The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2014
Comparative StudyRecovery of fibrinogen concentrate after intraosseous application is equivalent to the intravenous route in a porcine model of hemodilution.
Fibrinogen concentrate is increasingly considered as a hemostatic agent for trauma patients experiencing bleeding. Placing a venous access is sometimes challenging during severe hemorrhage. Intraosseous access may be considered instead. Studies of intraosseous infusion of coagulation factor concentrates are limited. We investigated in vivo recovery following intraosseous administration of fibrinogen concentrate and compared the results with intravenous administration. ⋯ Prospective, randomized, therapeutic feasibility study in an animal model, level V.
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J Trauma Acute Care Surg · May 2014
Comparative StudyComplex penetrating duodenal injuries: less is better.
The traditional management of complex penetrating duodenal trauma (PDT) has been the use of elaborate temporizing and complex procedures such as the pyloric exclusion and duodenal diverticulization. We sought to determine whether a simplified surgical approach to the management of complex PDT injuries improves clinical outcome. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · May 2014
Comparative StudyLevothyroxine therapy before brain death declaration increases the number of solid organ donations.
Protocols call for the start of hormonal therapy with levothyroxine after the declaration of brain death. As the hormonal perturbations occur during the process of brain death, the role of the early initiation of levothyroxine therapy (LT) to salvage organs is not well defined. The aim of this study was to evaluate the impact of early LT (before the declaration of brain death) on the number of solid organs procured per donor. ⋯ Therapeutic/care management study, level IV.
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J Trauma Acute Care Surg · May 2014
Guiding the management of intubated patients with pneumonia and ventilator-associated events using serial catheter-directed bronchoalveolar lavage.
We evaluated the role of serial catheter-directed bronchoalveolar lavage (CDBAL) in the diagnosis and management of pneumonia in ventilated surgical intensive care unit patients. ⋯ Diagnostic test, level III. Therapeutic study, level IV.
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J Trauma Acute Care Surg · May 2014
Predicting the need for massive transfusion in trauma patients: the Traumatic Bleeding Severity Score.
The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured trauma patients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system. ⋯ Prognostic study, level III.