AI Article Synopsis
- The study examines the impact of introducing mobile digital subtraction angiography directly in trauma resuscitation areas on patient outcomes during hemorrhage management.
- A retrospective analysis showed that the time taken from the decision to perform a transcatheter arterial embolization (TAE) significantly decreased after mobile angiography was implemented, leading to quicker interventions.
- The results revealed significant differences in body temperature and pH levels between patients treated with and without mobile angiography, highlighting improved metabolic restoration in those who received immediate angiographic procedures.
Article Abstract
Background: Digital subtraction angiography is frequently required in the initial evaluation of trauma patients. We hypothesized that mobile digital subtraction angiography technology directly into the trauma resuscitation area would save time in restoring metabolic derangements for patients with on-going hemorrhage.
Materials: This is a retrospective review of a cohort of trauma patients treated before and after the direct availability of mobile angiography in the trauma resuscitation room performed by the trauma surgeons. Data collected for comparison-included demographics, hemodynamic variables, metabolic factors (pH and temperature), units of blood administered, and outcomes.
Results: Mean age, Shock Index, and Injury Severity Score were similar. The interval from the decision to perform transcatheter arterial embolization (TAE) to starting TAE were significantly different (59 minutes +/- 45 minutes vs. 31 minutes +/- 11 minutes, p = 0.001). The other resuscitation intervals were similar. The mean Deltabody temperature from emergency department arrival through completion of TAE between the two groups were significantly different (-1.18 +/- 1.69 vs. -0.08 +/- 1.42, p = 0.026). The mean DeltapH from emergency department arrival through completion of TAE were also significantly different (-0.118 +/- 0.083 vs. 0.028 +/- 0.127, p = 0.001). There were clinically significant correlations between Deltabody temperature and resuscitation interval, and between DeltapH and resuscitation interval.
Conclusion: The introduction of mobile angiography into the trauma resuscitation room and the immediate availability of trained trauma surgeons to perform diagnostic and therapeutic angiographic procedures shortened the time required to restore normal physiology.
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| http://dx.doi.org/10.1097/TA.0b013e31819dcb2d | DOI Listing |
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From the Department of Surgery, Division of Acute Care Surgery, University of Florida College of Medicine (C.A.C.), Gainesville, Florida; Methodist Dallas Medical Center (M.L.), Dallas, Texas; Department of Surgery, Loma Linda University School of Medicine (R.C.), Loma Linda, California; Department of Surgery, Division of Trauma, Acute Care & Critical Care Surgery, Tulane University School of Medicine (J.C.D.), New Orleans, Louisiana; Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine (C.F.), Baltimore, Maryland; University of Kansas Medical Center (J.H.), Kansas City, Kansas; Department of Surgery, Division of Emergency General Surgery and Acute Care Surgery, University of Alabama at Birmingham (J.B.H.), Birmingham, Alabama; Department of Surgery, Division of Trauma and Acute Care Surgery, University of Alabama (J.B.H.), Bethesda, Maryland; Department of Surgery, Division of Trauma, Surgical Critical Care and Acute Care Surgery, University of Arizona College of Medicine-Phoenix (N.K.), Phoenix, Arizona; Division of Acute Care Surgery, Department of Surgery (M.J.M., M.S.), Los Angeles General Medical Center, Los Angeles, California; Division of Vascular Surgery and Endovascular Therapy (G.A.M.), Keck Medical Center of USC, Los Angeles, California; Department of Surgery, Division of Acute Care Surgery (L.J.M.), The University of Texas McGovern Medical School-Houston Red Duke Trauma Institute, Memorial Hermann Hospital, Houston, Texas; Department of Surgery, Division of General and Acute Care Surgery, Medical University of South Carolina (A.R.P.), North Charleston, South Carolina; Department of Surgery, Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine (K.M.S.), New Haven, Connecticut; Department of Surgery, Division of Trauma and Acute Care Surgery, UCSF Department of Surgery at Zuckerberg San Francisco General Hospital (R.T.), University of California, San Francisco, San Francisco, California; Department of Surgery, Division of Trauma and Acute Care Surgery, St. Joseph's Hospital and Medical Center (J.A.W.), Phoenix, Arizona; and Program in Trauma (D.M.S), University of Maryland School of Medicine, Baltimore, Maryland.
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