The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2012
Multicenter StudyCharacterization of acute coagulopathy and sexual dimorphism after injury: females and coagulopathy just do not mix.
Acute traumatic coagulopathy (ATC) predicts poor outcome after injury. Females have been demonstrated to be hypercoagulable early in the posttrauma period. It remains unclear whether presence of ATC alters sex-based outcomes after injury. This study's objective was to characterize the sex dimorphism after severe injury in the presence and absence of ATC. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Dec 2012
Multicenter StudyWho should we feed? Western Trauma Association multi-institutional study of enteral nutrition in the open abdomen after injury.
The open abdomen is a requisite component of a damage control operation and treatment of abdominal compartment syndrome.Enteral nutrition (EN) has proven beneficial for patients with critical injury, but its application in those with an open abdomen has not been defined. The purpose of this study was to analyze the use of EN for patients with an open abdomen after trauma and the effect of EN on fascial closure rates and nosocomial infections. ⋯ EN in the open abdomen after injury is feasible. For patients without a bowel injury, EN in the open abdomen is associated with increased fascial closure rates, decreased complication rates, and decreased mortality. EN should be initiated in these patients once resuscitation is completed. Although EN for patients with bowel injuries did not seem to affect the outcome in this study,prospective randomized controlled trials would further clarify the role of EN in this subgroup.
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J Trauma Acute Care Surg · Dec 2012
Multicenter Study Clinical TrialUsing micropower impulse radar technology to screen for pneumothorax: an international bi-institutional study.
Pneumothoraces (PTXs) are a common entity in thoracic trauma. Micropower impulse radar (MIR) has been able to detect PTXs in surgical patients. However, this technology has not been tested previously on trauma patients. The purpose of this study was to determine the sensitivity and specificity of MIR to detect clinically significant PTXs. We hypothesized that MIR technology can effectively screen trauma patients for clinically significant PTXs. ⋯ Diagnostic study, level III.