The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2012
Review Meta AnalysisSubglottic secretion drainage for preventing ventilator-associated pneumonia: an updated meta-analysis of randomized controlled trials.
Subglottic secretion drainage (SSD) has been shown to be associated with a lower incidence of ventilator-associated pneumonia (VAP) in a previous meta-analysis. However, a number of randomized controlled trials (RCTs) have been published since then, and so we aimed to conduct an updated meta-analysis. ⋯ I, meta-analysis.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyMortality pattern of the 26/11 Mumbai terror attacks.
Mumbai, one of the industrial capitals cities of the world, has witnessed a series of terror attacks over the last two decades. The 2008 Mumbai terror attacks referred as "26/11" drew widespread global condemnation and killed 166 people, in addition to wounding more than 300 people. The mortality pattern and the pathophysiology of organ injuries are presented. The objective of this study was to determine the different patterns of injury in a terrorist attack of such magnitude and clinical implications in reducing mortality. ⋯ V, epidemiological study.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyVentilator-associated pneumonia rates at major trauma centers compared with a national benchmark: a multi-institutional study of the AAST.
Ventilator-associated pneumonia (VAP) rates reported by the National Healthcare Safety Network (NHSN) are used as a benchmark and quality measure, yet different rates are reported from many trauma centers. This multi-institutional study was undertaken to elucidate VAP rates at major trauma centers. ⋯ III, prognostic study.
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J Trauma Acute Care Surg · May 2012
Multicenter StudyDeciphering the use and predictive value of "emergency medical services provider judgment" in out-of-hospital trauma triage: a multisite, mixed methods assessment.
"Emergency medical services (EMS) provider judgment" was recently added as a field triage criterion to the national guidelines, yet its predictive value and real world application remain unclear. We examine the use and independent predictive value of EMS provider judgment in identifying seriously injured persons. ⋯ Among this multisite cohort of trauma patients, EMS provider judgment was the most commonly used field trauma triage criterion, independently associated with serious injury, and useful in identifying high-risk patients missed by other criteria. However, there was variability in predictive value between sites.
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J Trauma Acute Care Surg · May 2012
Comparative StudyEffectiveness of short-term 6-hour high-volume hemofiltration during refractory severe septic shock.
The effectiveness of a single 6-hour session of high-volume hemofiltration (HVHF) was evaluated in terms of decreased norepinephrine (NE) requirements, progressive refractory hypotension and hypoperfusion by the fourth hour, and observed versus expected hospital mortality in patients with refractory severe septic shock. ⋯ III, therapeutic study.