The journal of trauma and acute care surgery
-
The surgical intensive care unit (SICU) is increasingly used as a surrogate operating room (OR). This study seeks to characterize a Level I trauma center's operative undertakings in the SICU versus OR for trauma and emergency general surgery patients. ⋯ Epidemiologic study, level III.
-
J Trauma Acute Care Surg · Mar 2013
Comparative StudyHMGB1 activity inhibition alleviating liver injury in heatstroke.
Heatstroke is generally considered as a sepsis-like syndrome induced by hyperthermia leading to multiorgan dysfunction. High-mobility group box 1 (HMGB1) has recently been identified as a mediator of systemic inflammation leading to multiorgan dysfunction in sepsis and nonsepsis. Elevation of plasma HMGB1 in heatstroke has been suggested in experimental models and clinical patients. By far, whether HMGB1 could be a potential therapeutic target in heatstroke is unknown. The objectives of this study are to use HMGB1 monoclonal antibody to specifically inhibit the activity of extracellular HMGB1 and to observe the possible protection of liver injury in a rat heatstroke model. ⋯ HMGB1 could be a potentially effective treatment target in heatstroke. The pathogenic mechanism of heatstoke is complicated, which needs comprehensive prevention and treatment.
-
J Trauma Acute Care Surg · Mar 2013
Randomized Controlled Trial Multicenter StudyOccult pneumothoraces in critical care: a prospective multicenter randomized controlled trial of pleural drainage for mechanically ventilated trauma patients with occult pneumothoraces.
Patients with an occult pneumothoraces (OPTXs) may be at risk of tension pneumothoraces (TPTXs) without drainage or pleural drainage complications if treated. ⋯ Therapeutic study, level III.
-
J Trauma Acute Care Surg · Mar 2013
Multicenter Study Comparative StudyLimb salvage after complex repairs of extremity arterial injuries is independent of surgical specialty training.
Major peripheral vascular trauma is managed by several surgical specialties. The impact of surgical specialty training and certification on outcome has not been evaluated. We hypothesized that general surgeons without specialty training in vascular surgery would have outcomes equivalent to surgeons with vascular training in the management of extremity arterial injuries requiring interposition grafting. ⋯ Therapeutic/care management, level III.
-
J Trauma Acute Care Surg · Mar 2013
Comparative StudyThe definition of polytrauma: variable interrater versus intrarater agreement--a prospective international study among trauma surgeons.
The international trauma community has recognized the lack of a validated consensus definition of "polytrauma." We hypothesized that using a subjective definition, trauma surgeons will not have substantial agreement; thus, an objective definition is needed. ⋯ Based on subjective assessments, trauma surgeons do not agree on the definition of polytrauma, with the subjective definition differing both within and across institutions.