The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2014
Unveiling posttraumatic stress disorder in trauma surgeons: a national survey.
The significance of posttraumatic stress disorder (PTSD) in trauma patients is well recognized. The impact trauma surgeons endure in managing critical trauma cases is unknown. The aim of our study was to assess the incidence of PTSD among trauma surgeons and identify risk factors associated with the development of PTSD. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Jul 2014
Never-frozen liquid plasma blocks endothelial permeability as effectively as thawed fresh frozen plasma.
Thawed fresh frozen plasma (TP) is a preferred plasma product for resuscitation but can only be used for up to 5 days after thawing. Never-frozen, liquid plasma (LQP) is approved for up to 26 days when stored at 1°C to 6°C. We have previously shown that TP repairs tumor necrosis factor α (TNF-α)-induced permeability in human endothelial cells (ECs). We hypothesized that stored LQP repairs permeability as effectively as TP. ⋯ LQP corrected TNF-α-induced EC permeability and preserved hemostatic potential after 28 days of storage, similar to TP stored for 5 days. The significant logistical benefit (fivefold) of prolonged LQP storage improves the immediate availability of plasma as a primary resuscitative fluid for bleeding patients.
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J Trauma Acute Care Surg · Jul 2014
Randomized Controlled TrialEarly propranolol administration to severely injured patients can improve bone marrow dysfunction.
Bone marrow (BM) dysfunction is common in severely injured trauma patients, resulting from elevated catecholamines and plasma granulocyte colony-stimulating factor (G-CSF) as well as prolonged mobilization of hematopoietic progenitor cells (HPCs). We have previously shown that propranolol (β-blocker [BB]) reduces HPC mobilization in a rodent model of injury and hemorrhagic shock. We hypothesize that BB would prevent BM dysfunction in humans following severe injury. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jul 2014
Multicenter StudyA prospective, multi-institutional study of pediatric all-terrain vehicle crashes.
Pediatric all-terrain vehicle (ATV) injuries have been increasing annually for more than a decade. The purpose of this study was to prospectively evaluate crash circumstances and clinical outcomes resulting from pediatric ATV crashes. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Jul 2014
Intracranial pressure response after pharmacologic treatment of intracranial hypertension.
The accepted treatment of increased intracranial pressure (ICP) in patients experiencing severe traumatic brain injury is multimodal and algorithmic, obscuring individual effects of treatment. Using continuous vital signs monitoring, we sought to measure treatment effect and ascertain the accuracy of manual data recording. ⋯ Therapeutic study, level IV.