Background:Hypovolemia is a common cause of hypotension and low cardiac index (CI) in cardiac surgery but no hemodynamic parameters reflect this status well. The accurate diagnosis of hypovolemia is important because the wrong treatment will cause ineffectiveness and bad consequences such as severe heart failure, pulmonary edema, ... Objectives: To evaluate the performance of diagnostic characteristics of the trendelenburg 300 test for hypovolemia in cardiac surgery. Subjects and method: The prospective, cross \ufffd?sectional and randomized controlled trial (RCT) study was conducted on 30 patients (18 males, 12 females and average age 47,17 \xb1 13,93) undergoing valvular repair/replacement or coronary revascularization. The Swan \ufffd?Ganz catheters were placed in 20 patients and PiCCO catheters in 10 patients. Trendelenburg 300 test is considered positive if blood pressure (BP), central venous pressure (CVP), CI and intrathoracic blood volume (ITBV) increase. Results: The hypovolemic status in cardiac surgical patients is diagnosed if BP and/or CI increase in trendelenburg 300 position (Se 87.5% and 65.63%; Sp 100% and 75%, area under ROC 0.83 and 0.81, respectively). Conclusion: The increases in BP and CI responding to trendelenburg 300 position are good indicators of hypovolemia in cardiac surgery.
Hypovolemia/ diagnosis ; Head-Down Tilt ; Thoracic Surgery ;

Background: According to WHO, there are 5 million deaths from kinds of injury a year in the world, of which 875000 deaths occur in children under 18 years old. Injury leads to 40000 deaths which account for 10.7% deaths due to all other causes a year in VietNam. Objective: To show conclusions of the situation of child injury, recommendations for prevention of child injury and methods in order to enhance emergency activity in Vietnam. Subjects and method: The authors collected information about all patients who had emergencies due to injury at Viet Duc hospital, from March 26th 2006 to Octorber 26th 2006. However, supervised cases were the patients under 18 years old who were examined and treated at the Department of Emergency. Results: During the period of study, 2536 patients under 18 years old were examined for injury, of which death and coming back home for death were 83 cases (3.27%). 974 children had emergency resulted from injury: male was more than female: 697 verus 227. The leading causes of child injury were fall and traffic accident, respetively 34% and 60%. The most common traumas were traumatic brain injury (45%), limbs injury (41%). Although most of cases had first aid at the hospitals in district or province level, the rate of non-first aid cases was high (34%). Conclusion: Child injury is a leading cause of child death in hospitals. Methods for prevention of child injury should focus on educating and propagandizing to minimize injuries caused by traffic accident and fall.
Wounds and Injuries ; Child