The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Apr 2015
Randomized Controlled TrialPredictors of muscle protein synthesis after severe pediatric burns.
Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Apr 2015
Differences in degree, differences in kind: characterizing lung injury in trauma.
Acute lung injury following trauma remains a significant source of morbidity and mortality. Although multiple trauma studies have used hypoxemia without radiographic adjudication as a surrogate for identifying adult respiratory distress syndrome (ARDS) cases, the differences between patients with hypoxemia alone and those with radiographically confirmed ARDS are not well described in the literature. We hypothesized that nonhypoxemic, hypoxemic, and ARDS patients represent distinct groups with unique characteristics and predictors. ⋯ Prognostic and epidemiologic study, level III.
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J Trauma Acute Care Surg · Apr 2015
Multicenter StudyEarly autologous fresh whole blood transfusion leads to less allogeneic transfusions and is safe.
The practice of transfusing ones' own shed whole blood has obvious benefits such as reducing the need for allogeneic transfusions and decreasing the need for other fluids that are typically used for resuscitation in trauma. It is not widely adopted in the trauma setting because of the concern of worsening coagulopathy and the inflammatory process. The aim of this study was to assess outcomes in trauma patients receiving whole blood autotransfusion (AT) from hemothorax. ⋯ Epidemiologic/prognostic study, level III.
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J Trauma Acute Care Surg · Apr 2015
Outcomes of trauma care at centers treating a higher proportion of older patients: the case for geriatric trauma centers.
The burden of injury among older patients continues to grow and accounts for a disproportionate number of trauma deaths. We wished to determine if older trauma patients have better outcomes at centers that manage a higher proportion of older trauma patients. ⋯ Prognostic and epidemiologic study, level III.
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J Trauma Acute Care Surg · Apr 2015
Comparative Study Observational StudySurvival of severe blunt trauma patients treated with resuscitative endovascular balloon occlusion of the aorta compared with propensity score-adjusted untreated patients.
Despite a growing call for use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for critically uncontrolled hemorrhagic shock, there is limited evidence of treatment efficacy. We compared the mortality between patients who received a REBOA with those who did not, adjusting for the likelihood of treatment and injury severity, to measure efficacy. ⋯ Epidemiologic study, level III; therapeutic study, level IV.