The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2015
Witnessed aspiration in trauma: Frequent occurrence, rare morbidity--A prospective analysis.
Aspiration events (AEs) are a well-recognized complication in trauma patients and have traditionally been considered a risk factor for pneumonia. Despite this, there is no consensus on the incidence or clinical significance of AE in the trauma population. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Dec 2015
Addition of low-dose valproic acid to saline resuscitation provides neuroprotection and improves long-term outcomes in a large animal model of combined traumatic brain injury and hemorrhagic shock.
Combined traumatic brain injury (TBI) and hemorrhagic shock (HS) is highly lethal. In a nonsurvival model of TBI + HS, addition of high-dose valproic acid (VPA) (300 mg/kg) to hetastarch reduced brain lesion size and associated swelling 6 hours after injury; whether this would have translated into better neurologic outcomes remains unknown. It is also unclear whether lower doses of VPA would be neuroprotective. We hypothesized that addition of low-dose VPA to normal saline (NS) resuscitation would result in improved long-term neurologic recovery and decreased brain lesion size. ⋯ In this long-term survival model of TBI + HS, addition of low-dose VPA to saline resuscitation resulted in attenuated neurologic impairment, faster neurologic recovery, smaller brain lesion size, and a quicker normalization of cognitive functions.
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J Trauma Acute Care Surg · Dec 2015
Role of computed tomography angiography in the management of Zone II penetrating neck trauma in patients with clinical hard signs.
The Western Trauma Association (WTA) describes the management of Zone 2 penetrating neck trauma (PNT) and recommends neck exploration (NE) for patients with clinical hard signs (HS). We hypothesize that in stable patients with HS, the management of PNT augmented by computed tomography angiography (CTA) results in fewer negative NE results. ⋯ Care management/therapeutic study, level IV.