The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Oct 2013
Randomized Controlled TrialPerioperative supplemental oxygen to reduce surgical site infection after open fixation of high-risk fractures: a randomized controlled pilot trial.
Higher concentrations of fraction of inspired oxygen (FIO2) have been shown to be associated with lower risk for surgical site infection in multiple studies outside the domain of orthopedic surgery. We evaluated the efficacy of high FIO2 administered during the perioperative period to reduce the rate of surgical site infection after open fixation of lower-extremity fractures at high risk of infection. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Aug 2013
Randomized Controlled TrialEffect of video laryngoscopy on trauma patient survival: a randomized controlled trial.
Many resuscitation scenarios include the use of emergency intubation to support injured patients. New video-guided airway management technology is available, which may minimize the risk to patients from this procedure. ⋯ Use of the GlideScope did not influence survival to hospital discharge among all patients and was associated with longer intubation times than direct laryngoscopy. Among the video laryngoscope cohort, a smaller subgroup of severe head injury trauma patients identified retrospectively seemed to be associated with a greater incidence of hypoxia of 80% or less and mortality.
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J Trauma Acute Care Surg · Jul 2013
Randomized Controlled Trial Multicenter Study Comparative StudyTransfusion of red blood cells in patients with a prehospital Glasgow Coma Scale score of 8 or less and no evidence of shock is associated with worse outcomes.
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J Trauma Acute Care Surg · Apr 2013
Randomized Controlled Trial Comparative StudyPerioperative myocardial infarctions are common and often unrecognized in patients undergoing hip fracture surgery.
The aim of this prospective cohort study was to assess the incidence and characteristics of acute myocardial infarction in patients undergoing surgery for acute hip fracture. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Randomized Controlled Trial Comparative StudyPlatelets are dominant contributors to hypercoagulability after injury.
Venous thromboembolic (VTE) disease has a high incidence following trauma, but debate remains regarding optimal prophylaxis. Thrombelastography (TEG) has been suggested to be optimal in guiding prophylaxis. Thus, we designed a phase II randomized controlled trial to test the hypothesis that TEG-guided prophylaxis with escalating low-molecular weight heparin (LMWH), followed by antiplatelet therapy would reduce VTE incidence. ⋯ Therapeutic study, level III.