The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2015
Multicenter StudyA new device for the prevention of pulmonary embolism in critically ill patients: Results of the European Angel Catheter Registry.
Pulmonary embolism (PE) is a potentially life-threatening complication of critical illness. In trauma and neurosurgical patients with contraindications to anticoagulation, inferior vena cava (IVC) filters have been used to prevent PE, but their associated long-term complication rates and difficulties associated with filter removal have limited their use. The Angel catheter is a temporary device, which combined an IVC filter with a triple-lumen central venous catheter (IVC filter-catheter) and is intended for bedside placement and removal when no longer indicated. ⋯ Therapeutic study, level V.
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J Trauma Acute Care Surg · Sep 2015
Multicenter Study Clinical Trial Observational StudyThe splenic injury outcomes trial: An American Association for the Surgery of Trauma multi-institutional study.
Delayed splenic hemorrhage after nonoperative management (NOM) of blunt splenic injury (BSI) is a feared complication, particularly in the outpatient setting. Significant resources, including angiography (ANGIO), are used in an effort to prevent delayed splenectomy (DS). No prospective, long-term data exist to determine the actual risk of splenectomy. The purposes of this trial were to ascertain the 180-day risk of splenectomy after 24 hours of NOM of BSI and to determine factors related to splenectomy. ⋯ Prognostic/epidemiological study, level III; therapeutic study, level IV.
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J Trauma Acute Care Surg · Aug 2015
Multicenter Study Observational StudyManagement of children with solid organ injuries after blunt torso trauma.
Management of children with intra-abdominal solid organ injuries has evolved markedly. We describe the current management of children with intra-abdominal solid organ injuries after blunt trauma in a large multicenter network. ⋯ Prognostic/epidemiologic study, level III; therapeutic study, level IV.
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J Trauma Acute Care Surg · Jul 2015
Multicenter StudyA multi-institutional analysis of prehospital tourniquet use.
Recent military studies demonstrated an association between prehospital tourniquet use and increased survival. The benefits of this prehospital intervention in a civilian population remain unclear. The aims of our study were to evaluate tourniquet use in the civilian population and to compare outcomes to previously published military experience. We hypothesized that incorporation of tourniquet use in the civilian population will result in an overall improvement in mortality. ⋯ Epidemiologic study, level V.
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J Trauma Acute Care Surg · May 2015
Multicenter StudyDoes unit designation matter? A dedicated trauma intensive care unit is associated with lower postinjury complication rates and death after major complication.
Recent data suggest that specialty intensive care units (ICUs) have outcomes better than those of mixed ICUs. The cause for this apparent discrepancy has not been well established. We hypothesized that trauma patients admitted to a dedicated trauma ICU (TICU) would have a lower complication rate as well as death after complication (failure to rescue [FTR]). ⋯ Prognostic study, level III.