The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2015
Randomized Controlled Trial Multicenter StudyThe impact of tranexamic acid on mortality in injured patients with hyperfibrinolysis.
In 2011, supported by data from two separate trauma centers, we implemented a protocol to administer tranexamic acid (TXA) in trauma patients with evidence of hyperfibrinolysis (HF) on admission. The purpose of this study was to examine whether the use of TXA in patients with HF determined by admission rapid thrombelastography was associated with improved survival. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · May 2015
Improved survival in UK combat casualties from Iraq and Afghanistan: 2003-2012.
The United Kingdom was at war in Iraq and Afghanistan for more than a decade. Despite assertions regarding advances in military trauma care during these wars, thus far, no studies have examined survival in UK troops during this sustained period of combat. The aims of this study were to examine temporal changes of injury patterns defined by body region and survival in a population of UK Military casualties between 2003 and 2012 in Iraq and Afghanistan. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · May 2015
Multicenter StudyTrends in pediatric spleen management: Do hospital type and ownership still matter?
Nonoperative management of traumatic blunt splenic injury is preferred over splenectomy because of improved outcomes and reduced complications. However, variability in treatment is previously reported with respect to hospital profit types and ownership. ⋯ Epidemiologic and prognostic study, level III.
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J Trauma Acute Care Surg · May 2015
Multicenter Study Observational StudyEarly acute kidney injury in military casualties.
While acute kidney injury (AKI) has been well studied in a variety of patient settings, there is a paucity of data in patients injured in the course of the recent wars in Iraq and Afghanistan. We sought to establish the rate of early AKI in this population and to define risk factors for its development. ⋯ Prognostic and epidemiologic study, level III.
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J Trauma Acute Care Surg · May 2015
Observational StudyInfluence of intra-abdominal pressure on the specificity of pulse pressure variations to predict fluid responsiveness.
The positive predictive value of pulse pressure variations (ΔPP) to discriminate patients who should respond to volume expansion (VE) may be altered in mechanically ventilated patients. Our goal was to determine whether intra-abdominal pressure (IAP) measurements could discriminate patients with true-positive ΔPP values versus patients with false-positive ΔPP values. ⋯ Diagnostic study, level II.