Purpose
INTRODUCTION:•Management and prognosis in a multi trauma patient is usually based on the hemodynamic parameters , however CT findings if used appropriately can guard them better.•To address these questions, we performed a retrospective review of the records of all patients with blunt trauma treated at our institution in a recent 4-year period.AIMS & OBJECTIVES:•To correlate the individual parameter used for assessing hemodynamic unstability with the outcome.•Toevaluate the best single or combined parameter for predicting the need for surgery.
Methods and Materials
•Hospital-based study conducted from MAY 2004 to JAN 2008.•164 consecutive patients who presented blunt trauma and undervent abdominopelvic CT for evaluation were included.Selection Criteria of the patient:•Patients with blunt abdominal trauma who underwent CT for evaluation of intra-abdominal injury prior to surgery.Exclusion Criteria of the patient:•Patients who did not have a follow up (laparotomy / follow up imaging if managed conservatively) were excluded.Selection Criteria of the patient:•Patients with blunt abdominal trauma who underwent CT for evaluation of intra-abdominal injury prior to surgery.Exclusion Criteria of the...
Results
•The mean age was 37 yrs, and 76 % were male.•69% of patients had CT done within 12 hrs of the trauma.•The major cause of blunt trauma in our study was RTA (86%).Hemodynamic status of Patients:Of the various parameters used in evaluating the hemodynamic stability of the patients, shock index more than 0.9 was seen in 63% of the patients. 88 % of the patients had hemoglobin less than 10 gm%. PCV less than 30% was seen in 60% of the patients.HEMOGLOBIN CORRELATION WITH HEMODYNAMIC...
Conclusion
•Flat IVC is the best predictor ofOM and combineduseof FFS< III and normal IVC are the best predictor for NOM.•To conclude prevalence of flat IVC andFFS among multiple-trauma patients is likely to be underestimated in assessing OM VSNOMand must be determined by independent application of reference standards such as CT in correlation with patient clinical status.•It is important to establish prognostic criteria allowing decisions for conservative or surgical treatment; CT findings may be used to make a first differentiation of severity of lesions, but hemodynamic...
References
Jeffrey. Michael. P. Federle The Collapsed. Inferior Vena Cava: CT Evidence of Hypovolemia. Am J Roentgenol. 1988;150:431-432.Willman Jurgen K, Roos J.E., Platz A. et al. Multi director CT : Detection of Active Hemorrhaged in Patients with Blunt Abdominal Trauma. AJR 2002; 179; 437-444.Pierre A. Poletti, Karen Kinkel, Bernard Vermeulen et al. Blunt Abdominal Trauma: Should US Be Used to Detect Both Free Fluid and Organ Injuries? Radiology 2003; 227:95.Wong YC, Wang LJ, See LC, Fang JF, Ng CJ, Chen CJ. Contrast material extravasation on contrast-enhanced...
Personal Information
Author details:Dr. Abhishek Mahajan, MBBS,MDFellow in Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]