Document Detail


Does CT evidence of a flat inferior vena cava indicate hypovolemia in blunt trauma patients with solid organ injuries?
MedLine Citation:
PMID:  21378583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nonoperative management for selective patients with solid organ injuries from blunt trauma has gained wide acceptance. However, for trauma surgeons, it is often difficult to estimate a patient's circulatory volume. Some authors have proposed that the presence of a collapsed inferior vena cava (IVC) on computed tomography (CT) scan correlates with inadequate circulatory volume. Our aim was to verify whether CT evidence of a flat IVC (FI) is an indicator of hypovolemia in blunt trauma patients with solid organ injuries.
METHODS: We conducted a retrospective chart review of all blunt trauma patients with solid organ injuries admitted to our Medical Center from July 2003 to September 2006. Of the 226 patients reviewed, 29 had CT evidence of FI. We compared Injury Severity Scores, hemodynamic parameters, fluid and blood transfusion requirements, mortality rate, and hospital course between patients with (FI group) and without FI (non-FI [NFI] group).
RESULTS: The FI group had higher rates of intensive care unit admission and mortality, in addition to longer intensive care unit stays, when compared with the NFI group. In addition, the patients in the FI group needed larger amounts of fluid and blood transfusions and presented lower hemoglobin levels during the first week of admission; furthermore, the majority deteriorated to a state of shock in the emergency department.
CONCLUSIONS: CT evidence of FI is a good indicator of hypovolemia and an accurate predictor for prognosis in trauma patients with blunt solid organ injuries.
Authors:
Yu-Ying Liao; Hung-Jung Lin; Yu-Hui Lu; Ning-Ping Foo; How-Ran Guo; Kuo-Tai Chen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  70     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-08-05     Completed Date:  2011-10-31     Revised Date:  2012-01-27    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1358-61     Citation Subset:  AIM; IM    
Affiliation:
Emergency Department , Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Injuries / radiography*
Adult
Blood Transfusion / statistics & numerical data
Chi-Square Distribution
Emergency Service, Hospital / organization & administration*
Female
Fluid Therapy
Hemodynamics
Hospital Mortality
Humans
Hypovolemia / radiography*
Injury Severity Score
Intensive Care Units / utilization
Length of Stay / statistics & numerical data
Male
Predictive Value of Tests
Retrospective Studies
Tomography, X-Ray Computed / methods*
Vena Cava, Inferior / radiography*
Wounds, Nonpenetrating / mortality,  radiography*,  therapy
Comments/Corrections
Comment In:
J Trauma. 2011 Oct;71(4):1092; author reply 1092   [PMID:  21986757 ]
J Trauma. 2011 Dec;71(6):1924-5; author reply 1925   [PMID:  22182907 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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