The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2019
Multicenter Study Clinical TrialIndocyanine green dye angiography as an adjunct to assess indeterminate burn wounds: A prospective, multicentered, triple-blinded study.
Clinical assessment of indeterminate burn wounds has been reported to yield poor accuracy, even when performed by burn experts. Indocyanine green (ICG) dye angiography has been found to be highly accurate in assessing burn depth, but there is still limited evidence of its use in indeterminate burn wounds. This study aims to compare the accuracy of ICG angiography to that of clinical assessment in assessing indeterminate burn wounds. ⋯ Indocyanine green angiography yields a significantly higher accuracy than clinical assessment in indeterminate burn wounds. This intervention can, thus, be a useful tool to aid clinical judgment.
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J Trauma Acute Care Surg · May 2019
Meta Analysis Comparative StudyComparison of the efficacy of a bougie and stylet in patients with endotracheal intubation: A meta-analysis of randomized controlled trials.
Endotracheal intubation (ETI) is a procedure widely performed for several clinical indications. In typical ETI, an endotracheal tube is placed into a patient's trachea with the help of a malleable metal rod covered with a clear plastic sheath (called a stylet). However, another intubation aid, a bougie (also named a gum elastic bougie or endotracheal tube introducer), was also introduced in the clinical setting to improve the efficacy of conventional ETI. ⋯ Systematic review and meta-analysis, level II.
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J Trauma Acute Care Surg · May 2019
Multicenter StudyThe why and how our trauma patients die: A prospective Multicenter Western Trauma Association study.
Historically, hemorrhage has been attributed as the leading cause (40%) of early death. However, a rigorous, real-time classification of the cause of death (COD) has not been performed. This study sought to prospectively adjudicate and classify COD to determine the epidemiology of trauma mortality. ⋯ Epidemiologic, level II.
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J Trauma Acute Care Surg · May 2019
Pediatric blunt renal trauma practice management guidelines: Collaboration between the Eastern Association for the Surgery of Trauma and the Pediatric Trauma Society.
Injury to the kidney from either blunt or penetrating trauma is the most common urinary tract injury. Children are at higher risk of renal injury from blunt trauma than adults, but no pediatric renal trauma guidelines have been established. The authors reviewed the literature to guide clinicians in the appropriate methods of management of pediatric renal trauma. ⋯ Guidelines study, level III.
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J Trauma Acute Care Surg · May 2019
Chest computed tomography imaging utility for radiographically occult rib fractures in elderly fall-injured patients.
Previous studies demonstrate an association between rib fractures and morbidity and mortality in trauma. This relationship in low-mechanism injuries, such as ground-level fall, is less clearly defined. Furthermore, computed tomography (CT) has increased sensitivity for rib fractures compared with chest x-ray (CXR); its utility in elderly fall patients is unknown. We sought to determine whether CT-diagnosed rib fractures in elderly fall patients with a normal CXR were associated with increased in-hospital resource utilization or mortality. ⋯ Diagnostic, level III.