Scand J Trauma Resus
-
Scand J Trauma Resus · Feb 2025
Letter ReviewBalloon occlusion of the aorta during cardiac arrest -a death blow to the intestines?
The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in non-traumatic cardiac arrest may result in worsened intestinal ischaemia. What are the consequences? ⋯ The impact of intestinal ischaemia following cardiac arrest is uncertain, but ischaemia is likely to be exacerbated by REBOA. However, inflation of the balloon will occur when the patient is still in cardiac arrest and is a means to achieve ROSC. Hence, we argue that the added intestinal ischaemia caused by REBOA may be of limited clinical importance, but this is still to be answered.
-
Scand J Trauma Resus · Feb 2025
ReviewProthrombin complex concentrate for reversal of oral anticoagulants in patients with oral anticoagulation-related critical bleeding: a systematic review of randomised clinical trials.
Swift reversal of oral anticoagulation is deemed essential for the outcome of patients with anticoagulation-related critical bleeding. The aim of this systematic review was to evaluate the benefits and harms of prothrombin complex concentrate (PCC) in patients with oral anticoagulants-related critical bleeding. ⋯ Among participants with VKA or DOAC-related critical bleeding, evidence from randomised clinical trials is currently insufficient to establish if PCC is superior or inferior versus other interventions in decreasing the risk of undesirable patient-relevant outcomes or improving health-related quality of life.
-
Scand J Trauma Resus · Feb 2025
ReviewProthrombin complex concentrate for reversal of oral anticoagulants in patients with oral anticoagulation-related critical bleeding: a systematic review of randomised clinical trials.
Swift reversal of oral anticoagulation is deemed essential for the outcome of patients with anticoagulation-related critical bleeding. The aim of this systematic review was to evaluate the benefits and harms of prothrombin complex concentrate (PCC) in patients with oral anticoagulants-related critical bleeding. ⋯ Among participants with VKA or DOAC-related critical bleeding, evidence from randomised clinical trials is currently insufficient to establish if PCC is superior or inferior versus other interventions in decreasing the risk of undesirable patient-relevant outcomes or improving health-related quality of life.
-
Scand J Trauma Resus · Feb 2025
ReviewPoint-of-care tests in the emergency medical services: a scoping review.
This scoping review aimed to summarize existing research on point-of-care tests (POCTs) within emergency medical services (EMS). There is a lack of comprehensive reviews covering the breadth and scope of application of POCTs in EMS despite growing interest and potential benefits in this setting. A review of the research will inform how we target future research efforts to support effective implementation and avoid duplication. ⋯ We identified a thriving base of research on POCT in the EMS, however most studies established the diagnostic accuracy of the tests with few RCTs, economic analyses or qualitative research on acceptability. The time-lag from diagnostic accuracy to developing an RCT is considerable. Investment in funding and infrastructure is needed to support the research pathway for potential POCTs beyond diagnostic accuracy to designs able to assess clinical effectiveness, acceptability and economic effectiveness.