J Trauma
-
Compensation for hemorrhage and shock requires coordination of responses and sufficient physiologic reserve capacity of the cardiovascular, respiratory, renal, and neuroendocrine systems. Intake of ethanol (EtOH) is known to degrade physiologic response to stress. The purpose of this study was to investigate how acute EtOH exposure changes responses to severe blood loss, shock, and resuscitation. ⋯ Acute EtOH exposure, with blood EtOH concentration similar to legal intoxication levels, limits physiologic reserve during hemorrhagic shock and resuscitation. In survivors of shock and resuscitation, compensation is compromised and physiologic reserve is adversely affected by acute EtOH intake.
-
Multicenter Study Comparative Study
Variability in computed tomography and magnetic resonance imaging in patients with cervical spine injuries.
The purpose of this study was to describe the performance of adjunctive radiologic imaging in patients with cervical spine injury. ⋯ The majority of patients with cervical spine injury undergo MRI and/or CT imaging. In clinical practice, MRI is superior at identifying soft tissue injuries, whereas CT performs better in identifying bony injuries. Cervical myelograms and tomograms are rarely obtained.
-
Randomized Controlled Trial Clinical Trial
Erythromycin reduces delayed gastric emptying in critically ill trauma patients: a randomized, controlled trial.
Early enteral feeding has been shown to be beneficial in improving outcome in critically injured trauma patients. Delayed gastric emptying occurs frequently in trauma patients, increasing the time to achieve nutritional goals, and limiting the benefit of early enteral feedings. Intravenous erythromycin is an effective agent for improving gastric motility in diabetics and postgastrectomy patients. The purpose of this study is to determine the effectiveness of erythromycin for improving gastric motility in critically injured trauma patients. ⋯ Intravenous erythromycin improves gastric motility and enhances early nutritional intake in critically injured patients.
-
Multicenter Study
Trauma in the elderly: intensive care unit resource use and outcome.
As the population ages, the elderly will constitute a prominent proportion of trauma patients. The elderly suffer more severe consequences from traumatic injuries compared with the young, presumably resulting in increased resource use. In this study, we sought to examine ICU resource use in trauma on the basis of age and injury severity. ⋯ Age is confirmed as an independent predictor of outcome (mortality) in trauma after stratification for injury severity in this largest study of elderly trauma patients to date. Elderly patients with severe injury (ISS > 30) have decreased ICU resource use secondary to associated increased mortality rates.