organ dysfunction. Crit Care. 2004;8:R234-42. 5. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801-10. 6. Wojtaszek M, Staśkiewicz G, Torres K, Jakubowski K, Rácz O, Cipora E. Changes of procalcitonin level in multipletraumapatients. Anaesthesiol Intensive Ther. 2014;46:78-82. 7. Rajkumari N, Mathur P, Sharma S, Gupta B, Bhoi S, Misra MC. Procalcitonin as a predictor of sepsis and outcome in severe trauma patients: a prospective study. J Lab Physicians. 2013;5:100-8. 8
OBJECTIVE: The present study was designed to describe the patterns of trauma patients using a newly-introduced trauma registry, as well as retrospectively assess the management and outcome facts of these patients. MATERIALS AND METHODS: The study included 2346 patients (62.15% male) with a mean age of 34.06 ± 23.77 years. Of these patients, 355 were multiple trauma patients. Privately owned vehicles were used as a mode of transportation for most of the trauma patients (96.65%). Data regarding patient demographics, arrival at the Emergency Department, mechanism of injury, injury severity, anatomical location and type of injury were collected and analyzed. RESULTS: Falls were the most prevalent mechanism of injury, accounting for 62.19% of the total admitted cases, with other causes (that also included occupational accidents and machinery trauma) being the second most prevalent, and MVAs - the third with a rate of 11.46%. The most commonly injured body regions were the extremities (50.26%), the head (42.50%), and the torso (19.39%). Fractures represented 11.46% of the injuries, while open wounds were much more frequent (29.41%). The mean abbreviated injury severity (AIS) score was 1.78 ± 1.48 for all admitted patients and 3.56 ± 1.02 for multiple trauma patients. A multi-disciplinary approach was required for 23% of the multiple trauma patients. The clinic admission rate for the whole patient sample was 13.55% and 48.96% for multiple trauma patients. The mean duration of stay for all clinic admissions was 2.7 days and 2.9 days for multiple trauma patients. CONCLUSIONS: With the epidemiology of trauma in Greece being rather poorly investigated, the present study manages to identify the major epidemiological patterns of trauma cases presenting to a tertiary regional hospital and addresses the need for development and implementation of injury prevention activities and policies
. 2009;40:907-11. 13. Jin H, Liu Z, Xiao Y, Fan X, Yan J, Liang H. Prediction of sepsis in trauma patients. Burn Trauma. 2014;2:106-13. 14. Tranca S, Petrișor C, Hagău N , Ciuce C. Can severity scores APACHE II, SOFA, ISS, and RTS be used to predict ICU septic complications in multipletraumapatients? J Crit Care Med. 2016;3:124-30. 15. Wafaisade A, Lefering R, Bouillon B, Sakka SG, Thamm OC, Paffrath T, et al.; Trauma Registry of the German Society for Trauma Surgery. Epidemiology and risk factors of sepsis after multiple trauma: An analysis of 29,829 patients from
Traumatic Brain Injury (TBI) is one of the leading causes of death among critically ill patients from the Intensive Care Units (ICU). After primary traumatic injuries, secondary complications occur, which are responsible for the progressive degradation of the clinical status in this type of patients. These include severe inflammation, biochemical and physiological imbalances and disruption of the cellular functionality. The redox cellular potential is determined by the oxidant/antioxidant ratio. Redox potential is disturbed in case of TBI leading to oxidative stress (OS). A series of agression factors that accumulate after primary traumatic injuries lead to secondary lesions represented by brain ischemia and hypoxia, inflammatory and metabolic factors, coagulopathy, microvascular damage, neurotransmitter accumulation, blood-brain barrier disruption, excitotoxic damage, blood-spinal cord barrier damage, and mitochondrial dysfunctions. A cascade of pathophysiological events lead to accelerated production of free radicals (FR) that further sustain the OS. To minimize the OS and restore normal oxidant/antioxidant ratio, a series of antioxidant substances is recommended to be administrated (vitamin C, vitamin E, resveratrol, N-acetylcysteine). In this paper we present the biochemical and pathophysiological mechanism of action of FR in patients with TBI and the antioxidant therapy available.
