The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2015
Randomized Controlled Trial Comparative StudyHeparin versus enoxaparin for prevention of venous thromboembolism after trauma: A randomized noninferiority trial.
Research comparing enoxaparin with unfractionated heparin (UFH) given every 12 hours for venous thromboembolism (VTE) prophylaxis after trauma overlooks original recommendations that UFH be given every 8 hours. We conducted a prospective, randomized, noninferiority trial comparing UFH every 8 hours and standard enoxaparin every 12 hours. We hypothesized that the incidence of VTE in trauma patients receiving UFH every 8 hours would be no more than 10% higher than that in patients receiving enoxaparin every 12 hours. ⋯ Therapeutic/care management study, level II.
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J Trauma Acute Care Surg · Nov 2015
Randomized Controlled Trial Comparative StudyImpact of common crystalloid solutions on resuscitation markers following Class I hemorrhage: A randomized control trial.
Resuscitation after hemorrhage with crystalloid solutions can lead to marked acidosis and iatrogenically worsen the lethal triad. The effect of differing solutions on base deficit and lactate has been sparsely prospectively studied in humans. We sought to quantify the effect of normal saline (NS) and lactated Ringer's (LR) resuscitation in voluntary blood donors as a model for Class I hemorrhage. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Nov 2015
Randomized Controlled Trial Comparative StudyAssociation of transfusion red blood cell storage age and blood oxygenation, long-term neurologic outcome, and mortality in traumatic brain injury.
The effect of red blood cell (RBC) storage on oxygenation in critically ill patients is still unknown. The objective of this study was to determine the association of RBC storage with oxygenation, long-term neurologic recovery, and death after traumatic brain injury. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Sep 2015
Randomized Controlled Trial Comparative StudyElevations in inflammatory cytokines are associated with poor outcomes in mechanically ventilated burn patients.
The treatment of burn patients who undergo mechanical ventilation is complicated by many factors; patient outcomes and mortality could potentially be improved with predictive biomarkers. Severe burn provokes a systemic inflammatory response characterized by the release of a host of cytokines. Recent studies evaluated the prognostic value of temporal changes in cytokine levels in several patient populations, but few have compared differences in the cytokine profiles of survivors and nonsurvivors following severe burn. We previously compared high-frequency percussive ventilation and low-tidal-volume ventilation and found no difference in mortality or cytokine levels between the two treatments. Since it is unknown whether cytokine levels are predictive of mortality in these patients, we performed a post hoc analysis comparing cytokine levels in survivors and nonsurvivors. ⋯ Prognostic/epidemiologic study, level IV; therapeutic study, level IV.
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J Trauma Acute Care Surg · May 2015
Randomized Controlled Trial Multicenter Study Comparative StudyAn open, parallel, randomized, comparative, multicenter investigation evaluating the efficacy and tolerability of Mepilex Ag versus silver sulfadiazine in the treatment of deep partial-thickness burn injuries.
Partial-thickness burns are among the most frequently encountered types of burns, and numerous dressing materials are available for their treatment. A multicenter, open, randomized, and parallel study was undertaken to determine the efficacy and tolerability of silver sulfadiazine (SSD) compared with an absorbent foam silver dressing, Mepilex Ag, on patients aged between 5 years and 65 years with deep partial-thickness thermal burn injuries (2.5-25% total body surface area). ⋯ Therapeutic study, level III.