Modified McPeek score in multiple trauma patients : Prospective evaluation of a points system for recording follow-up factors.

[Modified McPeek score in multiple trauma patients : Prospective evaluation of a points system for recording follow-up factors.] Anaesthesist. 2014 Apr 10; Authors: Mathis S, Kellermann S, Schmid S, Mutschlechner H, Raab H, Wenzel V, El Attal R, Kreutziger J Abstract BACKGROUND: Many commonly available trauma scores predict mortality, but to evaluate the success of a certain therapy or for difficult scientific and epidemiological purposes this may be insufficient in the face of improved survival rates. For outcome analysis of multiple trauma patients, the extent of medical resources needed could be an additional outcome measurement. McPeek et al. developed a potential scoring system for elective surgery patients, which was recently modified for multiple trauma patients. AIM: The current study investigated if the McPeek score could be prospectively used in multiple trauma patients and whether it could become an additional helpful tool in outcome assessment. Applicability was assessed by practical examples. MATERIAL AND METHODS: In this prospective single-centre study at the University Hospital of Innsbruck, Austria, between December 2008 and November 2010 multiple trauma patients (≥ 18 years) with an injury severity score (ISS) ≥ 17 were enrolled. Besides demographic data, prehospital vital parameters and diagnoses, all diagnoses from the trauma, mortality, length of stay in the intensive care unit and the hospital were recor...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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AbstractPurpose of ReviewThis review informs the practicing clinician regarding the pathophysiology of mild traumatic brain injury and its implication on the anesthetic management of patients presenting for surgery. It highlights several areas where data is sparse that might spark the interest of researchers. It proposes a broad guideline for managing patients who present for surgery.Recent FindingsThe post-concussive brain has a vulnerable window of risk in which secondary insult might worsen long-term outcome. Scheduling elective surgery beyond this window of vulnerability might be beneficial. Several biomarkers may prov...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
The clinical use of vasoactive drugs aims to improve hemodynamic variables and thereby maintain or restore adequate perfusion and oxygenation in accordance with metabolic demands. A main focus in the management of patients with brain pathology during surgery and neurointensive care is restoring and/or maintaining adequate cerebral perfusion pressure in order to ensure cerebral blood flow in accordance with metabolic demands. One commonly used clinical strategy is the administration of vasoactive drugs aiming to increase mean arterial blood pressure and thereby cerebral perfusion pressure. Here, we first describe the anatom...
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Review Articles Source Type: research
Several lines of evidences show that anesthetics influence neurotoxicity and neuroprotection. The possibility that different anesthetic agents potentially influence the pathophysiological and functional outcome following neurotrauma was examined in a rat m...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
Publication date: 2019Source: International Review of Neurobiology, Volume 146Author(s): Hari Shanker Sharma, Dafin Fior Muresanu, Ala Nozari, Rudy J. Castellani, Prasanta Kumar Dey, Lars Wiklund, Aruna SharmaAbstractSeveral lines of evidences show that anesthetics influence neurotoxicity and neuroprotection. The possibility that different anesthetic agents potentially influence the pathophysiological and functional outcome following neurotrauma was examined in a rat model of concussive head injury (CHI). The CHI was produced by an impact of 0.224 N on the right parietal bone by dropping a weight of 114.6 g from ...
Source: International Review of Neurobiology - Category: Neuroscience Source Type: research
Publication date: Available online 8 July 2019Source: International Review of NeurobiologyAuthor(s): Hari S. Sharma, Dafin F. Muresanu, Ala Nozari, Rudy J. Castellani, Prasanta K. Dey, Lars Wiklund, Aruna SharmaAbstractSeveral lines of evidences show that anesthetics influence neurotoxicity and neuroprotection. The possibility that different anesthetic agents potentially influence the pathophysiological and functional outcome following neurotrauma was examined in a rat model of concussive head injury (CHI). The CHI was produced by an impact of 0.224 N on the right parietal bone by dropping a weight of 114.6 g fro...
Source: International Review of Neurobiology - Category: Neuroscience Source Type: research
Fernando Zanela Areas1,2, Marcelo Liborio Schwarzbold1,2,3,4, Alexandre Paim Diaz1,4, Igor Kunze Rodrigues3,5,6, Daniel Santos Sousa3,7, Camila Leite Ferreira8, João Quevedo8,9, Katia Lin1,3,10, Emil Kupek3,11, Cristiane Ritter12,13, Felipe Dal Pizzol3,12,13 and Roger Walz1,2,3,10* 1Centro de Neurociências Aplicadas, Universidade Federal de Santa Catarina, Hospital Universitário, Florianópolis, Brazil 2Programa de Pós-Graduação em Neurociências, UFSC, Florianópolis, Brazil 3Programa de Pós-Graduação em Ciências Médicas, ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
We report a case of a 13-year-old girl with HGPS who presented with an extradural haematoma following head injury. A conservative approach was successfully employed in this case, avoiding the risks of general anaesthesia and surgery.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
Traumatic brain injury (TBI) results in systemic changes in coagulation and inflammation that contribute to post-traumatic morbidity and mortality. The potential interaction of platelets and pro-inflammatory cytokines in the modulation of coagulation, microthrombosis, and venous thromboembolic events after moderate TBI has not been determined. Using a murine model, we hypothesized that the degree of platelet-induced coagulation varies depending on the platelet aggregation agonist platelet-induced coagulation changes in a time-dependent manner following TBI, and changes in platelet-induced coagulation are mirrored by change...
Source: Shock - Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
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