The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Aug 2020
ReviewEmerging hemorrhage control and resuscitation strategies in trauma: Endovascular to extracorporeal.
This article reviews four emerging endovascular hemorrhage control and extracorporeal perfusion techniques for management of trauma patients with profound hemorrhagic shock including hemorrhage-induced traumatic cardiac arrest: resuscitative endovascular balloon occlusion of the aorta, selective aortic arch perfusion, extracorporeal life support, and emergency preservation and resuscitation. The preclinical and clinical studies underpinning each of these techniques are summarized. We also present an integrated conceptual framework for how these emerging technologies may be used in the future care of trauma patients in both resource-rich and austere environments.
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J Trauma Acute Care Surg · Aug 2020
OPEN TRACHEOSTOMY FOR COVID19 POSITIVE PATIENTS: A METHOD TO MINIMIZE AEROSOLIZATION AND REDUCE RISK OF EXPOSURE.
The COVID-19 virus is highly contagious, and thus there is a potential of infecting operating staff when operating on these patients. This case series describes a method of performing open tracheostomy for COVID-19 patients while minimizing potential aerosolization of the virus using typically available equipment and supplies. ⋯ Therapeutic/care management, Level V.
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J Trauma Acute Care Surg · Aug 2020
Complications and outcome after rib fracture fixation: A systematic review.
In recent years, there has been a growing interest in operative treatment for multiple rib fractures and flail chest. However, to date, there is no comprehensive study that extensively focused on the incidence of complications associated with rib fracture fixation. Furthermore, there is insufficient knowledge about the short- and long-term outcomes after rib fracture fixation. ⋯ Systematic Review, level III.
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J Trauma Acute Care Surg · Aug 2020
Observational StudyAcute respiratory distress syndrome in the forward environment. Retrospective analysis of acute respiratory distress syndrome cases among French Army war casualties.
According to the Joint Theater Trauma Registry, 26% to 33% of war casualties develop acute respiratory distress syndrome (ARDS), with high mortality. Here, we aimed to describe ARDS incidence and severity among patients evacuated from war zones and admitted to French intensive care units (ICUs). ⋯ Prognostic and epidemiological study, level III.
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J Trauma Acute Care Surg · Aug 2020
The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient.
The degree to which malnutrition impacts perioperative outcomes in the elderly emergency surgery (ES) patient remains unknown. We aimed to study the relationship between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and postoperative outcomes in elderly patients undergoing ES. ⋯ Prognostic study, Level IV.