sábado, 2 de noviembre de 2013


Cuidado del trauma todo el mundo: el trauma sigue siendo la enfermedad olvidada de la sociedad moderna.

Care of the injured worldwide: trauma still the neglected disease of modern society.
Sakran JV, Greer SE, Werlin E, McCunn M.
Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street (MSC 613/CSB 420), Charleston, SC 29425-6130, USA. sakran@musc.edu
Scand J Trauma Resusc Emerg Med. 2012 Sep 15;20:64. doi: 10.1186/1757-7241-20-64.
Traditionally, surgical diseases including emergency and injury care have garnered less attention and support internationally when compared to other medical specialties. Over the past decade however, healthcare professionals have increasingly advocated for the need to address the global burden of non-communicable diseases. Surgical disease, including traumatic injury, is among the top causes of death and disability worldwide and the subsequent economic burden is substantial, falling disproportionately on low- and middle-income countries (LMICs). The future of global health in these regions depends on a redirection of attention to diseases managed within surgical, anesthesia and emergency specialties. Increasing awareness of these disparities, as well as increasing focus in the realms of policy and advocacy, is crucial. While the barriers to providing quality trauma and emergency care worldwide are not insurmountable, we must work together across disciplines and across boundaries in order to negotiate change and reduce the global burden of surgical disease.

Manejo perioperatorio del trauma de cráneo

Perioperative management of traumatic brain injury.
Curry P, Viernes D, Sharma D.
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Int J Crit Illn Inj Sci. 2011 Jan;1(1):27-35. doi: 10.4103/2229-5151.79279.
Traumatic brain injury (TBI) is a major public health problem and the leading cause of death and disability worldwide. Despite the modern diagnosis and treatment, the prognosis for patients with TBI remains poor. While severity of primary injury is the major factor determining the outcomes, the secondary injury caused by physiological insults such as hypotension, hypoxemia, hypercarbia, hypocarbia, hyperglycemia and hypoglycemia, etc. that develop over time after the onset of the initial injury, causes further damage to brain tissue, worsening the outcome in TBI. Perioperative period may be particularly important in the course of TBI management. While surgery and anesthesia may predispose the patients to new onset secondary injuries which may contribute adversely to outcomes, the perioperative period is also an opportunity to detect and correct the undiagnosed pre-existing secondary insults, to prevent against new secondary insults and is a potential window to initiate interventions that may improve outcome of TBI. For this review, extensive Pubmed and Medline search on various aspects of perioperative management of TBI was performed, followed by review of research focusing on intraoperative and perioperative period. While the research focusing specifically on the intraoperative and immediate perioperative TBI management is limited, clinical management continues to be based largely on physiological optimization and recommendations of Brain Trauma Foundation guidelines. This review is focused on the perioperative management of TBI, with particular emphasis on recent developments.


Anestesiología y Medicina del Dolor
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