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Dae Sung Ma 12 Articles
Analysis of procedural performance after a pilot course on endovascular training for resuscitative endovascular balloon occlusion of the aorta
Sung Wook Chang, Dong Hun Kim, Dae Sung Ma, Ye Rim Chang
J Trauma Inj. 2023;36(1):3-7.   Published online September 22, 2022
DOI: https://doi.org/10.20408/jti.2022.0022
  • 1,486 View
  • 58 Download
AbstractAbstract PDF
Purpose
As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes.
Methods
Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016–August 2017, n=9) and postcourse (September 2017–February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups.
Results
Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course.
Conclusions
The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.
Summary
Extraanatomic bypass grafting in a patient with an infected femoral defect caused by a rollover accident: a case report
Dae Sung Ma, Dong Hun Kim, Jae-Wook Ryu, Sung Wook Chang
J Trauma Inj. 2022;35(Suppl 1):S23-S26.   Published online July 21, 2022
DOI: https://doi.org/10.20408/jti.2021.0005
  • 1,602 View
  • 54 Download
AbstractAbstract PDF
A 59-year-old male patient presented to the emergency department after a tractor rollover accident. His Injury Severity Score was 41 points. He had multiple pelvic bone fractures and a left common femoral artery injury with soft tissue loss. The injured arteries with skin defect were initially managed with endarterectomy and primary repair. However, the sepsis secondary to the infection from a skin defect became uncontrolled. The infected wound developed massive hemorrhage from the repaired arteries. Supportive measures were initiated to achieve hemostasis but unsuccessful. We performed an anastomosis with a prosthetic graft from the common iliac artery to the femoral artery above the knee, avoiding the wound through the lateral side of the anterior superior iliac spine. After revascularization, the patient recovered uneventfully. An extraanatomic graft reconstruction should be considered early when the autologous vein is unsuitable.
Summary
Extra-Pericardial Tamponade due to Internal Thoracic Artery Rupture after Blunt Trauma: A Case Report
Dongsub Noh, Sung Wook Chang, Dae Sung Ma
J Trauma Inj. 2021;34(3):183-186.   Published online September 30, 2021
DOI: https://doi.org/10.20408/jti.2021.0045
  • 2,971 View
  • 102 Download
  • 1 Citations
AbstractAbstract PDF

Cardiac tamponade is an acute life-threatening condition that predominantly involves the intra-pericardial space; however, an expanding mediastinal hematoma can also sometimes cause cardiac tamponade. Here we describe the case of a 45-year-old male driver in whom a traffic accident resulted in rupture of the left internal thoracic artery (ITA), extra-pericardial hematoma, and sternal fracture. After resuscitation, he was scheduled to undergo angio-embolization to repair the ruptured left ITA, but he suddenly developed cardiac tamponade that required a decompressive sternotomy. Nevertheless, the patient had an uncomplicated recovery, and this case suggests that extra-pericardial cardiac tamponade should be considered as a possible consequence of retro-sternal hematoma due to traumatic ITA rupture.

Summary

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  • Traumatic Pseudoaneurysms of the Internal Mammary Artery: Two Cases and Percutaneous Intervention
    Kayla A. Aikins, Zoé N. Anderson, Timothy M. Koci
    Diagnostics.2023; 14(1): 63.     CrossRef
Single-Center Clinical Analysis of Traumatic Thoracic Aortic Injuries: A Retrospective Observational Study
Dae Sung Ma, Yang Bin Jeon
J Trauma Inj. 2021;34(2):81-86.   Published online June 24, 2021
DOI: https://doi.org/10.20408/jti.2021.0019
  • 3,166 View
  • 102 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution.

Methods

During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed.

Results

Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0–41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7).

Conclusions

Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

Summary

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  • Patterns, management options and outcome of blunt thoracic aortic injuries: a 20-year experience from a Tertiary Care Hospital
    Hassan Al-Thani, Suhail Hakim, Mohammad Asim, Kaleem Basharat, Ayman El-Menyar
    European Journal of Trauma and Emergency Surgery.2022; 48(5): 4079.     CrossRef
Effects of Trauma-Related Shock on Myocardial Function in the Early Period Using Transthoracic Echocardiography
Dae Sung Ma
J Trauma Inj. 2021;34(2):119-125.   Published online June 30, 2021
DOI: https://doi.org/10.20408/jti.2021.0041
  • 2,326 View
  • 83 Download
AbstractAbstract PDF
Purpose

The present study aimed to analyze the effect of trauma-related shock on myocardial function in the early stages of trauma through transthoracic echocardiography (TTE) findings.

Methods

We performed a retrospective review and analysis of the medical records of patients aged ≥18 years who were evaluated by TTE within 2 days of admission for trauma-related shock (n=72). Patients were selected from a group of 739 patients admitted with trauma-related shock between January 2014 and December 2016.

Results

The incidence rate of myocardial dysfunction in the left ventricle (LV) was 6.8% (5/72), with rates of 7.7% (4/52) in the thoracic injury group and 5.0% (1/20) in the non-thoracic injury group. In the diastolic function of LV, relaxation abnormality was present in 55.8% (29/52) of patients in the thoracic injury group and 50% (10/20) of patients in the non-thoracic injury group.

