Evaluation of the management of severe trauma kidney injury and long-term renal function in children
To evaluate the management and long-term renal function with DMSA scintigraphy in pediatric severe traumatic kidney injury grade IV and V at the trauma center of Grenoble Teaching Hospital. This is a single-center observational retrospective study between 2004 and 2014. All children younger than 15...
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Veröffentlicht in: | The journal of trauma and acute care surgery 2018-06, Vol.84 (6), p.951-955 |
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creator | Overs, Camille Teklali, Youssef Boillot, Bernard Poncet, Delphine Rabattu, Pierre-Yves Robert, Yohan Piolat, Christian |
description | To evaluate the management and long-term renal function with DMSA scintigraphy in pediatric severe traumatic kidney injury grade IV and V at the trauma center of Grenoble Teaching Hospital.
This is a single-center observational retrospective study between 2004 and 2014. All children younger than 15 years and managed at the Grenoble teaching Hospital for a severe trauma kidney injury grade IV or V were included. The trauma grade was radiologically diagnosed on arrival at hospital, using the classification of the American Association for Surgery of Trauma. The management followed the algorithm in effect in the establishment. The assessment of the renal function was performed by a DMSA scintigraphy after at least 6 months from the injury.
Twenty-one children were managed for a severe renal trauma (16 IV and 5 V). The diagnosis was initially made by an ultrasonography (eight cases) or a computed tomography scan (13 cases). A child with a severe renal trauma IV underwent nephrectomy on day 6 of the trauma. Eleven children needed a therapeutic procedure (three embolizations, four double J stents, one arterial stent, one peritoneal lavage for a splenic hemoperitoneum, four pleural drainages). A DMSA scintigraphy was performed in 15 patients to assess the function of the injured kidney: 11 of 16 severe renal trauma IV with an average of 39.4%, and 17% in 4 of 5 severe renal trauma V analyzed.
Among the 21 children managed for a severe kidney trauma injury IV or V, 11 required a therapeutic procedure, one of them a nephrectomy. The DMSA scintigraphy performed after at least 6 months from the trauma found an injured renal function at 39.4% in 11 of 16 severe renal trauma IV analyzed, and 17% in 4 of 5 severe renal trauma V analyzed, which confirms the currently conservative management.
Type of study: original article, retrospective observational study, level IV. |
doi_str_mv | 10.1097/TA.0000000000001854 |
format | Article |
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This is a single-center observational retrospective study between 2004 and 2014. All children younger than 15 years and managed at the Grenoble teaching Hospital for a severe trauma kidney injury grade IV or V were included. The trauma grade was radiologically diagnosed on arrival at hospital, using the classification of the American Association for Surgery of Trauma. The management followed the algorithm in effect in the establishment. The assessment of the renal function was performed by a DMSA scintigraphy after at least 6 months from the injury.
Twenty-one children were managed for a severe renal trauma (16 IV and 5 V). The diagnosis was initially made by an ultrasonography (eight cases) or a computed tomography scan (13 cases). A child with a severe renal trauma IV underwent nephrectomy on day 6 of the trauma. Eleven children needed a therapeutic procedure (three embolizations, four double J stents, one arterial stent, one peritoneal lavage for a splenic hemoperitoneum, four pleural drainages). A DMSA scintigraphy was performed in 15 patients to assess the function of the injured kidney: 11 of 16 severe renal trauma IV with an average of 39.4%, and 17% in 4 of 5 severe renal trauma V analyzed.
Among the 21 children managed for a severe kidney trauma injury IV or V, 11 required a therapeutic procedure, one of them a nephrectomy. The DMSA scintigraphy performed after at least 6 months from the trauma found an injured renal function at 39.4% in 11 of 16 severe renal trauma IV analyzed, and 17% in 4 of 5 severe renal trauma V analyzed, which confirms the currently conservative management.
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This is a single-center observational retrospective study between 2004 and 2014. All children younger than 15 years and managed at the Grenoble teaching Hospital for a severe trauma kidney injury grade IV or V were included. The trauma grade was radiologically diagnosed on arrival at hospital, using the classification of the American Association for Surgery of Trauma. The management followed the algorithm in effect in the establishment. The assessment of the renal function was performed by a DMSA scintigraphy after at least 6 months from the injury.
Twenty-one children were managed for a severe renal trauma (16 IV and 5 V). The diagnosis was initially made by an ultrasonography (eight cases) or a computed tomography scan (13 cases). A child with a severe renal trauma IV underwent nephrectomy on day 6 of the trauma. Eleven children needed a therapeutic procedure (three embolizations, four double J stents, one arterial stent, one peritoneal lavage for a splenic hemoperitoneum, four pleural drainages). A DMSA scintigraphy was performed in 15 patients to assess the function of the injured kidney: 11 of 16 severe renal trauma IV with an average of 39.4%, and 17% in 4 of 5 severe renal trauma V analyzed.
Among the 21 children managed for a severe kidney trauma injury IV or V, 11 required a therapeutic procedure, one of them a nephrectomy. The DMSA scintigraphy performed after at least 6 months from the trauma found an injured renal function at 39.4% in 11 of 16 severe renal trauma IV analyzed, and 17% in 4 of 5 severe renal trauma V analyzed, which confirms the currently conservative management.
