The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2014
Randomized Controlled TrialAdjunctive treatment of abdominal catastrophes and sepsis with direct peritoneal resuscitation: indications for use in acute care surgery.
The success of damage-control surgery (DCS) for the treatment of trauma has led to its use in other surgical problems such as abdominal sepsis. Previous studies using direct peritoneal resuscitation (DPR) for the treatment of trauma have yielded promising results. We present the results of the application of this technique to patients experiencing abdominal sepsis. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Sep 2014
Randomized Controlled TrialEvaluation of standard versus nonstandard vital signs monitors in the prehospital and emergency departments: results and lessons learned from a trauma patient care protocol.
This study aimed to determine the effectiveness of using a wireless, portable vital signs monitor (WVSM) for predicting the need for lifesaving interventions (LSIs) in the emergency department (ED) and use a multivariate logistic regression model to determine whether the WVSM was an improved predictor of LSIs in the ED over the standard of care monitor currently being used. ⋯ Therapeutic/care management, level IV.
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J Trauma Acute Care Surg · Sep 2014
Randomized Controlled TrialOptimal training for emergency needle thoracostomy placement by prehospital personnel: didactic teaching versus a cadaver-based training program.
Tension pneumothorax can rapidly progress to cardiac arrest and death if not promptly recognized and appropriately treated. We sought to evaluate the effectiveness of traditional didactic slide-based lectures (SBLs) as compared with fresh tissue cadaver-based training (CBT) for placement of needle thoracostomy (NT). ⋯ In a CBT module, US Navy corpsmen were better trained to place NT accurately than their traditional didactic SBL counterparts. Further studies are indicated to identify the optimal components of effective simulation training for NT and other emergent interventions.
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J Trauma Acute Care Surg · Aug 2014
Randomized Controlled TrialNegative pleural suction in thoracic trauma patients: A randomized controlled trial.
The study aimed to establish the benefits of using chest tubes with negative pleural suction against trapped water in patients with penetrating or blunt chest trauma who underwent tube thoracostomy, in terms of the incidence of complications, such as persistent air leak, clotted hemothorax, empyema, and duration of stay. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Jul 2014
Randomized Controlled TrialEarly propranolol administration to severely injured patients can improve bone marrow dysfunction.
Bone marrow (BM) dysfunction is common in severely injured trauma patients, resulting from elevated catecholamines and plasma granulocyte colony-stimulating factor (G-CSF) as well as prolonged mobilization of hematopoietic progenitor cells (HPCs). We have previously shown that propranolol (β-blocker [BB]) reduces HPC mobilization in a rodent model of injury and hemorrhagic shock. We hypothesize that BB would prevent BM dysfunction in humans following severe injury. ⋯ Therapeutic study, level III.