Trauma Hybrid Operating Room (THOR) shortened procedure time in abdominopelvic trauma patients requiring surgery and interventional radiology procedures

Prichayudh, Supparerk; Rajruangrabin, Jaratvit; Sriussadaporn, Suvit; Pak‐art, Rattaplee; Sriussadaporn, Sukanya; Kritayakirana, Kritaya; Samorn, Pasurachate; Narueponjirakul, Natawat; Uthaipaisanwong, Apinan; Aimsupanimitr, Punthita; Chaisiriprasert, Patcharee; Kranokpiraksa, Pawanrat; Chanpen, Nantiskarn; Pinjaroen, Nutcha; Ouwongprayoon, Pongsakorn; Charoenvisal, Ching; Jantarattana, Trirat

doi:10.1016/j.injury.2022.11.004

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Furthermore, especially in post-depacking bleeding, the surgical approach may consist of major hepatic resection and portal vein ligation if the interventional approach did not work [26,32,[110][111][112][113][114].…”

Section: Discussionmentioning

confidence: 99%

“…CE-CT allows radiologists to assess the percentage of parenchymal injuries and then estimate the degree of damage and plan a surgical or medical approach [ 21 ]. Surely, if available, hybrid operating rooms also best benefit the fast execution of CE-CT of the interventional and surgical procedures [ 22 , 23 , 24 , 25 , 26 ]. CE-CT is also useful for monitoring injured patients after treatment to evaluate infective or hemorrhagic complications [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

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Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma

Brunese,

Avella,

Cappuccio

et al. 2024

JPM

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Background: Acute liver injury occurs most frequently due to trauma, but it can also occur because of sepsis or drug-induced injury. This review aims to analyze artificial intelligence (AI)’s ability to detect and quantify liver injured areas in adults and pediatric patients. Methods: A literature analysis was performed on the PubMed Dataset. We selected original articles published from 2018 to 2023 and cohorts with ≥10 adults or pediatric patients. Results: Six studies counting 564 patients were collected, including 170 (30%) children and 394 adults. Four (66%) articles reported AI application after liver trauma, one (17%) after sepsis, and one (17%) due to chemotherapy. In five (83%) studies, Computed Tomography was performed, while in one (17%), FAST-UltraSound was performed. The studies reported a high diagnostic performance; in particular, three studies reported a specificity rate > 80%. Conclusions: Radiomics models seem reliable and applicable to clinical practice in patients affected by acute liver injury. Further studies are required to achieve larger validation cohorts.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma

Brunese,

Avella,

Cappuccio

et al. 2024

JPM

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“…Such handovers are fraught with hazards and can contribute to deterioration of clinical practice ( 2 ). However, the development of hybrid rooms, with integrated resuscitation, imaging, surgical and angiography capacity, means that the same team can take care of the patient ( 43 ). This Trauma Hybrid Operating Room (THOR) concept not only mandates specific training in technical skills, but also poses significant challenges regarding NTS.…”

Section: Future Perspectives: Hybrid Room Teams and Ntsmentioning

confidence: 99%

Non-technical skills and teamwork in trauma: from the emergency department to the operating room

Alexandrino,

Martinho,

Ferreira

et al. 2023

Front. Med.

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Management of a trauma patient is a challenging process. Swift and accurate clinical assessment is required and time-sensitive decisions and life-saving procedures must be performed in an unstable patient. This requires a coordinated response by both the emergency room (ER) and operating room (OR) teams. However, a team of experts does not necessarily make an expert team. Root cause analysis of adverse events in surgery has shown that failures in coordination, planning, task management and particularly communication are the main causes for medical errors. While most research is focused on the ER trauma team, the trauma OR team also deserves attention. In fact, OR team dynamics may resemble more the ER team than the elective OR team. ER and OR trauma teams assemble on short notice, and their members, who are from different specialties and backgrounds, may not train regularly together or even know each other beforehand. And yet, they have to perform high-risk procedures and make high stake decisions, in a time-sensitive manner. The airline industry has long recognized the role of team training and non-technical skills (NTS) in reducing hazards. The implementation of the so called crew resource management or crisis resource management (CRM) has significantly made airline travel safer and the transposition to the medical context, with specific training in non-technical skills, has also brought great benefits. In fact, it is clear that adoption of non-technical skills (NTS) in healthcare has led to an increase in patient safety. In this narrative review we recapitulate some of the key non-technical skills and their relevance in trauma, with a focus on both the emergency department (ER) and the operating room (OR) teams, as well as on the transition of care from one to the other. Also, we explore the use of debriefing the team, as well as the roles of NTS training in both undergraduate and postgraduate settings. We review some of the existing trauma training courses and their roles in developing NTS. Finally, we briefly address the challenges posed by the development of trauma hybrid operating rooms.

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“…One goal of a hybrid room is to facilitate interventions in patients requiring angiography for hepatic bleeding. The benefits of the hybrid room include reduced transport times and reduced mortality due to blood loss in patients with liver hemorrhage [29]. A hybrid room consisting of an emergency trauma bay and an IR suite was described by Ahn et al [30] in the successful treatment of two renal trauma patients with severe injuries.…”

Section: Hybrid Roommentioning

confidence: 99%

Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

Roh

2023

J Trauma Inj

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Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

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Trauma Hybrid Operating Room (THOR) shortened procedure time in abdominopelvic trauma patients requiring surgery and interventional radiology procedures

Cited by 4 publications

References 13 publications

Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma

Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma

Non-technical skills and teamwork in trauma: from the emergency department to the operating room

Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

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