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Biomedical subjects

M J Segers

Publications and source records attributed to M J Segers.

At least 19 recordsLinked to original sources
PubMed1998

Hypothermia in trauma patients.

Accidental hypothermia (AH) can be defined as an unintentional decrease in core temperature below 35 degrees C during cold exposure by individuals without intrinsic thermoregulatory dysfunction. Pathophysiological changes can be attributed both to the severity of hypothermia and to co-morbid factors such as trauma, submersion, intoxication and underlying diseases. In trauma victims stratified according to the Injury Severity Score, the factor hypothermia is considered to be a poor prognostic sign for survival. In these patients rewarming therapy should be applied as soon as possible. In the Utrecht University Hospital, adult patients with AH are managed according to an algorithm based on their presenting hemodynamic conditions. Patients with perfusing cardiac rhythms and systolic pressures over 80 mmHg will receive continuous arteriovenous rewarming (CAVR). Arrested and hemodynamically instable patients are treated with cardiopulmonary bypass (CPB). In a 3-year period, 22 patients with AH were admitted to the emergency department. Fourteen patients had a trauma as the cause of hypothermia. Twenty patients were treated according to the algorithm (CAVR n = 18, CPB n = 2) and two patients were alternatively managed. Mortality in the CAVR group was 28% and total mortality reached 32%. Complications of CAVR are related to placement and removal of vascular catheters and may be severe in these patients with impaired coagulation. CAVR permits a good access to the (trauma-) patient and rewarming can be continued synchronously with diagnosis and treatment of various injuries.

Adolescent↗
PubMed1997

[Three patients with accidental hypothermia: customized rewarming].

Three patients, two men aged 47 and 33 years and a woman aged 33 years, became hypothermic after an accident with body temperatures of 34.5, 26.2 and 23.1 degrees C, respectively. Two of them developed circulatory disorders, for which reanimation was performed. All three patients recovered after active external heating using among other things warmed infusion fluids, a warmed waterbed, continuous arteriovenous rewarming and rewarming with the heart-lung machine. For the treatment to be successful, the type of rewarming selected should be guided by the degree of hypothermia, the circulatory situation and the severity of the accessory injuries.

Accidents, Traffic↗
PubMed1997

Bicycle-spoke injuries: a prospective study.

A prospective study of bicycle-spoke injuries was undertaken to assess the severity of soft tissue damage and the incidence of skeletal injuries. During a 12 month period, 59 children with spoke injuries were examined. Soft tissue damage was divided into three categories: bruising without laceration (four), bruising and superficial abrasions (49) and full thickness skin defects (six). Seventeen children had skeletal injuries: nine tibial fractures (five greenstick fractures and four spiral fractures) and eight epiphyseal injuries of the distal fibula. All fractures were treated non-operatively. The mean time for soft tissue healing was 16.5 days and the mean time for regaining full weight-bearing was 8.5 days. Soft tissue damage is the most important prognostic factor in the healing of a bicycle-spoke injury.

Ankle Injuries↗