The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2015
Randomized Controlled Trial Multicenter StudyThe impact of tranexamic acid on mortality in injured patients with hyperfibrinolysis.
In 2011, supported by data from two separate trauma centers, we implemented a protocol to administer tranexamic acid (TXA) in trauma patients with evidence of hyperfibrinolysis (HF) on admission. The purpose of this study was to examine whether the use of TXA in patients with HF determined by admission rapid thrombelastography was associated with improved survival. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Apr 2015
Randomized Controlled Trial Multicenter StudyA controlled resuscitation strategy is feasible and safe in hypotensive trauma patients: results of a prospective randomized pilot trial.
Optimal resuscitation of hypotensive trauma patients has not been defined. This trial was performed to assess the feasibility and safety of controlled resuscitation (CR) versus standard resuscitation (SR) in hypotensive trauma patients. ⋯ Therapeutic study, level I.
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J Trauma Acute Care Surg · Apr 2015
Randomized Controlled TrialPredictors of muscle protein synthesis after severe pediatric burns.
Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Sep 2014
Randomized Controlled Trial Multicenter StudyA dose-finding study of sufentanil sublingual microtablets for the management of postoperative bunionectomy pain.
Sufentanil sublingual microtablets (SSMs) at a dose of 15 µg per tablet have been studied for postoperative patient-controlled analgesia with a 20-minute lockout via a bedside handheld system over 2 days to 3 days of use. For more short-term (<24 hours) management of acute moderate-to-severe pain, such as in the ambulatory surgical setting, a single, higher-strength SSM dose administered via a health care provider would be of benefit as it would require less frequent administration and avoid the setup of a drug delivery system. ⋯ Therapeutic study, level I.
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J Trauma Acute Care Surg · Sep 2014
Randomized Controlled TrialA computerized kiosk to teach injury prevention: is it as effective as human interaction?
An emergency department (ED) visit may be an effective place to screen and educate families about injury prevention. The purpose of this study was to determine if a computerized kiosk in a pediatric ED can screen families for injury risk and encourage them to make more safety changes at follow-up survey compared with an injury prevention specialist (IPS). ⋯ A computerized kiosk based in a pediatric ED can help screen families for their injury risk. However, to elicit significant behavior change, an IPS discussing safety changes may be more effective.