Acil serviste “Genişletilmiş Acil Travma Ultrasonografisi” uygulamalarının klinik karar üzerine etkisi
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇÇalışmamızda, “Genişletilmiş Acil Travma Ultrasonografi” (GATUS) uygulamasının, çoklu travma hastasında, karıniçi yaralanma, hemotoraks, yanı sıra pnömotoraks saptamada duyarlılığını, ayrıca invaziv işlem gerekliliğiyle ilişkisini göstermeyi amaçladık.GEREÇ VE YÖNTEMAcil servise başvuran, çoklu travmalı hastalar çalışmaya alındı. Hasta hakkında klinik bilgisi olmayan araştırmacı acil hekimi tarafından yatakbaşı GATUS yapıldı. Supin akciğer grafiği bulguları, yapılan invaziv girişimler kaydedildi. Karın ve toraks bilgisayarlı tomografi (BT) (pnömotoraks düzeyine göre skorlama yapıldı) sonuçlarıysa radyoloji uzman düzeyinde değerlendirildi.BULGULARBT ile karşılaştırıldığında, karıniçi yaralanma ve hemotoraks için GATUS duyarlılıkları sırasıyla %54,5 ve %71 idi. GATUS ile tanılanamayan hemotoraks ve karıniçi yaralanmalarda herhangi bir invaziv müdahale yapılamadığı görüldü. Toraks BT’sinde pnömotoraks saptanan 33 (%30,8) hastadan GATUS ile 27 (%25,2) hasta pnömotoraks tanısı aldı (duyarlılık %81,8). Yapılan skorlamaya göre GATUS ile “genişliği 1 cm’den az veya uzunluğu midkoronal çizgiyi geçmeyen” pnömotoraksların atlandığı görüldü. Tüp torakostomi uygulanan hastaların tamamında, GATUS pozitifti.SONUÇGATUS, invaziv işlem gerektirebilecek pnömotoraksların saptanmasında, yüksek duyarlılık ile kullanılabilir. Hemotoraks ve karıniçi yaralanmaların tanınmasındaysa duyarlılığı düşük olmakla beraber invaziv işlem gerekliliğini öngörülmesinde yol gösterebilir.
BACKGROUNDWe aimed to show the sensitivity of Extended Focused Assessment with Sonography for Trauma (e-FAST) for detection of pneumothorax, hemothorax and intraabdominal injury. We also investigated the relationship between e-FAST and need for invasive treatment.METHODSThis study included patients who experienced multiple trauma. The emergency physician, who had no clinical information about the patient, performed e-FAST. Findings on a supine chest X-ray and invasive interventions were recorded. The results of abdomen and thorax computed tomography (CT) were reviewed (the size of the pneumothorax was scored).RESULTSCompared with CT, the sensitivities of e-FAST for intraabdominal injury and hemothorax were 54.5% and 71%, respectively. The patients with hemothorax and intraabdominal injuries were not identified with e-FAST, didn’t need for invasive intervention. Pneumothorax diagnosis was established in 27 patients with e-FAST (sensitivity 81.8%) from among 33 (30.8%) pneumothorax patients. According to the grading on CT, pneumothoraces less than 1 cm in width and not exceeding the midcoronal line in length were not identified. e-FAST was positive for all patients performed with tube thoracostomy.CONCLUSIONe-FAST can be used with high sensitivity for determination of pneumothorax requiring invasive procedure. It has low sensitivity in the diagnosis of intraabdominal injury and hemothorax; however, e-FAST can predict the need for invasive procedures.
BACKGROUNDWe aimed to show the sensitivity of Extended Focused Assessment with Sonography for Trauma (e-FAST) for detection of pneumothorax, hemothorax and intraabdominal injury. We also investigated the relationship between e-FAST and need for invasive treatment.METHODSThis study included patients who experienced multiple trauma. The emergency physician, who had no clinical information about the patient, performed e-FAST. Findings on a supine chest X-ray and invasive interventions were recorded. The results of abdomen and thorax computed tomography (CT) were reviewed (the size of the pneumothorax was scored).RESULTSCompared with CT, the sensitivities of e-FAST for intraabdominal injury and hemothorax were 54.5% and 71%, respectively. The patients with hemothorax and intraabdominal injuries were not identified with e-FAST, didn’t need for invasive intervention. Pneumothorax diagnosis was established in 27 patients with e-FAST (sensitivity 81.8%) from among 33 (30.8%) pneumothorax patients. According to the grading on CT, pneumothoraces less than 1 cm in width and not exceeding the midcoronal line in length were not identified. e-FAST was positive for all patients performed with tube thoracostomy.CONCLUSIONe-FAST can be used with high sensitivity for determination of pneumothorax requiring invasive procedure. It has low sensitivity in the diagnosis of intraabdominal injury and hemothorax; however, e-FAST can predict the need for invasive procedures.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Ulusal Travma ve Acil Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
19
Sayı
4
