Int�ressant... Avant de r�pondre plus longuement, pourait-tu expliquer ce que tu veut dire par "des cowboys"?
Ray ----- Original Message ----- From: "Charles Brault" <[EMAIL PROTECTED]> To: "URG-L Mailing List" <[EMAIL PROTECTED]> Sent: Friday, July 25, 2003 12:34 PM Subject: URG-L: Trauma,_transfert_et_�DU_(�cho_au_DU) > > Aille ! ! ! > Des cowboys ! > > > > The Role of Ultrasound in Patients with Possible Penetrating Cardiac > Wounds: A Prospective Multicenter Study > > Grace S. Rozycki,RDMS, MD, David V. Feliciano, MD, M. Gage Ochsner, > MD, M. Margaret Knudson, MD, David B. Hoyt, MD, Frank Davis, MD, > David Hammerman, BS, Vincent Figueredo, MD, J. Duncan Harviel, MD, > David C. Han, MD, and Judith A. Schmidt, DNSc > > Background: Ultrasound is quickly becoming part of the trauma > surgeon's practice, but its role in the patient with a penetrating > truncal injury is not well defined. The purpose of this study was to > evaluate the accuracy of emergency ultrasound as it was introduced > into five Level I trauma centers for the diagnosis of acute > hemopericardium. > > Methods: Surgeons or cardiologists (four centers) and technicians > (one center) performed pericardial ultrasound examinations on > patients with penetrating truncal wounds. By protocol, patients with > positive examinations underwent immediate operation. Vital signs, > base deficit, time from examination to operation, operative findings, > treatment, and outcome were recorded. > > Results: Pericardial ultrasound examinations were performed in 261 > patients. There were 225 (86.2%) true-negative, 29 (11.1%) > true-positive, 0 false-negative, and 7 (2.7%) false-positive > examinations, resulting in sensitivity of 100%, specificity of 96.9%, > and accuracy of 97.3%. The mean time from ultrasound to operation was > 12.1 + 5 minutes. > > Conclusion: Ultrasound should be the initial modality for the > evaluation of patients with penetrating precordial wounds because it > is accurate and rapid. > > References > > 1. Demetriades D, van der Veen BW. Penetrating injuries of the heart: > experience over two years in South Africa. J Trauma > 1983;23:1034-1041. > > 2. Ivatury RR, Rohman M, Steichen FM, et al. Penetrating cardiac > injuries: twenty-year experience. Ann Surg 1987;53:310-317. > > 3. Ameli S, Shah PK. Cardiac tamponade: pathophysiology, diagnosis, > and management. Cardiol Clin 1991;9:665-674. > > 4. Hancock EW. Cardiac tamponade. Heart Dis Stroke 1994;168-67-78. > > 5. Yao ST, Vanecko RM, Printen K, et al. Penetrating wounds of the > heart: a review of 80 cases. Ann Surg 1968;168:67-78 > > 6. Jimenez E, Martin M, Krukenkamp I, et al. 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