Abstract:
OBJECTIVE:The objective of this study was to examine the ability of Focused Assessment Using Sonography for Trauma (FAST) to discriminate between survivors and nonsurvivors undergoing resuscitative thoracotomy (RT). BACKGROUND:RT is a high-risk, low-salvage procedure performed in arresting trauma patients with poorly defined indications. METHODS:Patients undergoing RT from 10/2010 to 05/2014 were prospectively enrolled. A FAST examination including parasternal/subxiphoid cardiac views was performed before or concurrent with RT. The result was captured as adequate or inadequate with presence or absence of pericardial fluid and/or cardiac motion. A sensitivity analysis utilizing the primary outcome measure of survival to discharge or organ donation was performed. RESULTS:Overall, 187 patients arrived in traumatic arrest and underwent FAST. Median age 31 (1-84), 84.5% male, 51.3% penetrating. Loss of vital signs occurred at the scene in 48.1%, en-route in 23.5%, and in the ED in 28.3%. Emergent left thoracotomy was performed in 77.5% and clamshell thoracotomy in 22.5%. Sustained cardiac activity was regained in 48.1%. However, overall survival was only 3.2%. An additional 1.6% progressed to organ donation. FAST was inadequate in 3.7%, 28.9% demonstrated cardiac motion and 8.6% pericardial fluid. Cardiac motion on FAST was 100% sensitive and 73.7% specific for the identification of survivors and organ donors. CONCLUSIONS:With a high degree of sensitivity for the detection of potential survivors after traumatic arrest, FAST represents an effective method of separating those that do not warrant the risk and resource burden of RT from those who may survive. The likelihood of survival if pericardial fluid and cardiac motion were both absent was zero.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Inaba K,Chouliaras K,Zakaluzny S,Swadron S,Mailhot T,Seif D,Teixeira P,Sivrikoz E,Ives C,Barmparas G,Koronakis N,Demetriades Ddoi
10.1097/SLA.0000000000001421subject
Has Abstractpub_date
2015-09-01 00:00:00pages
512-8; discussion 516-8issue
3eissn
0003-4932issn
1528-1140pii
00000658-201509000-00013journal_volume
262pub_type
杂志文章abstract:OBJECTIVE:To review the current concepts in the mediastinal staging of nonsmall cell lung cancer (NSCLC), evaluating traditional and modern staging modalities. SUMMARY BACKGROUND DATA:Staging of NSCLC includes the assessment of mediastinal lymph nodes. Traditionally, computed tomography (CT) and mediastinoscopy are us...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.SLA.0000081086.37779.1a
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:To analyze outcomes after open small-incision surgery (minilaparotomy) and laparoscopic surgery for gallstone disease in general surgical practice. METHODS:This study was a randomized, single-blind, multicenter trial comparing laparoscopic cholecystectomy (LC) to minilaparotomy cholecystectomy (MC). Both ele...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-200112000-00005
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:Congenital diaphragmatic hernia (CDH) remains a significant cause of neonatal morbidity and mortality. SUMMARY OF BACKGROUND DATA:Previous studies have suggested that hospital volume is an independent predictor of in-hospital mortality. We sought to validate this effect using a large national database incor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f5b538
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures. BACKGROUND:Laparoscopic appendectomy has rare but relevant complications, namely i...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001742
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To investigate the long-term effect of cryopreservation on hepatocyte function, as well as attempt to improve cell viability and function through the utilization of the hypothermic preservation solution, HypoThermosol (HTS), as the carrier solution. SUMMARY BACKGROUND DATA:Advances in the field of bioartific...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000149303.48692.0f
更新日期:2005-01-01 00:00:00
abstract::Interactions between molecules control intra- and intercellular physiology. Cancer is emerging as a disease in which individual molecules are either overproduced, mutated, expressed at inappropriate stages of development, or lost due to inheritance or aberrant mitotic division. The major players in this contest of cel...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199007000-00002
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to define the incidence and etiology of small bowel obstruction (SBO) after nephrectomy for Wilms' tumor. SUMMARY BACKGROUND DATA:Intestinal obstruction is one of the most common postoperative complications after nephrectomy for nephroblastoma. However, few reports have evaluated ri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199321850-00011
更新日期:1993-11-01 00:00:00
abstract::The management of retroperitoneal hematomas remains confusing to many surgeons because the available literature frequently groups patients with blunt and penetrating etiologies together. Because the underlying injuries and their treatment may differ considerably, the nonoperative or operative approach to the common he...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199002000-00001
更新日期:1990-02-01 00:00:00
abstract::Studies were performed to further investigate an abnormality of the alternative complement pathway associated with burn injury. C3 conversion by inulin and cobra venom factor was measured in serial serum samples from 18 burned patients and in the sera from 25 normal controls. C3 conversion by both activating substance...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198108000-00018
更新日期:1981-08-01 00:00:00
abstract:BACKGROUND:In the era of pre- or perioperative therapy for gastric cancer, clinical staging before treatment appears to be increasingly important for prognosis, yet there are no data on the subject for resectable gastric cancer patients. OBJECTIVES:To evaluate the prognostic role of preoperative locoregional staging i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ca69a7
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the operation rate in Ghana and characterize it by types of procedures and hospital level. BACKGROUND:The Lancet Commission on Global Surgery recommended an annual rate of 5000 operations/100,000 people as a benchmark at which low- and middle-income countries could achieve most of the population-...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002457
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:By comparing cohorts in 2 exclusive time frames, the factors that affected the surgical outcomes of patients with hepatocellular carcinoma (HCC) are presented. SUMMARY BACKGROUND DATA:Reportedly, survival results of patients with HCC who underwent hepatectomy have improved in recent years. However, the major...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000217921.28563.55
更新日期:2006-08-01 00:00:00
