The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Apr 2015
Secondary brain injury in trauma patients: the effects of remote ischemic conditioning.
Management of traumatic brain injury (TBI) is focused on preventing secondary brain injury. Remote ischemic conditioning (RIC) is an established treatment modality that has been shown to improve patient outcomes secondary to inflammatory insults. The aim of our study was to assess whether RIC in trauma patients with severe TBI could reduce secondary brain injury. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Apr 2015
An analysis of the effectiveness of a state trauma system: treatment at designated trauma centers is associated with an increased probability of survival.
States struggle to continue support for recruitment, funding and development of designated trauma centers (DTCs). The purpose of this study was to evaluate the probability of survival for injured patients treated at DTCs versus nontrauma centers. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Apr 2015
Is limited prehospital resuscitation with plasma more beneficial than using a synthetic colloid? An experimental study in rabbits with parenchymal bleeding.
Reports of survival benefits of early transfusion of plasma with red blood cells (1:1 ratio) in trauma patients suggest that plasma may be a better fluid to replace Hextend for battlefield resuscitation. We studied possible advantages of prehospital resuscitation with plasma compared with Hextend or albumin in a model of uncontrolled hemorrhage. ⋯ Resuscitation with plasma or albumin better preserved coagulation function than did Hextend. However, despite these improvements, plasma resuscitation did not reduce blood loss or improve survival, while albumin administration seemed beneficial.
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J Trauma Acute Care Surg · Apr 2015
Hypotensive resuscitation in combination with arginine vasopressin may prolong the hypotensive resuscitation time in uncontrolled hemorrhagic shock rats.
The optimal resuscitation strategy for traumatic hemorrhagic shock is not completely determined. The objective of the present study was to investigate whether hypotensive resuscitation in combination with arginine vasopressin (AVP) can prolong the hypotensive resuscitation time by minimizing blood loss and stabilizing hemodynamics for uncontrolled hemorrhagic shock. ⋯ Hypotensive resuscitation in combination with early application of AVP could prolong the tolerance time of hypotensive resuscitation and "buy" longer safe prehospital transport time by reducing blood loss and stabilizing hemodynamics. This strategy may be a promising strategy for the early management of trauma patients with active bleeding.
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J Trauma Acute Care Surg · Apr 2015
Decreased mortality in traumatic brain injury following regionalization across hospital systems.
The Northern Ohio Trauma System (NOTS) was established to improve outcomes of trauma patients across the region. We hypothesized that mortality in patients with traumatic brain injury (TBI) would improve after regionalization. ⋯ Therapeutic/care management, level IV; epidemiologic study, level III.