The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2016
Multicenter Study Observational StudyThe AAST Prospective Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) Registry: Data on contemporary utilization and outcomes of aortic occlusion and resuscitative balloon occlusion of the aorta (REBOA).
Aortic occlusion (AO) for resuscitation in traumatic shock remains controversial. Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers an emerging alternative. ⋯ Therapeutic/care management study, level IV.
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J Trauma Acute Care Surg · Sep 2016
Civilian casualties of terror-related explosions: The impact of vascular trauma on treatment and prognosis.
A high prevalence (10%) of vascular trauma (VT) was previously described in terror-related trauma as compared with non-terror-related trauma (1%), in a civilian setting. No data regarding outcome of VT casualties of improvised explosive device (IED) explosions, in civilian settings, are available. The aim of the current study is to present the prognosis of civilian casualties of IED explosions with and without VT. ⋯ Prognostic/epidemiologic study, level V.
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J Trauma Acute Care Surg · Sep 2016
Multicenter StudyA multi-institutional study of hemostatic gauze and tourniquets in rural civilian trauma.
Life-threatening hemorrhage is a leading cause of preventable mortality in trauma patients. Since publication of the Hartford Consensus statement, there has been intense interest in civilian use of commercial hemostatic gauze and tourniquets. Although the military has studied their use on soldiers with wartime injuries, there are limited data on patient outcomes following civilian prehospital use and no data on the use in rural trauma. ⋯ Therapeutic study, level V.
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J Trauma Acute Care Surg · Sep 2016
Design of a cost effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) simulation.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct technique for salvaging patients with noncompressible torso hemorrhage. Current REBOA training paradigms require large animals, virtual reality simulators, or human cadavers for acquisition of skills. These training strategies are expensive and resource intensive, which may prevent widespread dissemination of REBOA. ⋯ Upon balloon inflation, the arterial waveform distal to the occlusion flattens, distal pulsation within the simulator is lost, and systolic blood pressures proximal to the balloon catheter increase by up to 62 mmHg. Further development and validation of this simulator will allow for refinement, reduction, and replacement of large animal models, costly virtual reality simulators, and perfused cadavers for training purposes. This will ultimately facilitate the low-cost, high-fidelity REBOA simulation needed for the widespread dissemination of this life-saving technique.
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J Trauma Acute Care Surg · Sep 2016
Early feeds not force feeds: Enteral nutrition in traumatic brain injury.
Brain Trauma Foundation guidelines recommend the early use of enteral nutrition to optimize recovery following traumatic brain injury (TBI). Our aim was to examine the effect of early feeds (≤24 hours) on clinical outcomes after TBI. ⋯ Therapeutic study, level IV.