The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2012
Randomized Controlled TrialKetamine/propofol admixture (ketofol) is associated with improved hemodynamics as an induction agent: a randomized, controlled trial.
Critically ill patients may require emergent intubations, and the use of some induction agents can lead to undesirable effects on hemodynamics. The use of "ketofol" (ketamine/propofol admixture) may allow for improved hemodynamic control. The primary aim of this study was to assess the hemodynamic effects of "ketofol" in a fixed-dose combination during induction of general anesthesia in a controlled environment. ⋯ "Ketofol" is associated with improved hemodynamic stability during the first 10 minutes after induction. Further study is needed to assess the efficacy of "ketofol" in critically ill patients and those with significant comorbidities. This combination has the potential to be used as an alternative agent for emergency induction during which time stable hemodynamics are desirable.
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J Trauma Acute Care Surg · Jul 2012
Review Meta AnalysisPrehospital trauma systems reduce mortality in developing countries: a systematic review and meta-analysis.
The majority of trauma deaths in the developing world occur outside of the hospital. In the mid-1990s, preliminary studies of prehospital trauma systems showed improvements in mortality. However, no empirical data are available to assess the overall benefit of these systems. We undertook a systematic review and meta-analysis to assess the effectiveness of prehospital trauma systems in developing countries. ⋯ Meta-analysis, level III+.
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J Trauma Acute Care Surg · Jul 2012
Criteria for empiric treatment of hyperfibrinolysis after trauma.
Recent studies identify a survival benefit from the administration of antifibrinolytic agents in patients with severe injury and trauma. However, identification of hyperfibrinolysis requires thromboelastography, which is not widely available. We hypothesized that analysis of patients with thromboelastography-diagnosed hyperfibrinolysis would identify clinical criteria for empiric antifibrinolytic treatment in the absence of thromboelastography. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jul 2012
Randomized Controlled TrialNext generation distal locking for intramedullary nails using an electromagnetic X-ray-radiation-free real-time navigation system.
Distal locking marks one challenging step during intramedullary nailing that can lead to an increased irradiation and prolonged operation times. The aim of this study was to evaluate the reliability and efficacy of an X-ray-radiation-free real-time navigation system for distal locking procedures. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Jul 2012
Clinical TrialIntensive exercise after thermal injury improves physical, functional, and psychological outcomes.
Although exercise programs after burns are considered a standard of care, there is limited evidence for efficacy in adult patients. This study aimed to investigate the effects of an exercise program on physical, functional, and quality of life measures. ⋯ Therapeutic study, level III.