Search Our Scientific Publications & Authors

Monaldi Arch Chest Dis 2021 Apr 16;91(2). Epub 2021 Apr 16.

Department of Anesthesiology and Perioperative Medicine, Division of Critical Care, Mayo Clinic, Rochester, MN.

COVID-19 has involved numerous countries across the globe and the disease burden, susceptible age group; mortality rate has been variable depending on the demographical profile, economic status, and health care infrastructure. In the current clinical environment, COVID-19 is one of the most important clinical differential diagnoses in patients presenting with respiratory symptoms. The optimal mechanical ventilation strategy for these patients has been a constant topic of discussion and very importantly so, since a great majority of these patients require invasive mechanical ventilation and often for an extended period of time. Read More

Trauma Surg Acute Care Open 2021 13;6(1):e000712. Epub 2021 Apr 13.

Department of Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.

Background: The American College of Surgeons Resources for Optimal Care of the Injured Patient recommends using hypotension, defined as systolic blood pressure ≤90 mm Hg, as an indicator of a full team trauma activation. We hypothesized that an elevated shock index (SI) predicts significant traumatic injuries better than hypotension alone.

Methods: This is a retrospective cohort study analyzing full team trauma activations between February 2018 and January 2020, excluding transfers and those who had missing values for prehospital blood pressure or heart rate. Read More

Anaesthesist 2021 Apr 23. Epub 2021 Apr 23.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

Background: The preclinical treatment of a traumatic or spontaneous tension pneumothorax remains a particular challenge in pediatric patients. Currently recommended interventions for decompression are either finger thoracostomy or needle decompression. Due to the tiny intercostal spaces, finger thoracostomy may not be feasible in small children and surgical preparation may be necessary. Read More

Ulus Travma Acil Cerrahi Derg 2021 May;27(5):374-376

Department of Emergency Medicine, University of Health Sciences Gülhane Faculty of Medicine, Ankara-Turkey.

Subcutaneous facial emphysema is a well-known consequence of oral and maxillofacial traumatic injury. In some rare cases, the subcutaneous air collection could spread through the retropharyngeal and paralatero-cervical spaces, reaching the mediastinum. A 55-year-old man was presented to the emergency room after a blast injury caused by a blown truck tire while trying to change tires. Read More

Semin Intervent Radiol 2021 Mar 15;38(1):75-83. Epub 2021 Apr 15.

Division of Interventional Radiology, Columbia University Irving Medical Center, New York, New York.

Trauma is one of the leading causes of death worldwide. Approximately two-thirds of trauma patients have thoracic injuries. Nonvascular injury to the chest is most common; however, while vascular injuries to the chest make up a small minority of injuries in thoracic trauma, these injuries are most likely to require intervention by interventional radiology (IR). Read More

Asian Cardiovasc Thorac Ann 2021 Apr 14:2184923211010089. Epub 2021 Apr 14.

Division of Thoracic Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Aim: Pneumomediastinum (PM) is associated with several etiologies and mechanisms. Although it has been described more than 100 years ago, the literature is limited to small retrospective studies. This study aimed to follow patients with coronavirus disease (COVID-19) that developed PM during hospitalization and describe their clinical and radiological evolution. Read More

Eur J Trauma Emerg Surg 2021 Apr 1. Epub 2021 Apr 1.

Trauma Unit, Shamir Medical Center, Zeriffin, Affiliated With Sackler Faculty of Medicine, Tel Aviv University, 70300, Tel Aviv, Zerifin, Israel.

Introduction: Occult pneumothorax (OPTX) is defined as air in the pleural space that was not suspected on plain chest X-ray but detected on CT. Controversy exists in the management of OPTX, especially in patients who require positive pressure ventilation (PPV). In this study, we investigated the need for tube thoracostomy (TT) in blunt trauma patients with OPTX. Read More

Worldviews Evid Based Nurs 2021 Apr 30;18(2):147-153. Epub 2021 Mar 30.

Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.

Background: Patients with traumatic brain injury, cerebral edema, and severe hyponatremia require rapid augmentation of serum sodium levels. Three percent sodium chloride is commonly used to normalize or augment serum sodium level, yet there are limited data available concerning the most appropriate route of administration. Traditionally, 3% sodium chloride is administered through a central venous catheter (CVC) due to the attributed theoretical risk of phlebitis and extravasation injuries when hyperosmolar solution is administered peripherally. Read More

J Coll Physicians Surg Pak 2021 Mar;31(3):267-272

Department of Emergency Medicine, Maltepe Medical Park Hospital, İstanbul, Turkey.

Objective: To investigate the relationship between the prevalence of cardiopulmonary resuscitation (CPR) related thoracic injury and patients' thoracic volume and dimensions.

Study Design: Observational study.

Place And Duration Of Study: Kartal Dr. Read More

Acute Med Surg 2020 Jan-Dec;7(1):e586. Epub 2020 Nov 4.

Department of Emergency and Critical Care Medicine Hyogo Emergency Medical Center Hyogo Japan.

Aim: To investigate the clinical features of traumatic asphyxia, specifically the presence of cardiac arrest and therapeutic efficacy. This review will be useful for future emergencies.

Methods: Sixteen traumatic asphyxia cases from our hospital between April 2007 and March 2019 were reviewed and divided into three groups: those experiencing cardiac arrest at the time of rescue (group A, six cases), those experiencing cardiac arrest after rescue (group B, five cases), and those who did not experience cardiac arrest (group C, five cases). Read More

Cureus 2021 Feb 3;13(2):e13097. Epub 2021 Feb 3.

Internal Medicine, University of Kentucky, Lexington, USA.

Dobhoff tube is a specialized small-bore and flexible nasogastric tube that makes it more comfortable for placement than a usual nasogastric tube. Dobhoff tube insertion is commonly considered a relatively safe bedside procedure, but it is not without its associated risks. Inadvertent tracheobronchial placement of Dobhoff tube has been associated with severe complications, most notably pneumothorax. Read More

Indian J Crit Care Med 2021 Feb;25(2):176-180

Department of Radiodiagnosis, SLBS Medical College, Mandi, Himachal Pradesh, India.

Background/objective: Traumatic pneumothorax is an ominous condition necessitating urgent appropriate action. It is typically detected on chest X-rays; however, these may not be able to detect the presence of a subtle pneumothorax, especially in supine position. Lung ultrasound is emerging as a promising modality for detecting pneumothorax in trauma patients. Read More

Acta Radiol 2021 Mar 4:284185121995804. Epub 2021 Mar 4.

Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark.

Background: This study examined whether ultra-low-dose chest computed tomography (ULD-CT) could improve detection of acute chest conditions.

Purpose: To determine (i) whether diagnostic accuracy of ULD-CT is superior to supine chest X-ray (sCXR) for acute chest conditions and (ii) the feasibility of ULD-CT in an emergency department.

Material And Methods: From 1 February to 31 July 2019, 91 non-traumatic patients from the Emergency Department were prospectively enrolled in the study if they received an sCXR. Read More

Cureus 2021 Jan 30;13(1):e13013. Epub 2021 Jan 30.

Department of Clinical Sciences, Alabama College of Osteopathic Medicine, Dothan, USA.

Management of a complex trauma patient is a critical skill for medical students, particularly during a general surgery or emergency medicine clerkship. However, gaining proficiency with this skillset may be challenging without prior medical or simulation experience. The aim of this technical report is to present a comprehensive high-fidelity medical simulation of a polytraumatized patient with numerous injuries sustained from a 20-foot fall. Read More

Ann R Coll Surg Engl 2021 Mar;103(3):e98-e100

Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Pneumothorax resulting from traumatic thoracic injury is a potentially life-threatening emergency requiring prompt recognition and management with an intercostal drain. A 34-year-old woman was brought into the emergency department after sustaining a stab injury to the right upper outer quadrant of the right breast. She described noticing a jelly-like substance from her wound, on the background of a prior cosmetic breast augmentation. Read More

Am J Surg 2021 Feb 20. Epub 2021 Feb 20.

