The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jun 2014
Randomized Controlled Trial Multicenter StudyDo all trauma patients benefit from tranexamic acid?
This study tested the hypothesis that early routine use of tranexamic acid (TXA) reduces mortality in a subset of the most critically injured trauma intensive care unit patients. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Jun 2014
Induced hypothermia reduces the hepatic inflammatory response in a swine multiple trauma model.
Mild therapeutic hypothermia following trauma has been introduced in several studies to reduce the posttraumatic inflammation and organ injury. In this study, we analyzed the effects of induced mild hypothermia (34°C) on the inflammation of the shock organs liver and kidney. ⋯ Therapeutic hypothermia seems to attenuate the hepatic inflammatory response and the associated liver injury after severe trauma. Therefore, induced hypothermia might represent a potential therapeutic strategy to avoid posttraumatic organ dysfunction.
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J Trauma Acute Care Surg · Jun 2014
Delayed hemorrhagic complications in the nonoperative management of blunt splenic trauma: early screening leads to a decrease in failure rate.
Delayed splenic rupture is the Achilles' heel of nonoperative management (NOM) for blunt splenic injury (BSI). Early computed tomographic (CT) scanning for features suggesting high risk of nonoperative failure, splenic pseudoaneurysms (SPAs), and arterial extravasation (AE), in concert with the appropriate use of splenic arterial embolization (SAE) is a viable method to reduce rates of failure of NOM. We report our 12-ear experience with a protocol for mandatory repeat CT evaluation at 48 hours and selective SAE. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jun 2014
Multicenter StudyImproving organ donation rates by modifying the family approach process.
The purpose of this study was to identify steps during family approach for organ donation that may be modified to improve consent rates of potential organ donors. ⋯ Epidemiologic study, level IV. Therapeutic study, level IV.
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J Trauma Acute Care Surg · Jun 2014
Observational StudyBlood alcohol content, injury severity, and adult respiratory distress syndrome.
Elevated blood alcohol content (BAC) is a risk factor for injury. Associations of BAC with adult respiratory distress syndrome (ARDS) have not been conclusively established.We evaluated the association of a BAC greater than 0 mg/dL with the intermediate outcomes, Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) score, and their association with ARDS development. ⋯ Epidemiologic study, level III.