J Trauma
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Comparative Study
Preservation of splenic immunocompetence after splenic artery angioembolization for blunt splenic injury.
Splenic artery angioembolization (SAE) is increasingly being used as an adjunct to nonoperative management for stable patients with blunt splenic injury (BSI). However, little is known about splenic immunocompetence after SAE. This study aims at assessing splenic immunocompetence after SAE for BSI. ⋯ Splenic immune function, measured by T-cell subset, generated only in the presence of an immunocompetent spleen, is preserved after SAE for BSI, main or partial.
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Comparative Study
Red blood cells accelerate the onset of clot formation in polytrauma and hemorrhagic shock.
Hemorrhage and coagulopathy are major contributors to death after trauma. The contribution of red blood cells (RBCs) in correcting coagulopathy is poorly understood. Current methods of measuring coagulopathy may fail to accurately characterize in vivo clotting. We aimed to determine the effect of RBCs on clotting parameters by comparing resuscitation regimens containing RBCs and plasma with those containing plasma alone. ⋯ Whole blood assays reveal that RBCs accelerate the onset of clot formation. Coagulation assays using spun plasma underestimate the effect of RBCs on clotting and do not completely characterize clot formation.
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Randomized Controlled Trial Comparative Study
Proper estimation of blood loss on scene of trauma: tool or tale?
Visually estimated amount of blood loss may influence decision making in the prehospital setting. The purpose of this study was to determine the ability and accuracy of paramedics and emergency physicians to visually estimate a volume of external blood loss and the influence of different vital signs. ⋯ With regard to all given amounts of blood loss, providing vital parameters suggesting instability (i.e., low blood pressure, high heart rate) led to a higher estimation of the lost blood volume in both paramedics and emergency physicians. However, estimations were influenced impressively by the given parameters. For both stable and unstable patients, small actual volumes were overestimated, whereas higher volumes tended to be underestimated. Neither occupational status (emergency physician or paramedic) nor gender or level of experience influenced accuracy of estimated blood loss significantly.
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Multicenter Study Comparative Study
Compliance with a sepsis bundle and its effect on intensive care unit mortality in surgical septic shock patients.
The Surviving Sepsis Campaign was launched in 2002, aiming at a 25% reduction in mortality in sepsis during a 5-year period. We hypothesized that the compliance with an adapted sepsis bundle would improve intensive care unit (ICU) survival in a cohort of surgical septic shock patients. ⋯ In surgical septic shock patients, the outcome was significantly related to the number of fulfilled therapeutic guidelines included in a sepsis bundle.