European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2024
Multidisciplinary management of high-grade pediatric liver injuries.
To present our experience of multidisciplinary management of high-grade pediatric liver injuries. ⋯ Conservative management of advanced liver injuries can result in significant morbidity and mortality due to high risk of complications. Trauma surgeons need to have multidisciplinary team for management of these patients to gain optimal outcome.
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Eur J Trauma Emerg Surg · Jun 2024
Observational StudyClinical validation of the "Straight-Leg-Evaluation-Trauma-Test" (SILENT) as a rapid assessment tool for injuries of the lower extremity in trauma bay patients.
Clinical assessment of the major trauma patient follows international validated guidelines without standardized trauma-specific assessment of the lower extremities for injuries. This study aimed to validate a novel clinical test for lower extremity evaluation during trauma resuscitation phase. ⋯ The SILENT test is a clinical applicable and feasible rule-out test for relevant injuries of the lower extremity. A negative SILENT test of the femur or the tibia might reduce the requirement of additional radiological imaging. Further large-scale prospective studies might be required to corroborate the beneficial effects of the SILENT test.
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Eur J Trauma Emerg Surg · Jun 2024
Machine learning in the prediction of massive transfusion in trauma: a retrospective analysis as a proof-of-concept.
Early administration and protocolization of massive hemorrhage protocols (MHP) has been associated with decreases in mortality, multiorgan system failure, and number of blood products used. Various prediction tools have been developed for the initiation of MHP, but no single tool has demonstrated strong prediction with early clinical data. We sought to develop a massive transfusion prediction model using machine learning and early clinical data. ⋯ We demonstrate the use of machine learning in developing an accurate prediction model for massive transfusion in trauma patients using early clinical data. This research demonstrates the potential utility of artificial intelligence as a clinical decision support tool.
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Eur J Trauma Emerg Surg · Jun 2024
The impact of hypertonic saline on damage control laparotomy after penetrating abdominal trauma.
The inability to achieve primary fascial closure (PFC) after emergency laparotomy increases the rates of adverse outcomes including fistula formation, incisional hernia, and intraabdominal infection. Hypertonic saline (HTS) infusion improves early PFC rates and decreases time to PFC in patients undergoing damage control laparotomy (DCL) after injury. We hypothesized that in patients undergoing DCL after penetrating abdominal injury, HTS infusion would decrease the time to fascial closure as well as the volume of crystalloid required for resuscitation without inducing clinically relevant acute kidney injury (AKI) or electrolyte derangements. ⋯ Level III.
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Eur J Trauma Emerg Surg · Jun 2024
Adjunctive hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries: a systematic review.
Traumatic crush injuries of the lower limb often accompany severe complications. The incorporation of hyperbaric oxygen therapy to standard trauma care may have the potential to diminish injury-related complications and improve outcome in such cases. This systematic review aims to evaluate the effectiveness of hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries. ⋯ Hyperbaric oxygen therapy is generally considered a safe therapeutic intervention and seems to have a beneficial effect on wound healing in severe lower limb soft tissue injuries when implemented as an addition to standard trauma care.