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Titolo:
Computer simulation of hypothermia during "damage control" laparotomy
Autore:
Hirshberg, A; Sheffer, N; Barnea, O;
Indirizzi:
Chaim Sheba Med Ctr, Dept Surg, IL-52621 Tel Hashomer, Israel Chaim Sheba Med Ctr Tel Hashomer Israel IL-52621 21 Tel Hashomer, Israel Tel Aviv Univ, Fac Engn, Dept Biomed Engn, IL-69978 Tel Aviv, Israel Tel Aviv Univ Tel Aviv Israel IL-69978 d Engn, IL-69978 Tel Aviv, Israel
Titolo Testata:
WORLD JOURNAL OF SURGERY
fascicolo: 9, volume: 23, anno: 1999,
pagine: 960 - 965
SICI:
0364-2313(199909)23:9<960:CSOHD">2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
ABBREVIATED LAPAROTOMY; PLANNED REOPERATION; TRAUMA; INJURY; MANAGEMENT; SURVIVAL; MODEL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Hirshberg, A Chaim Sheba Med Ctr, Dept Surg, IL-52621 Tel Hashomer, IsraelChaim Sheba Med Ctr Tel Hashomer Israel IL-52621 er, Israel
Citazione:
A. Hirshberg et al., "Computer simulation of hypothermia during "damage control" laparotomy", WORLD J SUR, 23(9), 1999, pp. 960-965

Abstract

"Damage control" is a surgical strategy for the staged repair of severe trauma that aims to avoid an irreversible physiologic insult marked by a self-propagating combination of hypothermia, coagulopathy, and acidosis. The point beyond which the physiologic insult becomes irreversible, however, remains ill-defined. The aim of this study was to address this problem by meansof a dynamic computer model of heat loss during laparotomy for exsanguinating hemorrhage. A single compartment model was developed using a graphic modeling tool and was implemented to calculate the time interval from the beginning of laparotomy to a core temperature of 32 degrees C, which is a marker of irreversible physiologic derangement in injured patients. A series ofsimulation runs showed that the exposed peritoneum is the dominant factor contributing to heat loss; the bleeding rate has a less marked effect. Elevation of the ambient temperature and rapid abdominal closure are effective interventions available to the surgeon to modify the heat loss curve. This study shows that during a "damage control" laparotomy for exanguinating hemorrhage the window of opportunity for salvage before the onset of an irreversible physiologic insult is no longer than 60 to 90 minutes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 09:08:52