The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2016
ReviewA systematic review of the use of resuscitative endovascular balloon occlusion of the aorta in the management of hemorrhagic shock.
Torso hemorrhage remains a leading cause of potentially preventable death within trauma, acute care, vascular, and obstetric practice. A proportion of patients exsanguinate before hemorrhage control. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct designed to sustain the circulation until definitive hemostasis. A systematic review was conducted to characterize the current clinical use of REBOA and its effect on hemodynamic profile and mortality. ⋯ Systematic review, level IV.
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J Trauma Acute Care Surg · Feb 2016
Randomized Controlled TrialThe incidence of ARDS and associated mortality in severe TBI using the Berlin definition.
The incidence of adult respiratory distress syndrome (ARDS) in severe traumatic brain injury (TBI) is poorly reported. Recently, a new definition for ARDS was proposed, the Berlin definition. The percentage of patients represented by TBI in the Berlin criteria study is limited. This study describes the incidence and associated mortality of ARDS in TBI patients. ⋯ Epidemiologic study, level II.
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J Trauma Acute Care Surg · Feb 2016
Controlled Clinical TrialA prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures.
Previous studies of surgical stabilization of rib fractures (SSRF) have been limited by small sample sizes, retrospective methodology, and inclusion of only patients with flail chest. We performed a prospective, controlled evaluation of SSRF as compared with optimal medical management for severe rib fracture patterns among critically ill trauma patients. We hypothesized that SSRF improves acute outcomes. ⋯ Therapeutic study, level II.
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J Trauma Acute Care Surg · Feb 2016
Prehospital airway technique does not influence incidence of ventilator-associated pneumonia in trauma patients.
The relationship between the prehospital airway device used and later development of ventilator-associated pneumonia (VAP) is unknown. We sought to determine if the prehospital airway device choice is associated with an increased risk of VAP in risk-adjusted critically injured patients. ⋯ Therapeutic study, level IV; epidemiologic study, level III.
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J Trauma Acute Care Surg · Feb 2016
Early leukocyte gene expression associated with age, burn size, and inhalation injury in severely burned adults.
In the patient with burn injury, older age, larger percentage of total body surface area (TBS) burned, and inhalation injury are established risk factors for death, which typically results from multisystem organ failure and sepsis, implicating burn-induced immune dysregulation as a contributory mechanism. We sought to identify early transcriptomic changes in circulating leukocytes underlying increased mortality associated with these three risk factors. ⋯ Epidemiologic study, level III.