Introduction of mobile angiography into the trauma resuscitation room.
BACKGROUND
Digital subtraction angiography is frequently required in the initial evaluation of trauma patients. We hypothesized that mobile digital subtraction angiography technology directly into the trauma resuscitation area would save time in restoring metabolic derangements for patients with on-going hemorrhage.


METHODS
This is a retrospective review of a cohort of trauma patients treated before and after the direct availability of mobile angiography in the trauma resuscitation room performed by the trauma surgeons. Data collected for comparison-included demographics, hemodynamic variables, metabolic factors (pH and temperature), units of blood administered, and outcomes.


RESULTS
Mean age, Shock Index, and Injury Severity Score were similar. The interval from the decision to perform transcatheter arterial embolization (TAE) to starting TAE were significantly different (59 minutes +/- 45 minutes vs. 31 minutes +/- 11 minutes, p = 0.001). The other resuscitation intervals were similar. The mean Deltabody temperature from emergency department arrival through completion of TAE between the two groups were significantly different (-1.18 +/- 1.69 vs. -0.08 +/- 1.42, p = 0.026). The mean DeltapH from emergency department arrival through completion of TAE were also significantly different (-0.118 +/- 0.083 vs. 0.028 +/- 0.127, p = 0.001). There were clinically significant correlations between Deltabody temperature and resuscitation interval, and between DeltapH and resuscitation interval.


CONCLUSIONS
The introduction of mobile angiography into the trauma resuscitation room and the immediate availability of trained trauma surgeons to perform diagnostic and therapeutic angiographic procedures shortened the time required to restore normal physiology.
Morozumi
Junya
J
Department of Emergency and Critical Care Medicine, Tokyo Medical University Hospital, Tokyo, Japan. junya99@tokyo-med.ac.jp
Ohta
Shoichi
S
Homma
Hiroshi
H
Sasaki
Hirokazu
H
Oda
Jun
J
Suzuki
Kaori
K
Ohtaka
Yuichi
Y
Noda
Mariko
M
Mishima
Shiro
S
Yukioka
Tetsuo
T
D000007:Abdominal Injuries; D000328:Adult; D015901:Angiography, Digital Subtraction / Q000295:instrumentation* / Q000379:methods; D001158:Arteries / Q000293:injuries*; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D004636:Emergency Service, Hospital; D005119:Extravasation of Diagnostic and Therapeutic Materials; D006801:Humans; D008875:Middle Aged; D019095:Point-of-Care Systems; D012189:Retrospective Studies; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000628:therapy*; D016019:Survival Analysis; D013898:Thoracic Injuries; D036542:Tomography, Spiral Computed / Q000295:instrumentation / Q000379:methods; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000150:complications