The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyPosttraumatic stress disorder following traumatic injury at 6 months: associations with alcohol use and depression.
Posttraumatic stress disorder (PTSD) is progressively recognized as a psychological morbidity in injured patients. Participants in a longitudinal study were identified as PTSD positive or PTSD negative at 6 months following injury. Risky alcohol use, depression, demographic, and injury-related variables were explored. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyThe conjoint effect of reduced crystalloid administration and decreased damage-control laparotomy use in the development of abdominal compartment syndrome.
Anticipation of abdominal compartment syndrome (ACS) is a factor for performing damage-control laparotomy (DCL). Recent years have seen changes in resuscitation patterns and a decline in the use of DCL. We hypothesized that reductions in both crystalloid resuscitation and the use of DCL is associated with a reduced rate of ACS in trauma patients. ⋯ Epidemiologic/therapeutic study, level IV.
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J Trauma Acute Care Surg · Feb 2014
Do one-time intracompartmental pressure measurements have a high false-positive rate in diagnosing compartment syndrome?
Intracompartmental pressure measurements are frequently used in the diagnosis of compartment syndrome, particularly in patients with equivocal or limited physical examination findings. Little clinical work has been done to validate the clinical use of intracompartmental pressures or identify associated false-positive rates. We hypothesized that diagnosis of compartment syndrome based on one-time pressure measurements alone is associated with a high false-positive rate. ⋯ Diagnostic study, level II.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyEnteral albuterol decreases the need for chronotropic agents in patients with cervical spinal cord injury-induced bradycardia.
Cervical spinal cord injury (CSCI) is often complicated by autonomic instability and life-threatening bradycardia. β-adrenergic receptors offer a potential target for modulating cardiac vagal activity and heart rate. Enteral albuterol may mitigate symptomatic bradycardia in CSCI patients. The purpose of this study was to examine the effect of enteral albuterol on the frequency of symptomatic bradycardia and the need for rescue therapy in CSCI patients. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyEvaluation of the oxygenation index in adult respiratory failure.
The oxygenation index (mean airway pressure × FIO2 divided by PaO2) was originally devised to measure severity of illness and predict outcome in neonatal respiratory failure. We evaluated the discrimination of a modified oxygenation index (modified with age) for predicting 28-day mortality in adults with respiratory failure (adult respiratory distress syndrome [ARDS]) using the ALVEOLI section of the ARDSNet database and validated the results in the full ARDSNet database. ⋯ Prognostic, level III.