https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:53320 Wed 22 Nov 2023 09:57:30 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:16782 Wed 11 Apr 2018 16:42:39 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:22611 80%, and four (33%) accepted by > 50%, but required discussion to produce revised definitions. One (8%) was rejected by > 50%. In addition to previous 2006 definitions, the panel also defined the open abdomen, lateralization of the abdominal musculature, polycompartment syndrome, abdominal compliance, and suggested a refined open abdomen classification system. Recommendations were possible regarding intra-abdominal pressure (IAP) measurement, approach to sustained IAH, philosophy of protocolized IAP management and same-hospital-stay fascial closure, use of decompressive laparotomy, and negative pressure wound therapy. Consensus suggestions included use of non-invasive therapies for treating IAH/ACS, considering body position and IAP, damage control resuscitation, prophylactic open abdomen usage, and prudence in early biological mesh usage. No recommendations were made for the use of diuretics, albumin, renal replacement therapies, and utilizing abdominal perfusion pressure as a resuscitation-endpoint. Collaborating Methodological Guideline Development and Clinical Experts produced Consensus Definitions/Clinical Management statements encompassing the most contemporary evidence. Data summaries now exist for clinically relevant IAH/ACS questions, which will facilitate future scientific reanalysis.]]> Wed 11 Apr 2018 15:45:19 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:27064 Wed 11 Apr 2018 12:19:11 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:34455 Wed 04 Sep 2019 09:56:05 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20162 Tue 24 Aug 2021 14:24:33 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52069 Thu 28 Sep 2023 08:52:42 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:6927 Sat 24 Mar 2018 08:40:24 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7097 Sat 24 Mar 2018 08:37:59 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7817 15; age > 18, head Abbreviated Injury Scale (AIS) <3 and survival >48 h). MOF was prospectively defined by the Denver MOF score greater than 3 points. Data are presented as % or Mean+/−SEM. Univariate statistical comparison was performed (Student t-test, X2 test), P < 0.05 was considered significant. Results: Twenty-nine patients met inclusion criteria (Age 40+/−4, ISS 29+/−3, Male 62%), five patients developed MOF. The incidence of MOF among trauma patients admitted to ICU was 2% (5/204) and 17% (5/29) in the high-risk cohort. The maximum average MOF score was 6.3 +/−1, with the average duration of MOF 5+/−2 days. Two patients had respiratory and cardiac failure, two patients had failure of respiratory, cardiac and hepatic systems, while one patient had failure of respiratory, hepatic and renal systems. One MOF patient died, all non MOF patients survived. MOF patients had longer ICU stays (20+/−4 versus 7+/−0.8 P= 0.01), tended to be older (60+/−11 versus 35+/−4 p=0.07). None of the previously described independent predictors (ISS, base deficit, lactate, transfusions) were different when the MOF patients were compared with the non-MOF patients. Conclusion: The incidence of MOF in Australia is consistent with the international data. In Australia MOF continues to cause significant late mortality and morbidity in trauma patients. MOF patients have longer ICU stay than high-risk non MOF patients, and use significant resources. Our preliminary data challenges the timeliness of the 10-year-old independent predictors of post-injury MOF. The epidemiology, the clinical presentation and the independent predictors of post-injury MOF require larger scale reassessment for the Australian context.]]> Sat 24 Mar 2018 08:37:36 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:9499 15/year] underwent autopsy and were prospectively evaluated during 2005. High-energy (HE) and low-energy (LE) deaths were categorized based on the mechanism of the injury, time frame (prehospitalization, <48 hours, 2–7 days, >7 days), and cause [which was determined by an expert panel and included central nervous system-related (CNS), exsanguination, CNS + exsanguination, airway, multiple organ failure (MOF)]. Data are presented as a percent or the mean ± SEM. Results: There were 175 deaths during the 12-month period. For the 103 HE fatalities (age 43 ± 2 years, ISS 49 ± 2, male 63%), the predominant mechanisms were motor vehicle related (72%), falls (4%), gunshots (8%), stabs (6%), and burns (5%). In all, 66% of the patients died during the prehospital phase, 27% died after <48 hours in hospital, 5% died after 3 to 7 days in hospital, and 2% died after >7 days. CNS (33%) and exsanguination (33%) were the most common causes of deaths, followed by CNS + exsanguination (17%) and airway compromise 8%; MOF occurred in only 3%. Six percent of the deaths were undetermined. All LE deaths (n = 72, age 83 ± 1 years, ISS 14 ± 1, male 45%) were due to low falls. All LE patients died in hospital (20% <48 hours, 32% after 3–7 days, 48% after 7 days). The causes of deaths were head injury (26%) and complications of skeletal injuries (74%). Conclusions: The HE injury mechanisms, time frames, and causes in our study are different from those in the earlier, seminal reports. The classic trimodal death distribution is much more skewed to early death. Exsanguination became as frequent as lethal head injuries, but the incidence of fatal MOF is lower than reported earlier. LE trauma is responsible for 41% of the postinjury mortality, with distinct epidemiology. The LE group deserves more attention and further investigation.]]> Sat 24 Mar 2018 08:35:36 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14325 Sat 24 Mar 2018 08:26:22 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:15356 Sat 24 Mar 2018 08:25:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:12321 Sat 24 Mar 2018 08:11:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:16061 Sat 24 Mar 2018 08:03:43 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:17326 120) or Glasgow Coma Scale score <14 on arrival were excluded. Nausea, vomiting, and antiemetic use were recorded. RESULTS: Convenience sample of 196 trauma resuscitation patients (68% men; age, 42 ± 18 years, mean Injury Severity Score 8 ± 7) were interviewed over the 5-month study period, of a total 369 admitted trauma patients (53%). Seventy-five (38%) patients reported some degree of nausea, 57 (29%) moderate or severe nausea, and 15 (8%) vomited. Older age and female gender were associated with vomiting (p < 0.01). Seventy-nine patients (40%) received a prophylactic antiemetic. Of these, four became nauseous (5%), compared with 71 of 117 (61%) for patients not given an antiemetic (p < 0.0001). CONCLUSIONS: Prehospital nausea and vomiting are more common in our cohort of trauma patients than the reported rates in the literature for nontrauma patients transported to hospital by ambulance. Only 40% of patients receive prophylactic antiemetics, but those patients are less likely to develop symptoms.]]> Sat 24 Mar 2018 08:01:47 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19806 Sat 24 Mar 2018 07:57:11 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5095 Sat 24 Mar 2018 07:48:52 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5194 Sat 24 Mar 2018 07:47:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5468 Sat 24 Mar 2018 07:46:59 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5329 15 from 16% to 13% during the 8-year study period (statistical significance not shown), the avoidable mortality rate remained unchanged at 25%! The findings and suggestions of the paper represent only one hospital and the recommendations are potentially relevant only to the major trauma centres in Australia and New Zealand. The aim of this editorial is to summarize the key findings of this landmark Australian paper, which are relevant to the delivery of surgical trauma care.]]> Sat 24 Mar 2018 07:45:56 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5026 Sat 24 Mar 2018 07:44:10 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4921 Sat 24 Mar 2018 07:21:12 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4774 Sat 24 Mar 2018 07:20:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52816 Mon 30 Oct 2023 08:44:26 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33969 Fri 25 Jan 2019 14:42:24 AEDT ]]>