European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
Ionised calcium levels during trauma resuscitation in predicting outcomes-a prospective cohort study.
Haemorrhage remains the leading cause of preventable mortality following trauma, often aggravated by the acidosis, hypothermia and coagulopathy-the lethal triad of trauma. However, the impact of trauma-induced hypocalcemia on the haemorrhage remains unclear. It is intuitive to consider perturbations of ionised calcium early during trauma resuscitation in acutely injured patients given its pathophysiological significance for an improved outcome. Thus, we conducted a prospective study to analyse the role of ionized calcium ion levels during trauma resuscitation and its association with the need for blood transfusion(s) requirement and mortality. ⋯ Ionized hypocalcaemia is widely prevalent among acutely injured. Trauma-induced hypocalcaemia at admission is associated with increased need for blood transfusions and increased mortality.
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Eur J Trauma Emerg Surg · Jan 2025
Review Meta AnalysisPost-operative complications associated with the pre-operative use of Aspirin in patients undergoing surgery for hip or femoral fracture: a meta-analysis.
The number of patients with hip and femoral fractures is increasing and is expected to further increase in upcoming years due to the ageing population and the life expectancy of the general population. In this analysis, we aimed to systematically assess the post-operative complications associated with the pre-operative use of Aspirin in patients undergoing surgery for hip or femoral fracture. ⋯ The post-operative complications associated with the pre-operative use of Aspirin in patients undergoing surgery for hip or femoral fracture were apparently not significantly different when compared to patients who were not on Aspirin. Therefore, Aspirin should not be considered an absolute contraindication in patients undergoing surgery for hip or femoral fracture. Hence, an early or emergency surgery for hip or femoral neck fracture in patients on Aspirin therapy should apparently not pose any problem. Further larger trials should be able to confirm this hypothesis.
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Eur J Trauma Emerg Surg · Jan 2025
Randomized Controlled TrialEffect of isotonic sodium bicarbonate infusion on perioperative acid-base status among patients undergoing emergency laparotomy for perforation peritonitis (ISABEL trial): a randomized controlled trial.
Perioperative metabolic acidosis negatively affects patient outcomes. Perioperative fluid therapy has a clinically significant effect on acid-base balance. This study was conducted to evaluate the effects of isotonic sodium bicarbonate infusion (ISB) versus balanced crystalloid solution (BCS) on perioperative acid-base balance, in terms of postoperative base excess, among patients undergoing emergency laparotomy for perforation peritonitis. ⋯ Infusing isotonic sodium bicarbonate (ISB) for intraoperative maintenance fluid therapy in patients undergoing emergency laparotomy for perforation peritonitis significantly improves perioperative acid-base balance with better postoperative clinical outcomes compared to a balanced crystalloid solution (BCS).
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Eur J Trauma Emerg Surg · Jan 2025
Letter Comparative StudyClinical and radiological comparisons of isolated posterior malleolar fractures treated surgically and conservatively.
Isolated posterior malleolar (PM) fractures are rare fractures without consensus regarding treatment decisions and functional outcomes. The study aims to compare the clinical and radiological results of patients treated surgically or conservatively for isolated PM fractures. ⋯ Level IV, retrospective cohort study.
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Eur J Trauma Emerg Surg · Jan 2025
Observational StudyIs pre-hospital haemoglobin an efficient marker of the need for transfusion and haemorrhagic shock in severe trauma patients? A retrospective observational study.
Haemorrhagic shock is the leading cause of preventable death among trauma patients. Early detection of severe haemorrhage is essential for initiating timely resuscitation and mobilizing resources for massive transfusion (MT) protocols and damage control procedures. This study aimed to assess the predictive value of prehospital haemoglobin (Hb) levels for the need for transfusion at admission, the presence of haemorrhagic shock (HS), and the necessity for MT or haemostatic surgery. Additionally, the study sought to compare the diagnostic accuracy of Hb with established multiparametric scores such as TASH, ABC, Red Flag, and Shock Index (SI). ⋯ Prehospital Hb levels are as effective as established multiparametric scores in predicting the need for transfusion, HS, MT, and haemostatic surgery. Due to its simplicity and practicality, Hb can serve as an alternative to complex scoring systems in prehospital settings, potentially improving triage and treatment outcomes in civilian and military trauma care.