Controle de danos no trauma abdominal e lesões associadas: experiência de cinco anos em um serviço de emergência



Título del documento: Controle de danos no trauma abdominal e lesões associadas: experiência de cinco anos em um serviço de emergência
Revista: Revista do Colegio Brasileiro de Cirurgioes
Base de datos: PERIÓDICA
Número de sistema: 000283553
ISSN: 0100-6991
Autores: 1
2
Instituciones: 1Hospital Universitario Cajuru, Servico de Cirurgia Geral, Cajuru, Parana. Brasil
2Pontificia Universidade Catolica do Parana, Curitiba, Parana. Brasil
Año:
Volumen: 33
Número: 4
Paginación: 215-219
País: Brasil
Idioma: Portugués
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés BACKGROUND: Based on the concept of damage control this study analyzes, epidemiologically, patients submitted to this surgical modality in the Cajuru University Hospital (HUC) in Curitiba, Paraná. METHODS: During the period of January 2001 through March 2005, records of patients of diverse trauma have been revised. RESULTS: Thirty nine patients were submitted to damage control, 35 were males (87.74%) and 4 were females (10.26%). Patients’ age varied from 4 to 73 years-old, average of 30.35 years-old. Penetrating trauma occurred in 24 patients (61.54%), including 18 patients (46.15%) victims of gunshot wounds and 6 (15.38%) victims of stabwounds. Abdominal blunt trauma occurred in 15 patients (38.46% of total). Injury Severity Score (ISS) was 44.03. The amount of blood derivates used was 7.2 red cell packages and 4.95 units of plasma. Ph during the first surgery was 71 and BE (base excess) -14.4. Duration of the first surgery was 174.18 minutes (2.9 hours). Immediate complications have been shown in 28 patients (53.85%). The survival rate was 20.51% (n=8) and time of permanence in Intensive Care Unit (ICU) after the first surgery was 41.75 hours (n=24). CONCLUSION: As a matter of fact, damage control can improve survival rates of multiple and severe injured patients if hemodynamics status in the first 24 hours after the trauma is stabilized. If this attempts fails, mortality still remains high; as it is demonstrated on this survey and on searched literature
Resumen en portugués (n=8) e o tempo médio de permanência na Unidade de Terapia Intensiva (UTI) após a primeira cirurgia foi de 41,75 horas (n=24). A maioria dos óbitos (n=17) ocorreu nas primeiras 24 horas de internação. CONCLUSÕES: O Damage Control é de fato uma medida que aumenta a taxa de sobrevida dos pacientes gravemente traumatizados, desde que esses mesmos pacientes tenham uma estabilização dentro das primeiras 24 horas, caso isso não ocorra a taxa de mortalidade ainda permanecerá elevada, como demonstrado neste levantamento e na literatura pesquisada
Disciplinas: Medicina
Palabras clave: Cirugía,
Gastroenterología,
Traumatología y ortopedia,
Traumatismos,
Lesiones,
Heridas,
Abdomen,
Control de daños,
Cirugía abdominal
Keyword: Medicine,
Gastroenterology,
Surgery,
Traumatology and orthopedics,
Trauma,
Wounds,
Lesions,
Abdomen,
Damage control,
Abdominal surgery
Texto completo: Texto completo (Ver HTML)