The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2019
Meta AnalysisThe effectiveness of junctional tourniquets: A systematic review and meta-analysis.
Junctional tourniquets have been incorporated into tactical combat casualty care for junctional vascular trauma. They apply external compression to stop blood flow in the groin and axilla. ⋯ Systematic review, level III.
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J Trauma Acute Care Surg · Mar 2019
Meta AnalysisComparing short-, long-, and oblique-axis approaches to ultrasound-guided internal jugular venous catheterization: A meta-analysis of randomized controlled trials.
Internal jugular venous catheterization is performed for numerous therapeutic interventions. Although ultrasound-guided internal jugular venous catheterization is the gold standard for this procedure, complications can still occur. Various scanning axes, namely, the short axis (SA), long axis (LA), and oblique axis (OA), have been developed to ameliorate these complications. This study compared the efficacy and safety of SA, LA, and OA approaches. ⋯ Systematic review and meta-analysis, level I.
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J Trauma Acute Care Surg · Mar 2019
Randomized Controlled Trial Multicenter StudyThe impact of hypothermia on outcomes in massively transfused patients.
Hypothermia is associated with poor outcomes after injury. The relationship between hypothermia during contemporary large volume resuscitation and blood product consumption is unknown. We evaluated this association, and the predictive value of hypothermia on mortality. ⋯ Prognostic, level III.
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J Trauma Acute Care Surg · Mar 2019
Meta AnalysisMassive transfusion protocols in nontrauma patients: A systematic review and meta-analysis.
Massive bleeding is a major cause of death both in trauma and nontrauma patients. In trauma patients, the implementation of massive transfusion protocols (MTP) led to improved outcomes. However, the majority of patients with massive bleeding are nontrauma patients. ⋯ Systematic review and meta-analysis, level III.
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J Trauma Acute Care Surg · Mar 2019
An unambiguous definition of pediatric hypotension is still lacking: Gaps between two percentile-based definitions and Pediatric Advanced Life Support/Advanced Trauma Life Support guidelines.
Data are lacking to provide cutoffs for hypotension in children based on outcome studies and Pediatric Advanced Life Support (PALS), and Advanced Trauma Life Support (ATLS) definitions are based on normal populations. The goal of this study was to compare different normal population based cutoffs including fifth percentile of systolic blood pressure (P5-SBP) in children and adolescents from the German Health Examination Survey for Children and Adolescents (KiGGS), US population data (Fourth Report), and cutoffs from PALS and ATLS guidelines. ⋯ Epidemiologic/prognostic, level III.