A Patient with Polytrauma Including a Severe Head Injury, Haemothorax and Cardiac Tamponade

Gunetilleke, Bhagya

doi:10.4038/slja.v17i2.1303

Cited by 3 publications

(9 citation statements)

References 3 publications

(14 reference statements)

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“…Penurunan berat badan, latihan olahraga dan pengobatan apnea tidur obstruktif sebelum dilakukan tindakan pembedahan dapat menurunkan resiko anestesi dan stres akibat operasi. [3][4][5][6] Hal-hal ini mungkin sulit pada pasienpasien yang datang dengan kegawatdaruratan medis yang memerlukan tindakan pembedahan segera, seperti pada pasien kami. [11][12][13][14] Fase edema harus diobati dengan penerapan PEEP, diuretik dan administrasi cairan terkontrol.…”

Section: Penilaian Pra Operasiunclassified

“…[16][17][18] A= Airway= Jalan Napas Evaluasi awal dan resusitasi pasien dengan trauma di bagian gawat darurat secara tradisional mengikuti pendekatan ''ABCD '-penilaian saluran napas, pernapasan, sirkulasi, dan cacat neurologis berat. [3][4][5][6][11][12][13][14][15][16][17][18] Fungsi pernafasan dasar harus ditetapkan dari riwayat pasien dan pemeriksaan fisik. Oksimetri portabel dengan laju nadi mungkin menjadi alat monitoring yang berguna lebih lanjut.…”

Section: Penilaian Pra Operasiunclassified

“…Supine arterial oxygen saturation (SpO 2 ) <96% pada udara ruangan memerlukan pemeriksaan lebih lanjut (spirometri, analisis gas darah arteri) untuk hasil yang lebih tepat. [3][4][5][6][11][12][13][14][15][16][17][18] Indikasi untuk intubasi endotrakeal segera pada pasien trauma adalah sebagai berikut 4 : cedera kepala dengan GCS <10; ketidakstabilan hemodinamik yang parah; obstruksi jalan nafas; pasien kombinasi yang membutuhkan sedasi atau analgesia; anestesi umum; trauma dada dengan hipoventilasi (dada anterior flail> 8 iga); tandatanda kegagalan pernapasan: apnea> 2-3 mnt, tingkat pernapasan <10 atau> 29 / mnt, PaO 2 <60 mmHg dan PaCO 2 > 55 mmHg.…”

Section: Penilaian Pra Operasiunclassified

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Tatakelola Anestesi untuk Dekompresi Kraniektomi pada Cedera Otak Traumatik Berat dengan Penyulit Obesitas Morbid

Sumardi¹,

Rachman

Oetoro³

2020

JNI

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Anestesi dan pembedahan mungkin meyebabkan risiko yang cukup besar untuk pasien obesitas, apalagi obesitas morbid. Populasi orang gemuk meningkat, baik di negara maju dan berkembang, sehingga para ahli anestesi lebih sering menghadapi tantangan dalam mengelola pasien obesitas. Trauma multipel bertanggung jawab atas 5 juta kematian per tahun di seluruh dunia dan merupakan penyebab kematian utama bagi orang-orang muda di bawah 40 tahun, mewakili peristiwa akut dan tak terduga. Kami akan melaporkan seorang lelaki 36 tahun dengan obesitas morbid, BMI 48,97 kg/m2, yang mengalami multipel trauma akibat kecelakaan lalulintas, yang akan menjalani operasi evakuasi perdarahan subdural dan dekompresi kraniektomi. Pemilihan obat dan dosis aman sangat sulit pada pasien dengan multipel trauma, karena mungkin status volumenya tidak diketahui secara akurat. Rencana anestesi harus mempertimbangkan status resusitasi dan riwayat penyakit penyerta lain. Peran penting lainnya dari anestesiologis adalah pencegahan cedera sekunder yang disebabkan oleh syok berulang atau resusitasi tidak tepat. Anesthesia Management for Craniectomy Decompression on Severe Brain Traumatic Injury with Comorbid Morbid Obesity AbstractAnesthesia and surgery may cause considerable risk for obese patients, especially morbid obesity. Obese populations increase, both in developed and developing countries, so anesthesiologists more often face challenges in managing obese patients. Multiple traumas is responsible for 5 million deaths per year worldwide and is the leading cause of death for young people under 40, representing acute and unexpected events. We will report a 36-year-old man with morbid obesity, a BMI of 48.97 kg/m2, who experienced multiple traumas due to a traffic accident, who will undergo an evacuation operation for subdural hemorrhage and craniectomy decompression. The selection of drugs and safe doses is very difficult in patients with multiple traumas, because their volume status may not be accurately known. Anesthetic plan must consider resuscitation status and history of other comorbidities. Another important role of anesthesiologist is the prevention of secondary injury caused by recurrent shock or improper resuscitation.