Type of study: original article, retrospective observational study, level IV.</description><subject>Acute Kidney Injury - diagnostic imaging</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Acute Kidney Injury - therapy</subject><subject>Adolescent</subject><subject>Child</subject><subject>Female</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Kidney Function Tests</subject><subject>Male</subject><subject>Radiopharmaceuticals</subject><subject>Retrospective Studies</subject><subject>Technetium Tc 99m Dimercaptosuccinic Acid</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>2163-0755</issn><issn>2163-0763</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUF1rwjAUDWNjivMXDEYe91KXNG1qHkXcBwh7cc_lNrnRujZ1SSv471enk7H7cO_lcD7gEHLP2YQzlT2tZhP2Z_g0Ta7IMOZSRCyT4vryp-mAjEPYHlmpVCJNb8kgVomM2VQNiVnsoeqgLRtHG0vbDdIaHKyxRtcekYB79EhbD10N9LM0Dg-0dNvOHyg4Q6vGraMWfU09Oqio7Zz-cSsd1ZuyMj18R24sVAHH5zsiH8-L1fw1Wr6_vM1ny0gLlrYRGD2VgoHlQhXApLQGpAWjuEkw01lhCplBmnFbSK3AguoXs2CFtsgSKUbk8eS7881Xh6HN6zJorCpw2HQhjxnLeG-eqJ4qTlTtmxA82nznyxr8IecsPzacr2b5_4Z71cM5oCtqNBfNb5_iG0AFeHI</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Overs, Camille</creator><creator>Teklali, Youssef</creator><creator>Boillot, Bernard</creator><creator>Poncet, Delphine</creator><creator>Rabattu, Pierre-Yves</creator><creator>Robert, Yohan</creator><creator>Piolat, Christian</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201806</creationdate><title>Evaluation of the management of severe trauma kidney injury and long-term renal function in children</title><author>Overs, Camille ; Teklali, Youssef ; Boillot, Bernard ; Poncet, Delphine ; Rabattu, Pierre-Yves ; Robert, Yohan ; Piolat, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-adc8630af139ba066fda6fad91d4e7c7bdb67a571fb6c9afa99af0faf3cfe0463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute Kidney Injury - diagnostic imaging</topic><topic>Acute Kidney Injury - physiopathology</topic><topic>Acute Kidney Injury - therapy</topic><topic>Adolescent</topic><topic>Child</topic><topic>Female</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Kidney Function Tests</topic><topic>Male</topic><topic>Radiopharmaceuticals</topic><topic>Retrospective Studies</topic><topic>Technetium Tc 99m Dimercaptosuccinic Acid</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Overs, Camille</creatorcontrib><creatorcontrib>Teklali, Youssef</creatorcontrib><creatorcontrib>Boillot, Bernard</creatorcontrib><creatorcontrib>Poncet, Delphine</creatorcontrib><creatorcontrib>Rabattu, Pierre-Yves</creatorcontrib><creatorcontrib>Robert, Yohan</creatorcontrib><creatorcontrib>Piolat, Christian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of trauma and acute care surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Overs, Camille</au><au>Teklali, Youssef</au><au>Boillot, Bernard</au><au>Poncet, Delphine</au><au>Rabattu, Pierre-Yves</au><au>Robert, Yohan</au><au>Piolat, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of the management of severe trauma kidney injury and long-term renal function in children</atitle><jtitle>The journal of trauma and acute care surgery</jtitle><addtitle>J Trauma Acute Care Surg</addtitle><date>2018-06</date><risdate>2018</risdate><volume>84</volume><issue>6</issue><spage>951</spage><epage>955</epage><pages>951-955</pages><issn>2163-0755</issn><eissn>2163-0763</eissn><abstract>To evaluate the management and long-term renal function with DMSA scintigraphy in pediatric severe traumatic kidney injury grade IV and V at the trauma center of Grenoble Teaching Hospital.
This is a single-center observational retrospective study between 2004 and 2014. All children younger than 15 years and managed at the Grenoble teaching Hospital for a severe trauma kidney injury grade IV or V were included. The trauma grade was radiologically diagnosed on arrival at hospital, using the classification of the American Association for Surgery of Trauma. The management followed the algorithm in effect in the establishment. The assessment of the renal function was performed by a DMSA scintigraphy after at least 6 months from the injury.
Twenty-one children were managed for a severe renal trauma (16 IV and 5 V). The diagnosis was initially made by an ultrasonography (eight cases) or a computed tomography scan (13 cases). A child with a severe renal trauma IV underwent nephrectomy on day 6 of the trauma. Eleven children needed a therapeutic procedure (three embolizations, four double J stents, one arterial stent, one peritoneal lavage for a splenic hemoperitoneum, four pleural drainages). A DMSA scintigraphy was performed in 15 patients to assess the function of the injured kidney: 11 of 16 severe renal trauma IV with an average of 39.4%, and 17% in 4 of 5 severe renal trauma V analyzed.
Among the 21 children managed for a severe kidney trauma injury IV or V, 11 required a therapeutic procedure, one of them a nephrectomy. The DMSA scintigraphy performed after at least 6 months from the trauma found an injured renal function at 39.4% in 11 of 16 severe renal trauma IV analyzed, and 17% in 4 of 5 severe renal trauma V analyzed, which confirms the currently conservative management.
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subjects | Acute Kidney Injury - diagnostic imaging Acute Kidney Injury - physiopathology Acute Kidney Injury - therapy Adolescent Child Female Humans Injury Severity Score Kidney Function Tests Male Radiopharmaceuticals Retrospective Studies Technetium Tc 99m Dimercaptosuccinic Acid Tomography, Emission-Computed, Single-Photon Tomography, X-Ray Computed Treatment Outcome |
title | Evaluation of the management of severe trauma kidney injury and long-term renal function in children |
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