Conclusions

This study may suggest that traumatic shock without thoracic injury may influence myocardial function in the early stages after trauma. Therefore, evaluation of myocardial function may be needed for patients experiencing shock after trauma, regardless of the presence of thoracic injury.

Summary
Comparison of Resting Energy Expenditure Using Indirect Calorimetry and Predictive Equations in Trauma Patients: A Pilot Study
Dae Sung Ma, Gil Jae Lee
J Trauma Inj. 2021;34(1):13-20.   Published online March 31, 2021
DOI: https://doi.org/10.20408/jti.2021.0023
  • 3,127 View
  • 119 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients.

Methods

Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/ day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%.

Results

Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO2 was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/ day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127).

Conclusions

The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

Summary

Citations

Citations to this article as recorded by  
  • Determining the appropriate resting energy expenditure requirement for severe trauma patients using indirect calorimetry in Korea: a retrospective observational study
    Hak-Jae Lee, Sung-Bak Ahn, Jung Hyun Lee, Ji-Yeon Kim, Sungyeon Yoo, Suk-Kyung Hong
    Journal of Trauma and Injury.2023; 36(4): 337.     CrossRef
Traumatic Tricuspid Regurgitation as a Cause of Failure to Wean from Mechanical Ventilation
Yang Bin Jeon, Chul Hyun Park, Dae Sung Ma
J Trauma Inj. 2020;33(4):264-268.   Published online November 19, 2020
DOI: https://doi.org/10.20408/jti.2020.0005
  • 2,629 View
  • 55 Download
AbstractAbstract PDF

A 55-year-old man underwent emergent sternotomy due to cardiac tamponade occurring just after an accidental fall from a 10-m height. Tricuspid valve regurgitation was found on echocardiography while he was on mechanical ventilation after the operation. The patient was weaned successfully from mechanical ventilation after tricuspid valve repair under cardiopulmonary bypass. Traumatic tricuspid valve regurgitation is a rare blunt chest injury and its symptoms occur late. Tricuspid regurgitation should be considered as a reason for failure to wean from mechanical ventilation after blunt cardiac trauma.

Summary
The Successful Removal of a Foreign Body in the Spleen via Diaphragm Laceration Site by Video-Assisted Thoracoscopic Surgery
Yang Bin Jeon, Sung Youl Hyun, Dae Sung Ma
J Trauma Inj. 2019;32(2):122-125.   Published online June 30, 2019
DOI: https://doi.org/10.20408/jti.2018.055
  • 2,957 View
  • 79 Download
  • 1 Citations
AbstractAbstract PDF

A 73-year-old man, who, in an inebriated state, had slipped in a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. Based on the chest and abdominopelvic computed tomography, he was diagnosed with multiple rib fractures and hemopneumothorax on the left hemithorax and was found to have a bony fragment in the spleen. He had not presented peritonitis and exsanguinous symptoms during the observation period. Seven days later, computed tomography of the abdomen showed suspected diaphragmatic injury and a retained foreign body in the spleen. On exploration by video assisted thoracoc surgery (VATS), a herniated omentum through the lacerated site of the diaphragm was observed. After omentectomy using Endo Gia, the foreign body in the spleen was observed through the lacerated site of the diaphragm. Traumatic diaphragm rupture with a foreign body, in the spleen, was successfully managed by video assisted thoracic surgery via the lacerated site of the diaphragm.

Summary

Citations

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  • The role of VATS in the removal of intrathoracic foreign bodies — a systematic review
    Fahmi Hussein Kakamad, Razhan Kawa Ali, Bnar Jamal Hama Amin, Shvan Hussein Mohammed, Diyar Adnan Omar, Karukh Khalid Mohammed, Sanaa Othman Karim, Suhaib Hussein Kakamad, Rawezh Qadir Mohammed Salih, Diyar Abubaker Mohammed, Abdulwahid Mohammed Salih, Mo
    Indian Journal of Thoracic and Cardiovascular Surg.2023; 39(2): 125.     CrossRef
Upper Extremity Deep Vein Thrombosis after Clavicle Fracture and Immobilization
Sung Jin Kim, Dae Sung Ma, Sung Youl Hyun, Yang Bin Jeon, Seok Joo, Ahram Han
J Trauma Inj. 2018;31(1):34-37.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.34
  • 3,805 View
  • 44 Download
AbstractAbstract PDF

Upper extremity deep vein thrombosis (DVT) is an unusual condition compared to lower extremity DVT, and it represents about 10% of all DVTs. We report a case of upper extremity DVT after clavicle fracture and immobilization.

Summary
Delayed Surgical Management of Traumatic Pseudoaneurysm of the Ascending Aorta in Multiple Trauma
Dae Sung Ma, Sung Jin Kim, Seok Joo, Sung Youl Hyun, Yang Bin Jeon
J Trauma Inj. 2018;31(1):29-33.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.29
  • 3,355 View
  • 49 Download
AbstractAbstract PDF

Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.

