Scand J Trauma Resus
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Scand J Trauma Resus · May 2020
Randomized Controlled Trial Multicenter StudyNitrous oxide/oxygen plus acetaminophen versus morphine in ST elevation myocardial infarction: open-label, cluster-randomized, non-inferiority study.
Studies have shown disparate results on the consequences of morphine use in ST-segment elevation myocardial infarction (STEMI). No study has evaluated alternative treatments that could be at least non-inferior to morphine without its potentially damaging consequences for myocardial function and platelet reactivity. The aim of this study was to evaluate whether nitrous oxide/oxygen plus intravenous acetaminophen (NOO-A) is non-inferior to morphine to control chest pain in STEMI patients. ⋯ Analgesia provided by NOO-A was inferior to morphine at 30 min in patients with acute STEMI in the prehospital setting. Rates of serious adverse events did not differ between groups.
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Scand J Trauma Resus · Mar 2020
Multicenter StudyImpact of blunt chest trauma on outcome after traumatic brain injury- a matched-pair analysis of the TraumaRegister DGU®.
Traumatic brain injury (TBI) is associated with high rates of long-term disability and mortality. Our aim was to investigate the effects of thoracic trauma on the in-hospital course and outcome of patients with TBI. ⋯ Chest trauma in general, regardless of its initial severity (AISThorax= 2-5), is associated with decreased chance of good neurologic recovery after TBI. Affected patients should be considered "at risk" and vigilance for the maintenance of optimal neuro-protective measures should be high.
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Scand J Trauma Resus · Mar 2020
Multicenter Study Observational StudyArtificial intelligence algorithm to predict the need for critical care in prehospital emergency medical services.
In emergency medical services (EMSs), accurately predicting the severity of a patient's medical condition is important for the early identification of those who are vulnerable and at high-risk. In this study, we developed and validated an artificial intelligence (AI) algorithm based on deep learning to predict the need for critical care during EMS. ⋯ The AI algorithm accurately predicted the need for the critical care of patients using information during EMS and outperformed the conventional triage tools and early warning scores.
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Scand J Trauma Resus · Dec 2019
Multicenter StudyIntra-patient potassium variability after hypothermic cardiac arrest: a multicentre, prospective study.
To date, the decision to set up therapeutic extra-corporeal life support (ECLS) in hypothermia-related cardiac arrest is based on the potassium value only. However, no information is available about how the analysis should be performed. Our goal was to compare intra-individual variation in serum potassium values depending on the sampling site and analytical technique in hypothermia-related cardiac arrests. ⋯ We found important and clinically relevant variability in potassium values between sampling sites. Clinical decisions should not rely on one biological indicator. However, according to our results, the site of lowest potassium, and therefore the preferred site for a single potassium sampling is central venous blood. The use of multivariable prediction tools may help to mitigate the risks inherent in the limits of potassium measurement.
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Scand J Trauma Resus · Nov 2019
Multicenter Study Observational StudyImpact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry.
Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming have been validated. However, little is known about the association between rewarming rate (RR) and mortality in patients with AH. ⋯ This study showed that slower RR is independently associated with in-hospital mortality.