The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2020
Diaphragm pacing improves respiratory mechanics in acute cervical spinal cord injury.
Cervical spinal cord injury (CSCI) is devastating with ventilator-associated pneumonia being a main driver of morbidity and mortality. Laparoscopic diaphragm pacing implantation (DPS) has been used for earlier liberation from mechanical ventilation. We hypothesized that DPS would improve respiratory mechanics and facilitate liberation. ⋯ Therapeutic IV.
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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
Multicenter StudyRepeat computed tomography head scan is not indicated in trauma patients taking novel anticoagulation: A multicenter study.
The number of trauma patients on prehospital novel oral anticoagulants (NOACs) is increasing. After an initial negative computed tomography of the head (CTH), practice patterns are variable for obtaining repeat CTH to evaluate for delayed intracranial hemorrhage (ICH-d). However, the risks and outcomes of ICH-d for patients on NOACs are unclear. We hypothesized that, for these patients, the incidence of ICH-d is low, similar to that of warfarin, and when it occurs, it does not result in clinically significant worse outcomes. ⋯ Prognostic/epidemiologic study, level III.Therapeutic, level IV.
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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
Historical ArticleThe Israel Defense Forces Trauma Registry: 22 years of point-of-injury data.
Trauma is the leading cause of death among casualties between 1 and 44 years. A large proportion of trauma deaths occurs even before arriving at a medical facility. The paucity of prehospital data is a major reason for the lagging development of prehospital trauma care research. This study aims to describe the Israel Defense Forces Prehopistal Trauma Registry, the steps taken to improve data collection and quality, the resulting trends, and the registry's contribution to policymaking. ⋯ Retrospective study, level III.