Department of Surgery, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada; The Trauma Program, Foothills Medical Centre, Calgary, Alberta, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada; Canadian Forces Medical Services, Ottawa, Ontario, Canada. Electronic address:

Introduction: Patients with occult pneumothorax (OPTX) requiring positive-pressure ventilation (PPV) face uncertain risks of tension pneumothorax or chest drainage complications.

Methods: Adults with traumatic OPTXs requiring PPV were randomized to drainage/observation, with the primary outcome of composite "respiratory distress" (RD)).

Results: Seventy-five (75) patients were randomized to observation, 67 to drainage. Read More

Heart Lung 2021 May-Jun;50(3):437-440. Epub 2021 Jan 29.

Inova Health System, Critical Care Medicine, 3300 Gallows Rd., Falls Church, VA 22042, United States.

Spontaneous Pneumothorax in the setting of coronavirus disease 19 (COVID-19) has been rarely described and is a potentially lethal complication. We report our institutional experience. Patients with confirmed COVID-19 who were admitted at 5 hospitals within the Inova health system between February 21 and May 2020 were included in the study. Read More

Respir Med Case Rep 2021 30;32:101354. Epub 2021 Jan 30.

Intensive Care Unit, Mohammed VI University Hospital Center, Faculty of Medecine and Pharmacy of Oujda, Mohammed I University, Oujda, Morocco.

Pneumopericardium is a rare complication of a blunt thoracic trauma. It is defined as the presence of air in the pericardial sac. There are just a few cases described in the literature. Read More

Ann Thorac Surg 2021 Feb 13. Epub 2021 Feb 13.

Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg The Netherlands. Electronic address:

Spontaneous pneumothorax can be classified in primary and secondary variants. We present a 58-year-old patient presented with a 7-week history of severe coughing, chest pain and he noticed progressive swelling of the face and upper part of the body. His medical history revealed osteoporosis and severe rheumatoid arthritis treated with steroids and DMARDs (disease modifying antirheumatic drugs). Read More

Zentralbl Chir 2021 Feb 15;146(1):126-144. Epub 2021 Feb 15.

A pneumothorax is defined by the presence of free air between the pleura visceralis and the pleura partietalis. The lung separates from the chest wall, which then, depending on several parameters, leads to a slight or clinically threatening impairment of lung function. Non-specific signs such as thoracic pain or coughing are common and do not correlate with the extent of the pneumothorax. Read More

Emerg Med J 2021 Feb 11. Epub 2021 Feb 11.

Emergency Department, Southmead Hospital, North Bristol NHS Trust, Westbury on Trym, Bristol, UK.

Background: Traumatic pneumothoraces are present in one-fifth of multiple trauma victims. Traditional teaching mandates the insertion of a chest drain in the majority of cases. However, recent observational evidence suggests a trend towards conservative management. Read More

Eur J Med Res 2021 Feb 8;26(1):19. Epub 2021 Feb 8.

Department of General and Visceral Surgery, University Hospital OWL of the University Bielefeld, campus Bielefeld-Bethel, Bielefeld, Germany.

Background: Diaphragmatic lesions as a result of blunt or penetrating trauma are challenging to detect in the initial trauma setting. This is especially true when diaphragmatic trauma is part of a polytrauma. Complications of undetected diaphragmatic defects with incarcerating bowel are rare, but as in our patient can be serious. Read More

Am J Emerg Med 2021 May 24;43:62-68. Epub 2021 Jan 24.

