[Prospective evaluation of the role of abdominal echocardiography in the treatment of seriously traumatized patients].
The reliability of abdominal ultrasonography (US) in a clinical algorithm for emergency management of blunt trauma was evaluated prospectively. From November 1, 1987 to December 31, 1988, of 111 severe trauma victims admitted to our ICU, 63 were screened according to protocol by US for peritoneal fluid and splenic and/or hepatic injuries. The mean age was 49.6 years. The mean ISS and APACHE II Score was 26.9 and 13.7 respectively. The sensitivity of US for detection of peritoneal fluid was 95%, specificity 97.6%, positive predictive value 95%, negative predictive value 97.6% with a prevalence of 31.7%. For hepatic and splenic injuries instead the results were not as good as for abdominal fluid. Twelve patients underwent laparotomy and 6 with abdominal injuries were successfully treated nonoperatively with serial US examinations. Overall mortality was 12 (19%). No patients died for delayed or missed diagnosis of abdominal injury.
Possamai
C
C
Corbanese
U
U
Ruga
P
P
Cipriano
R
R
Scarpellini
M
M
Uzzielli
G
G
Da Ros
A
A
D000007:Abdominal Injuries / Q000175:diagnosis*; D000328:Adult; D000465:Algorithms; D001202:Ascitic Fluid / Q000175:diagnosis; D004452:Echocardiography; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013154:Spleen / Q000293:injuries
Valutazione prospettica del ruolo dell'ecografia addominale nel trattamento del grave traumatizzato.