| Does CT evidence of a flat inferior vena cava indicate hypovolemia in blunt trauma patients with solid organ injuries? | |
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MedLine Citation:
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PMID: 21378583 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Yu-Ying Liao; Hung-Jung Lin; Yu-Hui Lu; Ning-Ping Foo; How-Ran Guo; Kuo-Tai Chen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 70 ISSN: 1529-8809 ISO Abbreviation: J Trauma Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-08-05 Completed Date: 2011-10-31 Revised Date: 2012-01-27 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 1358-61 Citation Subset: AIM; IM |
Affiliation:
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Emergency Department , Chi-Mei Medical Center, Liouying, Tainan, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Injuries
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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:
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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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