Summary
Emergency Surgical Management of Traumatic Cardiac Injury in Single Institution for Three Years
Seok Joo, Dae Sung Ma, Yang Bin Jeon, Sung Youl Hyun
J Trauma Inj. 2017;30(4):166-172.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.166
  • 3,189 View
  • 61 Download
AbstractAbstract PDF
Purpose

Thoracic traumas represent 10?15% of all traumas and are responsible for 25% of all trauma mortalities. Traumatic cardiac injury (TCI) is one of the major causes of death in trauma patients, rarely present in living patients who are transferred to the hospital. TCI is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. This study is to describe our experiences about emergency cardiac surgery in TCI.

Methods

This is a retrospective clinical analysis of patients who had undergone emergency cardiac surgery in our trauma center from January 2014 to December 2016. Demographics, physiologic data, mechanism of injuries, the timing of surgical interventions, surgical approaches and outcomes were reviewed.

Results

The number of trauma patients who arrived at our hospital during the study period was 9,501. Among them, 884 had chest injuries, 434 patients were evaluated to have over 3 abbreviated injury scale (AIS) about the chest. Cardiac surgeries were performed in 18 patients, and 13 (72.2%) of them were male. The median age was 47.0 years (quartiles 35.0, 55.3). Eleven patients (61.1%) had penetrating traumas. Prehospital cardiopulmonary resuscitations (CPR) were performed in 4 patients (22.2%). All of them had undergone emergency department thoracotomy (EDT), and they were transferred to the operating room for definitive repair of the cardiac injury, but all of them expired in the intensive care unit. Most commonly performed surgical incision was median sternotomy (n=13, 72.2%). The majority site of injury was right ventricle (n=11, 61.1%). The mortality rate was 22.2% (n=4).

Conclusions

This study suggests that penetrating cardiac injuries are more often than blunt cardiac injury in TCI, and the majority site of injury is right ventricle. Also, it suggests prehospital CPR and EDT are significantly responsible for high mortality in TCI.

Summary
Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury
Tae Kyoo Lim, Byug Chul Yu, Dae Sung Ma, Gil Jae Lee, Min A Lee, Sung Yeol Hyun, Yang Bin Jeon, Kang Kook Choi
J Trauma Inj. 2017;30(4):140-144.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.140
  • 5,005 View
  • 119 Download
  • 6 Citations
AbstractAbstract PDF
Purpose

The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI).

Methods

A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP).

Results

The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were 24.2±6.1 and 5.4±0.8, respectively. The mean ONSD of the TBI group (5.5±1.0 mm) was higher than that of the non-TBI group (4.7±0.6 mm). Some significant differences in age (55.3±18.1 vs. 49.0±14.8, p<0.001), GCS (11.7±4.1 versus 13.3±3.0, p<0.001), and ONSD (5.5±1.0 vs. 4.7±0.6, p<0.001) were observed between the TBI and the non-TBI group. An ROC analysis was used to assess the correlation between TBI and ONSD. Results showed an area under the ROC curve (AUC) value of 0.752. The same analysis was used in the TBI with midline shift group, which showed an AUC of 0.912.

Conclusions

An ONSD of >5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.

Summary

Citations

Citations to this article as recorded by  
  • Correlation Between Optic Nerve Sheath Diameter at Initial Head CT and the Rotterdam CT Score
    Aletor O Amakhian, Elohor B Obi-Egbedi-Ejakpovi, Eghosa Morgan, Ademola A Adeyekun, Munir M Abubakar
    Cureus.2023;[Epub]     CrossRef
  • Sono-clinical decision rule for repeat head computed tomography scan in traumatic brain injury in emergency settings
    Priyanka Modi, Sanjeev Bhoi, Savan Pandey
    WFUMB Ultrasound Open.2023; 1(2): 100026.     CrossRef
  • Sonographic Measurement of the Optic Nerve Sheath Diameter to Improve Detection of Elevated Intracranial Pressure
    Faten Farid Awdallah, Islam Hassan Abulnaga, Suzy Fawzy Michael, Hassan Khaled Nagi, Mohamed Hosny Abdallah
    Biomedical and Pharmacology Journal.2022; 15(3): 1677.     CrossRef
  • Serial Optic Nerve Sheath Diameter via Radiographic Imaging
    Diane McLaughlin, Lisa Anderson, Jinhong Guo, Molly McNett
    Neurology Clinical Practice.2021;[Epub]     CrossRef
  • The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma
    Kaan Çelik, Bekir Enes Demiryurek
    Arquivos de Neuro-Psiquiatria.2021; 79(10): 879.     CrossRef
  • MRI measurement of optic nerve sheath diameter using 3D driven equilibrium sequence as a non-invasive tool for the diagnosis of idiopathic intracranial hypertension
    Ahmed S. Abdelrahman, Mai M. K. Barakat
    Egyptian Journal of Radiology and Nuclear Medicine.2020;[Epub]     CrossRef

J Trauma Inj : Journal of Trauma and Injury