The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2012
Comparative StudyEffectiveness of short-term 6-hour high-volume hemofiltration during refractory severe septic shock.
The effectiveness of a single 6-hour session of high-volume hemofiltration (HVHF) was evaluated in terms of decreased norepinephrine (NE) requirements, progressive refractory hypotension and hypoperfusion by the fourth hour, and observed versus expected hospital mortality in patients with refractory severe septic shock. ⋯ III, therapeutic study.
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J Trauma Acute Care Surg · May 2012
Comparative StudyFocused rapid echocardiographic evaluation versus vascular cather-based assessment of cardiac output and function in critically ill trauma patients.
Focused rapid echocardiographic evaluation (FREE) is a comprehensive transthoracic echocardiogram tailored for the intensive care unit. It assesses both the cardiac index (CI) and left ventricular ejection fraction (EF). FREE and vascular catheter-derived CI was compared, and the ability of CI to detect moderate to severe dysfunction (EF <40%) was determined. ⋯ III, diagnostic study.
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J Trauma Acute Care Surg · May 2012
Comparative StudyLate reconstruction of posterior acetabular wall fractures using iliac crest.
Reconstructing late posterior acetabular wall fractures is challenging. This study evaluates the use of the iliac crest strut graft for posterior acetabular wall reconstruction. ⋯ IV, therapeutic study.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyQuality indicators used by trauma centers for performance measurement.
To describe the quality indicators (QIs) that trauma centers use for quality measurement and performance improvement. Measuring and reporting quality of care is a critical step to improve the quality of care. QIs compare actual trauma care against ideal criteria and identify patients in whom care may have been suboptimal and should be further reviewed. ⋯ Our study provides the first description of the QIs used by verified trauma centers in four high-income countries with similar systems of trauma care. The majority of trauma centers measure QIs designed to examine the safety, effectiveness, efficiency, and timeliness of hospital processes and outcomes. Opportunities exist to standardize existing QIs to allow broader implementation and develop new QIs to examine patient-centered care and equality of care.
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J Trauma Acute Care Surg · May 2012
Comparative StudyTraditional systolic blood pressure targets underestimate hypotension-induced secondary brain injury.
Vital signs, particularly blood pressure, are often manipulated to maximize perfusion and optimize recovery from severe traumatic brain injury (sTBI). We investigated the utility of automated continuously recorded vital signs to predict outcomes after sTBI. ⋯ III, prognostic study.