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Section: Penilaian Pra Operasiunclassified

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Tatakelola Anestesi untuk Dekompresi Kraniektomi pada Cedera Otak Traumatik Berat dengan Penyulit Obesitas Morbid

Sumardi¹,

Rachman

Oetoro³

2020

JNI

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“…9) Among various types of polytrauma, severe traumatic brain injury (TBI) is classified as Glasgow Coma Scale (GCS) score<9, carries a poor prognosis and the mortality in severe brain injury is approximately 25% with only 20% recovering with a good outcome. 11) The successful management of polytraumatised patients remains challenging despite of expanding scientific knowledge and modern diagnostic and therapeutic approaches. Initial management of the polytrauma patient is of vital importance to minimizing both patient morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Polytrauma on the Follow-Up Neuroimaging and Patients' Prognosis

Kim

2010

J Korean Neurotraumatol Soc

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Our point of interest was focused on the relationship between prognosis and radiographic findings in brain computed tomography (CT) and/or magnetic resonance imaging (MRI) from long-term bedridden patients due to polytrauma with head injury who had been followed-up for more than 6 months. Methods: We had reviewed 47 long-term (>6 months) admitted patients due to polytrauma for 8 years. We retrospectively studied patients' prognosis using clinical parameters such as age, gender, duration of admission, mode of injury, previous medical disease, associated injuries, diffuse axonal injury, space occupying lesion, Glasgow Coma Scale (GCS) score, Glasgow Outcome Scale (GOS) and operative procedures done. Results: GOS was correlated well with GCS score in polytrauma patients (p<0.001). The operative procedure (decompressive craniectomy) had strong impact on the formation of ventriculomegaly (Evans index≥0.3; p<0.001). The mode of injury also had statistical significance on post-traumatic cerebral infarction (p=0.022). Conclusion: Our study reveals the effect of polytrauma has significant impact on the follow-up neuroimaging and patients' prognosis. But further study using larger number of experimental groups is needed for more statistically significant result.

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“…It is the second most common reason of lethal outcomes in all age groups and the leading cause of death in adults younger than 45years. Among the causes of deaths due to trauma, motor vehicle crashes accounts for as much as 70% of deaths [1]. Polytrauma is the complicated process caused by the damage of a few body areas with manifestation of mutual overloading syndrome, which results in deep metabolism violations [2].…”

Section: Introductionmentioning

confidence: 99%

Evidence of Posttraumatic Coagulopathy in Case of the Severe Combined Thoracic Trauma

Stupnytskyi¹,

Жуков²

2016

AMS

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A Patient with Polytrauma Including a Severe Head Injury, Haemothorax and Cardiac Tamponade

Cited by 3 publications

References 3 publications

Tatakelola Anestesi untuk Dekompresi Kraniektomi pada Cedera Otak Traumatik Berat dengan Penyulit Obesitas Morbid

Tatakelola Anestesi untuk Dekompresi Kraniektomi pada Cedera Otak Traumatik Berat dengan Penyulit Obesitas Morbid

The Effect of Polytrauma on the Follow-Up Neuroimaging and Patients' Prognosis

Evidence of Posttraumatic Coagulopathy in Case of the Severe Combined Thoracic Trauma

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