, Jakubowski K, Racz O, Cipora E. Changes of procalcitonin level in multipletraumapatients. Anaesthesiol Intensive Ther. 2014;46(2):78-82. DOI: 10.5603/AIT.2014.0015 4. Rajkumari N, Mathur P, Sharma S, Gupta B, Bhoi S, Misra M. Procalcitonin as a predictor of sepsis and outcome in severe trauma patients: a prospective study. J Lab Physicians. 2013;5(2):100-8. DOI: 10.4103/0974-2727.119852 5. Lenz A, Franklin GA, Cheadle WG. Systemic inflammation after trauma. Injury. 2007;38(12):1336-45. DOI: 10.1016/j.injury.2007.10.003 6. Haasper C, Kalmbach M, Dikos GD, Meller R, Muller
Patients with multiple trauma with thoracic trauma have higher death rates compared to multiple trauma patients without thoracic trauma, mainly because of cardiac injury. We investigated the 24 hours prognostic value of NT-proB-type Natriuretic Peptide (Nt-ProBNP) in polytraumatised patients with thoracic trauma.
The study group was composed of 33 patients, 25 males and 8 females. During the study, the endpoint, which was death in the first 24 hours after admission was observed in 33% of the patients (11 patients).
Using a cut-off point of 125 pg/ml, the sensitivity of the test was 100% and the specificity was 59.09%. Accoring to the results of the study, NT-ProBNP proves that it might be useful in detecting patients with a bad prognosis, the analyzed enzyme having the capacity of identifying polytrauma patients with thoracic trauma that have high risk of death in the first 24 hours after admission.
biomarker for acute renal injury after cardiac surgery. Lancet 2005; 365(9466): 1231-1238. 5. Makris K, Markou N, Evodia E, et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) as an eary marker of acute kidney injury in critically ill multipletraumapatients. Clin Chem Lab Med 2009; 47(1): 79-82.
diagnosis of drowning. Forensic Sci Int . 2008;182:20-26. 4. Zhang M, Zhou GJ, Zhao S, Yang JX, Lu X, Gan JX, et al. Delayed diagnosis of tooth aspiration in three multipletraumapatients with mechanical ventilation. Crit Care . 2011;15:424. 5. Pérez-Cárceles MD, del Pozo S, Sibón A, et al. Serum biochemical markers in drowning: diagnostic efficacy of Strontium and other trace elements. Forensic Sci Int . 2012;214:159-166.
L, Vernic C, Nartita R, Sandesc D. Influence of antioxidant therapy on the clinical status of multipletraumapatients. A retrospective single center study. Rom J Anaesth Intensive Care . 2015;.22:89-96. 4. Park JH, Lim BG, Kim H, Lee IO, Kong MH, Kim NS. Comparison of Surgical Pleth Index – guided analgesia with conventional analgesia practices in children. Anesthesiology . 2015;122:1280-7. 5. Chen X, Thee C, Gruenewald M, Wnent J, Illies C, Hoecker J, Hanss R, Steinfath M, Bein B. Comparison of surgical stress index-guided analgesia with standard clinical
References 1. Vallier HA, Wang X, Moore TA, Wilber JH, Como JJ. Timing of orthopaedic surgery in multipletraumapatients: Development of a protocol for early appropriate care. J Orthop Trauma. 2013; 27(10):543-551. 2. Lamb CM, MacGoey P, Navarro AP, Brooks AJ. Damage control surgery in the era of damage control resuscitation. Br J Anaesth. 2014 Aug; 113(2):242-9. doi: 10.1093/bja/aeu233. 3. Amin Osama A et al. Damage control orthopedic surgery (DOC): Is there an Influence on outcome? International Journal of Health Sciences. 2011; 5,2 Suppl 1: 39-40. 4