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Thu Feb 2 05:17:45 GMT 2006

Dr Wolfer

Still does not make it suitable for trauma - first stop the bleeding then add the drugs etc. More at a basic science level: If the patient with a major head injruy and no source of bleeding is hypotensive then you either have a high spinal cord injury or a pre-mortality response to a major head injury; both of the latter carry a significant less than one month mortality. What I'm saying is - is it all worth it; unless you have the donor team standing by???

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
Program Manager: Emergency Medicine (U.S.)
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Department of Surgery Room 4064
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa

2 Lorient Close
Vredekloof, Brackenfell
7560, Western Cape,
South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302
Home: +27219813098

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of RWolfer at aol.com
Sent: Thursday, February 02, 2006 1:31 AM
To: trauma-list at trauma.org
Subject: Re: Noradrenaline for Severe Traumatic Brain Injury

There are now several studies that show that Levophed is a better pressor 
than dopamine .  It is better at improving pressure, renal blood flow and urine 
output.  There was a very recent study in Chest. RW
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Noradrenaline for Severe Traumatic Brain Injury