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Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

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Abstract

Objectives

The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients.

Methods

A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles.

Results

80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients.

Conclusions

US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions.

Riassunto

Obiettivi

L’obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell’ecografia nella gestione del paziente con politrauma. L’articolo è diviso in due parti: nella prima (‘Semeiotica ecografica e tecnica di esecuzione dell’esame’) verrà data attenzione agli aspetti prevalentemente tecnici dell’ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell’integrazione dell’ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato.

Metodi

Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni.

Risultati

Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell’ecografia nel politrauma.

Conclusioni

L’ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all’accezione più ampia di Resuscitative Ultrasonography (RUS) e viene oggi vista come un’estensione e un potenziamento dell’esame fisico, finalizzata a orientare in modo più sicuro l’approccio al problema clinico e aumentare la tempestività e la sicurezza degli interventi.

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Conflict of interest

Dr. Soccorsa Sofia declares that she has no conflict of interest related to this paper.

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  1. Department of Emergency Medicine and Urgent Care, Ospedale Maggiore, Largo Bartolo Nigrisoli 2, 40135, Bologna, Italy

    Soccorsa Sofia

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Sofia, S. Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques. J Ultrasound 16, 147–159 (2013). https://doi.org/10.1007/s40477-013-0047-4

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