Articles: trauma.
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Scand J Trauma Resus · Jul 2018
Multicenter StudyAssociation between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients - a retrospective Analysis.
Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma. ⋯ In adult trauma patients, pre-hospital higher blood glucose levels were related to tachycardic and shockable rhythms. Cardiac arrest was more frequently observed in hypoglycaemic and hyperglycaemic pre-hospital trauma patients. The rate of ROSC rose significantly with rising blood glucose concentration. Blood glucose measurements in addition to common vital parameters (GCS, heart rate, blood pressure, breathing frequency) may help identify patients at risk for cardiopulmonary arrest and dysrhythmias.
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Multicenter Study
Interactive Effect between On-Scene Hypoxia and Hypotension on Hospital Mortality and Disability in Severe Trauma.
It is unclear whether effect size of the hypoxia is different on in-hospital mortality and disability according to hypotension status in the field. ⋯ The effect of hypoxia was much greater in the hypotensive group than in the non-hypotensive group both in terms of mortality and disability.
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Multicenter Study Observational Study
Procedural Sedation and Analgesia in Trauma Patients in an Out-of-Hospital Emergency Setting: A Prospective Multicenter Observational Study.
The quality of procedural analgesia and sedation among trauma patients has not been studied much in the prehospital setting. The main objective of this study was to characterize the quality of procedural analgesia sedation practices in prehospital settings in trauma patients. ⋯ Procedural sedation-analgesia was inadequate in almost half of the trauma patients in the out-of-hospital setting. The reasons of these failures were probably multiple. The non-administration of a sedative drug despite an indication or non-adapted doses, in the context of a lack of specific protocols, was certainly one of them.
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Critical care medicine · Jul 2018
Multicenter StudyImpact of ICU Structure and Processes of Care on Outcomes After Severe Traumatic Brain Injury: A Multicenter Cohort Study.
It is uncertain whether dedicated neurocritical care units are associated with improved outcomes for critically ill neurologically injured patients in the era of collaborative protocol-driven care. We examined the association between dedicated neurocritical care units and mortality and the effects of standardized management protocols for severe traumatic brain injury. ⋯ Compared with dedicated neurocritical care models, standardized management protocols for severe traumatic brain injured patients are process-targeted intervention strategies that may improve clinical outcomes.
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Critical care medicine · Jul 2018
Multicenter StudyMarkedly Deranged Injury Site Metabolism and Impaired Functional Recovery in Acute Spinal Cord Injury Patients With Fever.
To characterize the effect of fever after acute, traumatic spinal cord injury on injury site metabolism and patient outcome. ⋯ Early after spinal cord injury, fever is associated with more deranged injury site metabolism than normothermia and worse prognosis.