outcome. We investigated whether routine follow-up CT is beneficial in sedated and mechanically ventilated trauma patients.

Methods: The study design is a retrospective chart review.

Pros and cons of etomidate--more discussion than evidence?

Purpose Of Review: To evaluate the most recent publications in the long-lived debate over the use of etomidate in critically ill septic and trauma patients.

Recent Findings: Virtually without controversy is the hemodynamic stability after its use for induction of anesthesia on the one hand, and its negative effect on steroid synthesis on the other. The rating of the relative importance of both phenomena for the outcome of patients is however a highly controversial issue.

High-frequency oscillatory ventilation with and without arteriovenous extracorporeal lung assist in patients with severe respiratory failure.

Purpose: Elimination of carbon dioxide by an arteriovenous extracorporeal lung assist (av-ECLA) can facilitate the lung protective capabilities of high-frequency oscillatory ventilation (HFOV). This case series describes patients treated with HFOV because of severe respiratory failure with and without additional av-ECLA.

Methods: A retrospective analysis of 31 patients regarding patient characteristics, gas exchange, respirator settings, hemodynamics, and outcome.

Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time.

Objective: Whole-body multislice helical computed tomography (MSCT) becomes increasingly important as a diagnostic tool in patients with multiple injuries. We describe time requirement of two different diagnostic approaches to multiple injuries one with whole-body-MSCT (MSCT Trauma-Protocol) as the sole radiologic procedure and one with conventional use of radiography, combined with abdominal ultrasound and organ focused CT (Conventional-Trauma-Protocol).

Methods: Observational study with retrospective analysis of time requirements for resuscitation, diagnostic workup and transfer to definitive treatment after changing from conventional to MSCT Trauma-Protocol.

Application of standard operating procedures accelerates the process of trauma care in patients with multiple injuries.

Objective: Objective of this study is to determine whether the formulation of standard operating procedures (SOPs) and their incorporation in a trauma pathway are associated with an improvement of trauma treatment process.

Materials And Methods: A retrospective data analysis of traumatized patients treated before the introduction of the SOPs (group I) and after a SOP training period of 6 months (group II) was performed. The time required for resuscitation (period A), diagnostic workup (period B) and total stay in the emergency room (period C) was used as a marker of trauma team performance.

Whole-body multislice computed tomography as the primary and sole diagnostic tool in patients with blunt trauma: searching for its appropriate indication.

In our hospital, whole-body multislice computed tomography is used as the primary diagnostic tool in patients with suspected multiple trauma. A triage rule is used for its indication. We have retrospectively analyzed data of sedated, intubated and ventilated patients consecutively admitted to our trauma center to assess whether the triage rule can help identify patients with severe trauma (injury severity score > or = 16).