Pediatric solid organ injury – frequency of abdominal imaging is determined by the treating department

Zimmermann, Peter; Schmidt, Torben; Nelson, Jana; Gosemann, Jan‐Hendrik; Bassler, Stefan; Stahmeyer, Jona T.; Hirsch, Wolfgang; Lacher, Martin; Zeidler, Jan

doi:10.1097/md.0000000000023057

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…This could aid in monitoring posttraumatic organ damage, and thus potentially avoid the overload of the need for CT scans, particularly in children after AT caused by external trauma or maltreatment. 38 As a limitation of the study, we only investigated male mice, even though some gender differences after blunt AT are likely and have been reported in rats during the development of an abdominal compartment syndrome. 39 Future studies need to also address the organ response in female mice.…”

Section: Discussionmentioning

confidence: 99%

“…Further studies using this blunt AT model should not only define additional DAMPs, including mitochondrial debris, 36,37 but also whether damage markers such as L‐FABP and intestinal‐fatty acid binding protein could reliably discriminate the damaged organs with a sufficient spatial resolution. This could aid in monitoring posttraumatic organ damage, and thus potentially avoid the overload of the need for CT scans, particularly in children after AT caused by external trauma or maltreatment 38 …”

Section: Discussionmentioning

confidence: 99%

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Temporal–spatial organ response after blast‐induced experimental blunt abdominal trauma

et al. 2021

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Abdominal trauma (AT) is of major global importance, particularly with the increased potential for civil, terroristic, and military trauma. The injury pattern and systemic consequences of blunt abdominal injuries are highly variable and frequently underestimated or even missed, and the pathomechanisms remain still poorly understood. Therefore, we investigated the temporal-spatial organ and immune response after a standardized blast-induced blunt AT. Anesthetized mice were exposed to a single blast wave centered on the epigastrium. At 2, 6, or 24 h after trauma, abdominal organ damage was assessed macroscopically, microscopically, and biochemically. A higher degree of trauma severity, determined by a reduction of the distance between the epigastrium and blast inductor, was reflected by a reduced survival rate. The hemodynamic monitoring during the first 120 min after AT revealed a decline in the mean arterial pressure within the first 80 min, whereas the heart rate remained quite stable. AT induced a systemic damage and inflammatory response, evidenced by elevated HMGB-1 and IL-6 plasma levels. The macroscopic injury pattern of the abdominal organs (while complex) was consistent, with the following frequency: liver > pancreas > spleen > left kidney > intestine > right kidney > others > lungs and was reflected by microscopic liver and pancreas damages. Plasma levels of organ dysfunction markers increased during the first 6 h after AT and subsequently declined, indicating an early, temporal impairment of the function on a multi-organ level. The established highly reproducible murine blunt AT, with time-and trauma-severity-dependent organ injury patterns, systemic inflammatory response, and impairment of various organ functions, reflects characteristics of human AT. In the future, thisThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Temporal–spatial organ response after blast‐induced experimental blunt abdominal trauma

et al. 2021

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“…Consequently, one strength of this study is the large study population we were able to analyze. Many studies have demonstrated the ability of claims data to adequately represent pediatric care conditions [ 12 , 21 , 22 , 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…This represents a further advantage of specialized pediatric trauma care. Medical professionals who provide care to children daily might be more conscious of the potential long-term effects of radiation exposure, including the increased risk of cancer-related deaths [ 12 , 13 ]. In addition, pediatric departments typically cooperate with pediatric radiologists who ensure that radiation exposure is kept to a minimum [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Because of anatomical and physiological differences, children with thoracic injuries present different injury patterns than adults [ 8 , 10 , 11 ]. Evaluating pediatric trauma patients can be difficult because of physiological and developmental factors that vary with age, changes in mental condition, and the discomfort that inexperienced medical providers may experience when caring for children [ 12 , 13 ]. Research indicates that injured children who receive medical care at adult trauma centers have a notably higher in-hospital mortality compared with those treated at pediatric trauma centers [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Management of Children and Adolescents with Chest Trauma in Pediatric and Non-Pediatric Departments—A Claims Data Analysis

et al. 2023

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Background: To investigate the management of children and adolescents with isolated and combined chest trauma in pediatric (PD) and non-pediatric departments (non-PD). Methods: Anonymized claims data were provided by two large German statutory health insurance funds, covering 6.3 million clients over a 10-year period (2010–2019). Data were extracted for patients who had an inpatient ICD diagnosis of section S20–S29 (injuries to the thorax) and were ≤18 years of age. Demographic and clinical data were analyzed. Results: A total of 4064 children and adolescents with chest trauma were included (mean age 12.0 ± 5.0 years; 55% male). In 1928 cases (47.4%), treatment was provided at PD. Patients admitted to PD underwent CT imaging less frequently (8.1%; non-PD: 23.1%; p < 0.0001). Children with a chest drain treated at university/maximum care hospitals (UM) showed more injuries involving multiple body regions compared with non-UM (25.8% vs. 4.5%; p = 0.0061) without a difference in the length of hospital stay. Conclusion: Children and adolescents with chest trauma are treated almost equally often in pediatric and adult departments. CT is significantly less frequently used in pediatric departments. Patients with a chest drain treated at a UM showed more concomitant injuries without a longer hospital stay. However, the clinical validity of this finding is questionable.

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Characteristics and Validation of Pediatric Extremity Vascular Trauma in Dedicated Pediatric and Adult Trauma Centers: A Scoping Review Protocol

Argyriou,

Varlami,

Kambouri

et al. 2024

Annals of Vascular Surgery

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Pediatric solid organ injury – frequency of abdominal imaging is determined by the treating department

Abstract: Supplemental Digital Content is available in the text

Cited by 5 publications

References 26 publications

Temporal–spatial organ response after blast‐induced experimental blunt abdominal trauma

Temporal–spatial organ response after blast‐induced experimental blunt abdominal trauma

Management of Children and Adolescents with Chest Trauma in Pediatric and Non-Pediatric Departments—A Claims Data Analysis

Characteristics and Validation of Pediatric Extremity Vascular Trauma in Dedicated Pediatric and Adult Trauma Centers: A Scoping Review Protocol

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