The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Oct 2014
Impact of epinephrine and norepinephrine on two dynamic indices in a porcine hemorrhagic shock model.
Pulse pressure variations (PPVs) and stroke volume variations (SVVs) are dynamic indices for predicting fluid responsiveness in intensive care unit patients. These hemodynamic markers underscore Frank-Starling law by which volume expansion increases cardiac output (CO). The aim of the present study was to evaluate the impact of the administration of catecholamines on PPV, SVV, and inferior vena cava flow (IVCF). ⋯ The present study demonstrates that intravenous administrations of norepinephrine and epinephrine increase IVCF, whatever the volemic conditions are. The concomitant decreases in PPV and SVV corroborate the fact that catecholamine administration recruits unstressed blood volume. In this regard, understanding a decrease in PPV and SVV values, after catecholamine administration, as an obvious indication of a restored volemia could be an outright misinterpretation.
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J Trauma Acute Care Surg · Oct 2014
Honoring patients' organ donation decisions when family conflict is present: Experience from a single organ procurement organization.
Donor designation refers to the laws and processes for documentation of an individual's wishes regarding organ donation should that person become eligible for donation at death. All 50 states have laws supporting donor designation. Donor-family conflict arises when a designated donor's family attempts to rescind the donor's authorization to donate. Little guidance exists in the current literature to address these situations. ⋯ Therapeutic/care management study, level V.
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J Trauma Acute Care Surg · Oct 2014
The quest for a universal definition of polytrauma: a trauma registry-based validation study.
A pilot validation recommended defining polytrauma as patients with an Abbreviated Injury Scale (AIS) score greater than 2 in at least two Injury Severity Score (ISS) body regions (2 × AIS score > 2). This study aimed to validate this definition on larger data set. We hypothesized that patients defined by the 2 × AIS score > 2 cutoff have worse outcomes and use more resources than those without 2 × AIS score > 2 and that this would therefore be a better definition of polytrauma. ⋯ Diagnostic test/ criteria, level III.
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J Trauma Acute Care Surg · Oct 2014
Applicability of the predictors of the historical trauma score in the present Dutch trauma population: modelling the TRISS predictors.
The extensively used trauma scores to evaluate trauma center performances have been derived decades ago. This leaves its applicability in the current trauma population a subject of discussion.In this study, we evaluate the applicability of the current trauma scores in today's trauma population. ⋯ Prognostic study, level III.