The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jan 2014
Randomized Controlled TrialAn intensive physiotherapy program improves mobility for trauma patients.
Physiotherapy is integral to modern trauma care. Early physiotherapy and mobility have been shown to improve outcomes in patients with isolated injuries; however, the optimal intensity of physiotherapy in the multitrauma patient population has not yet been examined. The primary aim of this study was to determine whether an intensive physiotherapy program resulted in improved inpatient mobility. ⋯ Therapeutic study, level 1.
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J Trauma Acute Care Surg · Jan 2014
Randomized Controlled TrialFindings of a randomized controlled trial using limited transthoracic echocardiogram (LTTE) as a hemodynamic monitoring tool in the trauma bay.
We hypothesize that limited transthoracic echocardiogram (LTTE) is a useful tool to guide therapy during the initial phase of resuscitation in trauma patients. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Dec 2013
Randomized Controlled Trial Comparative StudyVasopressin for cerebral perfusion pressure management in patients with severe traumatic brain injury: preliminary results of a randomized controlled trial.
After traumatic brain injury (TBI), catecholamines (CAs) may be needed to maintain adequate cerebral perfusion pressure (CPP), but there are no recommended alternative vasopressor therapies. This is an interim report of the first study to test the hypothesis that arginine vasopressin (AVP) is a safe and effective alternative to CAs for the management of CPP in patients with severe TBI. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Dec 2013
Randomized Controlled Trial Comparative StudyA prospective evaluation of platelet function in patients on antiplatelet therapy with traumatic intracranial hemorrhage.
Platelet transfusion is increasingly used in patients with traumatic intracranial hemorrhage (ICH) on aspirin therapy to minimize the progression of ICH. We hypothesized (null) that platelet transfusion in this cohort of patients does not improve platelet function. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Nov 2013
Randomized Controlled Trial Comparative StudyBrain-type natriuretic peptide and right ventricular end-diastolic volume index measurements are imprecise estimates of circulating blood volume in critically ill subjects.
Surrogate indicators have often been used to estimate intravascular volume to guide fluid management. Brain-type natriuretic peptide (BNP) has been used as a noninvasive adjunct in the diagnosis of fluid overload and as a marker of response to therapy, especially in individuals with congestive heart failure. Similarly, right ventricular end-diastolic volume index (RVEDVI) measurements represent another parameter used to guide fluid resuscitation. The aim of this study was to evaluate whether BNP and RVEDVI are clinically valuable parameters that can distinguish among hypovolemia, euvolemia, and hypervolemia, as measured by blood volume (BV) analysis in critically ill surgical subjects. ⋯ Diagnostic study, level III.