Articles: trauma.
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Randomized Controlled Trial Multicenter Study Comparative Study
Fibrinogen Early In Severe Trauma studY (FEISTY): study protocol for a randomised controlled trial.
Haemorrhage is a leading cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage. Early fibrinogen replacement is recommended by several international trauma guidelines using either fibrinogen concentrate (FC) or cryoprecipitate (Cryo). There is limited evidence to support one product over the other with widespread geographic and institutional variation in practice. This pilot trial is the first randomised controlled trial comparing FC to Cryo in traumatic haemorrhage. ⋯ The optimal method for replacing fibrinogen in traumatic haemorrhage is fiercely debated. In this trial the feasibility and efficacy of fibrinogen supplementation using FC will be compared to Cryo. The results of this pilot study will facilitate the design of a larger trial with sufficient power to address patient-centred outcomes.
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Multicenter Study Observational Study
Emergency Department triage of traumatic head injury using brain electrical activity biomarkers: a multisite prospective observational validation trial.
A brain electrical activity biomarker for identifying traumatic brain injury (TBI) in emergency department (ED) patients presenting with high Glasgow Coma Scale (GCS) after sustaining a head injury has shown promise for objective, rapid triage. The main objective of this study was to prospectively evaluate the efficacy of an automated classification algorithm to determine the likelihood of being computed tomography (CT) positive, in high-functioning TBI patients in the acute state. ⋯ Using an EEG-based biomarker high accuracy of predicting the likelihood of being CT+ was obtained, with high NPV and sensitivity to any traumatic bleeding and to hematomas. Specificity was significantly higher than standard CT decision rules. The short time to acquire results and the ease of use in the ED environment suggests that EEG-based classifier algorithms have potential to impact triage and clinical management of head-injured patients.
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Multicenter Study
Interpretation of Cerebrospinal Fluid White Blood Cell Counts in Young Infants With a Traumatic Lumbar Puncture.
We determine the optimal correction factor for cerebrospinal fluid WBC counts in infants with traumatic lumbar punctures. ⋯ Correction of the cerebrospinal fluid WBC count substantially reduced the number of infants with cerebrospinal fluid pleocytosis while misclassifying only 1 infant with bacterial meningitis of those aged 29 to 60 days.
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Multicenter Study
Imaging algorithms and CT protocols in trauma patients: survey of Swiss emergency centers.
To identify imaging algorithms and indications, CT protocols, and radiation doses in polytrauma patients in Swiss trauma centres. ⋯ • Swiss trauma centres have internal standardized imaging algorithms for trauma patients • Whole-body CT is most commonly used for imaging of trauma patients • CT protocols and radiation doses vary greatly across Swiss trauma centres.
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Scand J Trauma Resus · Apr 2017
Multicenter Study Observational StudyHypothermia in trauma victims at first arrival of ambulance personnel: an observational study with assessment of risk factors.
Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. ⋯ Prospective, multicenter, open, observational study; Level IV.