The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2017
Preperitoneal pelvic packing reduces mortality in patients with life-threatening hemorrhage due to unstable pelvic fractures.
A 2015 American Association for the Surgery of Trauma trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized that preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Feb 2017
Outcome of suicidal hanging patients and the role of targeted temperature management in hanging-induced cardiac arrest.
No specific treatment is available for hanging-induced cardiac arrest (CA). We hypothesized that targeted temperature management (TTM) may improve the outcome of hanging-induced CA patients at hospital discharge. ⋯ Therapeutic study, level IV; prognostic study, level IV.
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J Trauma Acute Care Surg · Feb 2017
Observational StudyAssessment of key plasma metabolites in combat casualties.
Previous studies have indicated that hemorrhagic shock and injury cause significant early changes in metabolism. Recently, global changes in metabolism have been described using metabolomics in animal models and civilian trauma. We evaluated metabolic changes associated with combat injury to identify early biomarkers and aid in triage. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2017
ReviewExtracorporeal life support in trauma: Worth the risks? A systematic review of published series.
Extracorporeal life support (ECLS) is a potentially life-saving procedure for trauma patients with severe respiratory failure. Despite this, only a limited number of publications report series of trauma patients who underwent ECLS. The performance and safety of this technology in trauma patients is not fully understood. We described the efficacy and complications of ECLS in trauma patients with respiratory failure. ⋯ Systematic review, level III.
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J Trauma Acute Care Surg · Feb 2017
Observational StudySympathoadrenal activation and endotheliopathy are drivers of hypocoagulability and hyperfibrinolysis in trauma: A prospective observational study of 404 severely injured patients.
One third of severely injured patients present with a laboratory-based diagnosis of coagulopathy. This study investigated clinical and biomarker profile of patients with rapid thrombelastography (rTEG) coagulopathy, hypothesizing that sympathoadrenal activation and endothelial damage were drivers of this condition. ⋯ Prognostic, Level III.