Alberto Garcia - Academia.edu (original) (raw)

Papers by Alberto Garcia

Journal of the American College of Surgeons, 2017

Panamerican Journal of Trauma, Critical Care & Emergency Surgery, 2020

The American Surgeon, 2011

The increased use of damage control surgery in complex trauma patients requires accurate prognost... more The increased use of damage control surgery in complex trauma patients requires accurate prognostic indicators. We compared the discriminatory capacity of commonly used trauma and intensive care unit (ICU) scores, including revised trauma score, injury severity scores, trauma score-injury severity scores, acute physiology and chronic health evaluations II, and clinical and laboratory parameters, on 83 consecutive trauma patients admitted to the ICU, undergoing damage control. Logistic regressions were built for mortality prediction within 30 days. Performances of the models were assessed in terms of discrimination and calibration. Areas under the receiver operating characteristic curve from the models were compared. Overall mortality was 38.5 per cent. A “clinical” model was constructed including ICU admission pH and hypothermia (≤ 35 C °) and the number of packed red blood cells during the first 24 hours. This model was adjusted for age and demonstrated better discrimination for mo...

Infectio, 2018

La infección por Clostridium difficile es la principal causa de diarrea asociada al cuidado de la... more La infección por Clostridium difficile es la principal causa de diarrea asociada al cuidado de la salud. Durante los últimos años se ha incrementado la morbilidad y mortalidad por esta infección. Las recientes investigaciones se orientan a la búsqueda de tratamientos alternativos a la colectomía subtotal para los pacientes con infecciones severas por Clostridium difficile, es por esto que el presente artículo tiene como objetivo hacer la revisión del caso clínico de una paciente con colitis severa por Clostridium difficile refractaria al manejo de primera línea, que respondió satisfactoriamente al tratamiento con lavado colónico anterógrado con vancomicina vía ileostomía en asa.

Colombia Medica, 2015

Introduction: The internal jugular vein locates anterior or anterolateral to the common carotid a... more Introduction: The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position. Aim: To identify variables associated with the anterior location of the internal jugular vein. Methods: Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed. Results: Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. Th...

World Journal of Emergency Surgery, 2019

Background Tractotomy has become the standard of care for transfixing through-and-through lung in... more Background Tractotomy has become the standard of care for transfixing through-and-through lung injuries as it can be performed quickly with little blood loss and a low risk of complications. However, packing with laparotomy pads could be a feasible alternative to tractotomy on selected patients. We describe a series of four patients with lung trauma in which packing of the pulmonary wound tract was used as the primary and unique surgical strategy for arresting hemorrhage from injuries of the lung parenchyma. Methods Packing of the traumatic tract is achieved by gently pulling a laparotomy pad with a Rochester clamp and adjusting it to the cavity to stop the bleeding. The pack is removed in a subsequent surgery by moistening and tractioning it softly to avoid additional damage. The operation is completed by manual compression of the wounded lobe. We present a case series of our experience with this approach. Results From 2012 to 2016, we treated four patients with the described metho...

Colombian Journal of Anesthesiology, 2017

Revista Colombiana de Cirugía, 2019

Revista Colombiana de Cirugía, 2018

Panamerican Journal of Trauma, Critical Care & Emergency Surgery, 2016

RESUMEN Introducción El trauma es una causa común de consulta a servicio de emergencia en Cali, C... more RESUMEN Introducción El trauma es una causa común de consulta a servicio de emergencia en Cali, Colombia. De todas las consultas a urgencias el 30% representan trauma, siendo la 5 causa de mortalidad. Las características demográficas y el patrón del trauma que reciben los ancianos no han sido profundamente estudiados en países de ingresos medios. El objetivo de nuestro trabajo es caracterizar las lesiones relacionadas con trauma en pacientes ancianos e identificar posibles medidas preventivas. Métodos Un análisis secundario de la base de datos del registro de la Sociedad Panamericana de Trauma implementado en dos centros de referencia para trauma en Cali, Colombia, durante el periodo 2012-2013. Se incluyeron pacientes de 65 años o mayores. Las variables que se analizaron fueron demográficas, características de las lesiones, score de severidad del trauma (ISS), información clínica al ingreso, e información relacionada con la disposición final del paciente. Resultados De 14315 pacient...

Revista Colombiana de Anestesiología, 2017

Colombian Journal of Anesthesiology, 2017

The journal of trauma and acute care surgery, 2015

Damage control (DC) has improved survival from severe abdominal and extremity injuries. The data ... more Damage control (DC) has improved survival from severe abdominal and extremity injuries. The data on the surgical strategies and outcomes in patients managed with DC for severe thoracic injuries are scarce. This is a retrospective review of patients treated with DC for thoracic/pulmonary complex trauma at two Level I trauma centers from 2006 to 2010. Subjects 14 years and older were included. Demographics, trauma characteristics, surgical techniques, and resuscitation strategies were reviewed. A total of 840 trauma thoracotomies were performed. DC thoracotomy (DCT) was performed in 31 patients (3.7%). Pulmonary trauma was found in 25 of them. The median age was 28 years (interquartile range [IQR], 20-34 years), Revised Trauma Score (RTS) was 7.11 (IQR, 5.44-7.55), and Injury Severity Score (ISS) was 26 (IQR, 25-41). Nineteen patients had gunshot wounds, four had stab wounds, and two had blunt trauma.Pulmonary trauma was managed by pneumorrhaphy in 3, tractotomy in 12, wedge resection...