The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2013
Multicenter Study Comparative Study Clinical TrialMechanical ventilation weaning and extubation after spinal cord injury: a Western Trauma Association multicenter study.
Respiratory failure after acute spinal cord injury (SCI) is well recognized, but data defining which patients need long-term ventilator support and criteria for weaning and extubation are lacking. We hypothesized that many patients with SCI, even those with cervical SCI, can be successfully managed without long-term mechanical ventilation and its associated morbidity. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Dec 2013
Multicenter Study Comparative StudyBlunt cerebrovascular injury in children: underreported or underrecognized?: A multicenter ATOMAC study.
Blunt cerebrovascular injury (BCVI) has been well described in the adult trauma literature. The risk factors, proper screening, and treatment options are well known. In pediatric trauma, there has been very little research performed regarding this injury. We hypothesize that the incidence of BCVI in children is lower than the 1% reported incidence in adult studies and that many children at risk are not being screened properly. ⋯ Prognostic/epidemiologic study, level III; therapeutic study, level IV.
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J Trauma Acute Care Surg · Dec 2013
Comparative StudyOctogenarians and motor vehicle collisions: postdischarge mortality is lower than expected.
Motor vehicle collisions (MVCs) are the second leading cause of injury among octogenarians. Physicians and families lack outcomes-based data to assist in the decision-making process concerning injury treatment in this population. The purpose of this study was to evaluate 1-year postdischarge mortality in octogenarian MVC patients, cause of death, and patterns predictive of mortality. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Dec 2013
Randomized Controlled Trial Comparative StudyA prospective evaluation of platelet function in patients on antiplatelet therapy with traumatic intracranial hemorrhage.
Platelet transfusion is increasingly used in patients with traumatic intracranial hemorrhage (ICH) on aspirin therapy to minimize the progression of ICH. We hypothesized (null) that platelet transfusion in this cohort of patients does not improve platelet function. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Dec 2013
Comparative StudyRunning on empty? The compensatory reserve index.
Hemorrhage is a leading cause of traumatic death. We hypothesized that state-of-the-art feature extraction and machine learning techniques could be used to discover, detect, and continuously trend beat-to-beat changes in arterial pulse waveforms associated with the progression to hemodynamic decompensation. ⋯ Machine modeling can quickly and accurately detect and trend central blood volume reduction in real time during the compensatory phase of hemorrhage as well as estimate when an individual is "running on empty" and will decompensate (CRI, 0), well in advance of meaningful changes in traditional vital signs.