abstract::Twenty patients with extremity soft tissue tumors were prospectively evaluated with magnetic resonance imaging (MRI) and computed tomography (CT) scans with subsequent anatomic correlation of surgical findings. MRI and CT had a similar percentage of accuracy in assessing tumor relationship with major neurovascular (80...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198704000-00002
更新日期:1987-04-01 00:00:00
abstract::Twenty-seven patients with postoperative enterocutaneous fistulas were treated with parenteral nutrition and SMS 201-995 (100 micrograms/8 hours, subcutaneously), a long half-life somatostatin analogue. At the time SMS 201-995 was started, 11 patients had low output fistulas (less than 1000 ml/48 hours), 11 patients h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198907000-00009
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:Esophagectomy for esophageal cancer is associated with substantial postoperative morbidity as a result of infectious complications. In a prior phase II study, granulocyte colony-stimulating factor (G-CSF) was shown to improve leukocyte function and to reduce infection rates after esophagectomy. The aim of the...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.sla.0000129705.00210.24
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair. BACKGROUND:Lightweight meshes reduce postoperative pain and stiffness in open anterior ingu...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000001579
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To examine the financial impact of quality improvement using Medicare payment data. BACKGROUND:Demonstrating a business case for quality improvement--that is, that fewer complications translates into lower costs--is essential to justify investment in quality improvement. Prior research is limited to cross-se...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001069
更新日期:2015-08-01 00:00:00
abstract::Thrombotic thrombocytopenic purpura (TTP) is a disease process characterized by microangiopathic anemia, fever, neurologic manifestations, renal abnormalities, and thrombocytopenia. These clinical findings are caused by vascular occlusions of the microcirculation. At present the utilization of splenectomy, in the trea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197811000-00021
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility and safety of laparoscopic liver resections. SUMMARY BACKGROUND DATA:The use of the laparoscopic approach for liver resections has remained limited for technical reasons. Progress in laparoscopic procedures and the development of dedicated technology have made it possible to conside...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200012000-00004
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:To assess long-term outcome and prognostic factors for extreme surgery by vascular and plastic surgical teamwork for leg salvage in patients with critically ischemic large tissue defects. SUMMARY BACKGROUND DATA:Combined vascular reconstruction and microvascular free-flap transfer has been used to improve di...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000247985.45541.e8
更新日期:2006-12-01 00:00:00
abstract::Forty-nine patients undergoing elective or emergent gastric surgery have been included in this study. Gastric needle aspiration was performed at the time of surgery in each case, followed by qualitative aerobic and anaerobic bacteriologic analysis. In 18 patients undergoing elective operation for chronic nonobstructin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197511000-00004
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVE:Compare outcomes of non-emergent laparoscopic to open colon surgery. BACKGROUND:Laparoscopy has revolutionized much of gastrointestinal surgery. Colon and rectal surgery has seen drastic changes with many of the abdominal operations being performed laparoscopically. However, data comparing recovery and compl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819ec903
更新日期:2009-04-01 00:00:00
abstract::Verapamil administered before treatment, but not after treatment, had a beneficial effect on a 90-minute warm ischemia-reperfusion rat liver injury model. The possible activation of proteases converting the xanthine dehydrogenase to xanthine oxidase, the significant mitochondrial calcium loading during the ischemic pe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199102000-00008
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:This study hypothesized that tumor size, number of tumors, surgical approach, and tumor histology significantly affected microwave ablation (MWA) success and recurrence-free survival. BACKGROUND:Although many hepatobiliary centers have adopted MWA, the factors that influence local control are not well descri...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000234
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Metabolic activity of transformed human liver (Hep G2) cells and primary rat hepatocytes were compared during in vitro application of a gel entrapment bioartificial liver. BACKGROUND:Clinical trials of bioartificial liver devices containing either transformed liver cells or primary hepatocytes have been init...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To identify patient characteristics associated with the development of local recurrence and the effect of local recurrence on subsequent morbidity and mortality in patients with intermediate- to high-grade extremity soft tissue sarcomas. SUMMARY BACKGROUND DATA:Numerous studies on extremity soft tissue sarco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000048448.56448.70
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine characteristics of the most cited publications in the history of the American Surgical Association (ASA). SUMMARY BACKGROUND DATA:The Annals of Surgery has served as the journal of record for the ASA since 1928, with a special issue each year dedicated to papers present...
journal_title:Annals of surgery
pub_type: 历史文章,杂志文章
doi:10.1097/SLA.0000000000003633
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The authors determined if more radical surgery with extended lymphadenectomy improves the results of gastrectomy in patients with adenocarcinoma of the gastric antrum. SUMMARY BACKGROUND DATA:The overall survival in patients with gastric cancer is disappointing. Improved survival has been reported by Japanes...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199408000-00009
更新日期:1994-08-01 00:00:00
abstract::Gastric carcinoma following operation for benign peptic ulcer disease has been considered rare but nine patients have been seen during the past five years. All were male patients, the average time interval from prior ulcer operation to development of cancer was 17 years, but was a short as ten years. The symptoms of c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197803000-00007
更新日期:1978-03-01 00:00:00
abstract::Segments of rat inferior vena cava were modified by proteolytic digestion and dialdehyde starch tanning in an attempt to alter their antigenic nature and increase their tensile strength. These tissues were found to retain their ability to sensitize allogeneic recipients in both the intradermal and intra-aortic positio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197708000-00018
更新日期:1977-08-01 00:00:00