ABSTRACT
The aim of the present study is to assess a possibility and validity of prognostic scales ISS-RTS-TRISS, PRISM, APACHE II and PTS to be used for the automated calculation in decision support when treating children with severe mechanical traumas. The mentioned scales are used in the Hospital Information System (HIS) MEDIALOG. The retrospective study was conducted using clinical and physiological data collected at the admission and during the first 24 hours of hospitalization in 166 patients. Scales PRISM, APACHE II, ISS-RTS-TRISS were used for calculating the severity of injury and for prognosis in death outcomes. Scale PTS was used for evaluating the severity index only. Our research has shown that ISS-RTS-TRISS has excellent discrimination ability, PRISM and APACHE II prognostic scales have acceptable discrimination ability; moreover, they all have significant calibration ability. PTS scale has acceptable discrimination ability. It has been showed that automated calculation scales ISS-RTS-TRISS, PRISM, APACHE II and PTS are useful for assessing outcomes in children with severe mechanical trauma.
Subject(s)
Decision Support Systems, Clinical , Decision Support Techniques , Diagnosis, Computer-Assisted/methods , Trauma Severity Indices , Wounds and Injuries/diagnosis , Wounds and Injuries/epidemiology , Child , Child, Preschool , Europe/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Prognosis , Reproducibility of Results , Risk Assessment , Sensitivity and Specificity , Wounds and Injuries/therapyABSTRACT
Mechanical support of the failing heart in the form of bypass of the left and right ventricles by roller pumps was used in 25 dogs with model cardiogenic shock. Early application of left ventricular bypass in acute heart failure normalizes the myocardial bioenergy state and promotes reversible changes in myocardial ultrastructure as demonstrated by an increased surface area of mitochondrial cristae. On the basis of hemodynamics and morphology, we conclude that pump-aided bypass of ventricles without synchronization is a simple and effective method of circulation assistance. Mechanical support duration from 1 to 138 hours has been used in 10 patients following corrective heart surgery.
