J Trauma
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The purpose of this study was to compare the outcomes of trauma patients with an Injury Severity Score (ISS) > 12 who had the trauma team involved (TTA) in their resuscitative care to those that did not (TTNA). ⋯ In a Level I trauma center, the outcomes of trauma patients with an ISS > 12 are statistically significantly better if the trauma team is activated than if the patients are managed on an individual service-by-service basis.
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The clinical features and successful management of a patient with right main bronchus disruption after blunt chest trauma are described. The presentation was one of bilateral tension pneumothoraces. A high index of suspicion, coupled with appropriate airway management at presentation, was vital for the successful treatment of this patient. Surgical resection using a sleeve lobectomy, an operation rarely used in trauma patients, was highly effective in this patient, and the technique is described in this report.
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Review Case Reports
Aortic dissection after trauma: case report and review of the literature.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of volume control and pressure control ventilation: is flow waveform the difference?
To examine the hypothesis that a decelerating inspiratory flow waveform is responsible for improvements in gas exchange during pressure control ventilation for acute lung injury. ⋯ Both pressure control ventilation and volume control ventilation with a decelerating flow waveform provided better oxygenation at a lower peak inspiratory pressure and higher mean airway pressure compared to volume control ventilation with a square flow waveform. The results of our study suggest that the reported advantages of pressure control ventilation over volume control ventilation with a square flow waveform can be accomplished with volume control ventilation with a decelerating flow waveform.