Der Würzburger Schockraumalgorithmus

Wurmb, Thomas; Frühwald, Peter; Brederlau, Jörg; Steinhübel, Bernhard; Frommer, Marvin Lucas; Kuhnigk, Herbert; Kredel, Markus; Knüpffer, J.; Hopfner, Witiko; Maroske, J.; Moll, Roland; Wagner, R; Thiede, A.; Schindler, G.; Roewer, Norbert

doi:10.1007/s00101-005-0850-1

Anaesthesist

2005

DOI: 10.1007/s00101-005-0850-1

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Der Würzburger Schockraumalgorithmus

Thomas Wurmb

Peter Frühwald²,

Jörg Brederlau

et al.

Abstract: The Würzburg polytrauma algorithm worked well. There was excellent cooperation within the interdisciplinary leading team consisting of anaesthesiologists, surgeons, and radiologists. The principles of ATLS could be respected. Mobile whole body multislice CT was an effective tool in the diagnostic evaluation of polytrauma patients.

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Cited by 34 publications

References 26 publications

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Systematic review and meta-analysis of immediate total-body computed tomography compared with selective radiological imaging of injured patients

Sierink¹,

Saltzherr²,

Reitsma

et al. 2011

British Journal of Surgery

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Background:The aim of this review was to assess the value of immediate total-body computed tomography (CT) during the primary survey of injured patients compared with conventional radiographic imaging supplemented with selective CT.Methods: A systematic search of the literature was performed in MEDLINE, Embase, Web of Science and Cochrane Library databases. Reports were eligible if they contained original data comparing immediate total-body CT with conventional imaging supplemented with selective CT in injured patients. The main outcomes of interest were overall mortality and time in the emergency room (ER).Results: Four studies were included describing a total of 5470 patients; one study provided 4621 patients (84·5 per cent). All four studies were non-randomized cohort studies with retrospective data collection. Mortality was reported in three studies. Absolute mortality rates differed substantially between studies, but within studies mortality rates were comparable between immediate total-body CT and conventional imaging strategies (pooled odds ratio 0·91, 95 per cent confidence interval 0·79 to 1·05). Time in the ER was described in three studies, and in two was significantly shorter in patients who underwent immediate total-body CT: 70 versus 104 min (P = 0·025) and 47 versus 82 min (P < 0·001) respectively. Conclusion:This review showed differences in time in the ER in favour of immediate total-body CT during the primary trauma survey compared with conventional radiographic imaging supplemented with selective CT. There were no differences in mortality. The substantial reduction in time in the ER is a promising feature of immediate total-body CT but well designed and larger randomized studies are needed to see how this will translate into clinical outcomes.

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Systematic review and meta-analysis of immediate total-body computed tomography compared with selective radiological imaging of injured patients

Sierink¹,

Saltzherr²,

Reitsma

et al. 2011

British Journal of Surgery

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Indications for total-body computed tomography in blunt trauma patients: a systematic review

Treskes

Saltzherr

Luitse

et al. 2016

Eur J Trauma Emerg Surg

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PurposeTotal-body CT scanning (TBCT) could improve the initial in-hospital evaluation of severe trauma patients. Indications for TBCT, however, differ between trauma centers, so more insight in how to select patients that could benefit from TBCT is required. The aim of this review was to give an overview of currently used indications for total-body CT in trauma patients and to describe mortality and Injury Severity Scores of patient groups selected for TBCT.MethodsA systematic review was performed by searching MEDLINE and Embase databases. Studies evaluating or describing criteria for selection of patients with potentially severe injuries for TBCT during initial trauma care were included. Also, studies comparing total-body CT during the initial assessment of injured patients with conventional imaging and selective CT in specific patient groups were included.ResultsThirty eligible studies were identified. Three studies evaluated indications for TBCT in trauma with divergent methods. Combinations of compromised vital parameters, severe trauma mechanisms and clinical suspicion on severe injuries are often used indications; however, clinical judgement is used as well. Studies describing TBCT indications selected patients in different ways and were difficult to compare regarding mortality and injury severity.ConclusionsIndications for TBCT in trauma show a wide variety in structure and cut-off values for vital parameters and trauma mechanism dimensions. Consensus on indications for TBCT in trauma is lacking.Electronic supplementary materialThe online version of this article (doi:10.1007/s00068-016-0711-4) contains supplementary material, which is available to authorized users.

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Schockraummanagement ohne konventionelle Radiographie?

Wurmb

Frühwald²,

Brederlau

et al. 2006

Anaesthesist

Self Cite

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Der Würzburger Schockraumalgorithmus

Cited by 34 publications

References 26 publications

Systematic review and meta-analysis of immediate total-body computed tomography compared with selective radiological imaging of injured patients

Systematic review and meta-analysis of immediate total-body computed tomography compared with selective radiological imaging of injured patients

Indications for total-body computed tomography in blunt trauma patients: a systematic review

Schockraummanagement ohne konventionelle Radiographie?

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