Department of Emergency Medicine, Chungbuk National University Hospital, 776, Sunhwan-ro, Seowon-gu, Cheongju, Republic of Korea. Electronic address:

Introduction: Point-of-care (POC) ultrasound protocols are commonly used for the initial management of patients with cardiac arrest in the emergency department (ED). However, there is little published evidence regarding any mortality benefit. We compared and studied the effect of implementation of the modified SESAME protocol in terms of clinical outcomes and resuscitation management. Read More

Am J Perinatol 2021 Jan 31. Epub 2021 Jan 31.

Neonatal Division, Department of Pediatrics, Western University, London, Canada.

Objective:  Laryngeal mask airway (LMA) has emerged as an alternative surfactant delivery method. The effectiveness of this method for the delivery of surfactant is uncertain. A meta-analysis of randomized control trials (RCTs) comparing LMA with standard methods of surfactant delivery for the outcomes of surfactant dose repetition, oxygen requirement, mechanical ventilation, intubation, mortality, bronchopulmonary dysplasia (BPD), and pneumothorax. Read More

Am J Case Rep 2021 Jan 24;22:e928094. Epub 2021 Jan 24.

Saint George's University School of Medicine, True Blue, Grenada.

BACKGROUND The prevalence of chronic medical conditions continues to rise, as does the number of patients seeking alternative treatments for them. Chronic pain is a prevalent medical complaint and acupuncture often is used to treat it. The Chinese literature documents several adverse events (AEs) associated with acupuncture, including cardiac tamponade, pneumothorax, infection, and nerve injuries. Read More

Niger J Clin Pract 2021 Jan;24(1):127-131

Department of Radiology, Hitit University School of Medicine, Çorum, Turkey.

Objectives: We aimed to evaluate the findings of whole-body computed tomography (WBCT) in pediatric high-energy trauma patients and to determine the distribution of injuries.

Materials And Methods: The WBCT images of 1132 pediatric patients who were admitted to emergency department between 2013 and 2018 for high-energy trauma were evaluated retrospectively. Six hundred and twenty patients with abdominal, chest, head, and skeletal injuries were included. Read More

Rev Med Suisse 2021 Jan;17(720-1):50-53

Service des urgences, Département des centres interdisciplinaires et logistique médicale, CHUV, 1011 Lausanne.

2020 has seen the birth of several relevant studies in emergency medicine of which the following is a selection : 1) conservative treatment for primary spontaneous pneumothorax may be offered ; 2) tranexamic acid does not provide benefit in gastrointestinal bleeding ; 3) the Canadian Syncope Risk Score is validated for the risk stratification of syncopal patients ; 4) early administration of tranexamic acid does not have a significant effect on the neurological prognosis of patients with moderate to severe trauma brain injury ; 5) the notion of frailty seems to be predictive of mortality in the event of intra-hospital cardiac arrest in elderly patients ; 6) a pharmacological cardioversion strategy followed by electrical cardioversion is as effective as initial electrical cardioversion for atrial fibrillation in the emergency room. Read More

Eur J Pediatr 2021 Feb 7;180(2):513-518. Epub 2021 Jan 7.

Department of Neonatology, Cleveland Clinic Children's, 900 Euclid Avenue, M31-37, Cleveland, OH, 44195, USA.

We aimed to assess the prevalence and outcomes of esophageal perforation in very low birth weight infants. This retrospective cohort study utilized the US National Inpatient Sample dataset for the years 2000 to 2017. A total of 1,755,418 very low birth weight infants were included; of them, 861 (0. Read More

Injury 2021 Feb 24;52(2):225-230. Epub 2020 Dec 24.

Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Xing Street, Guishan District, Taoyuan City, Taiwan.

Background: Surgery is usually suggested to treat massive haemothorax (MHT). The MHT criteria are based on penetrating trauma observations in military scenarios; the need for surgery in blunt trauma patients remains questionable. This study aimed to determine the characteristics of blunt trauma patients with MHT who required surgery. Read More