The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Aug 2020
ReviewEmerging hemorrhage control and resuscitation strategies in trauma: Endovascular to extracorporeal.
This article reviews four emerging endovascular hemorrhage control and extracorporeal perfusion techniques for management of trauma patients with profound hemorrhagic shock including hemorrhage-induced traumatic cardiac arrest: resuscitative endovascular balloon occlusion of the aorta, selective aortic arch perfusion, extracorporeal life support, and emergency preservation and resuscitation. The preclinical and clinical studies underpinning each of these techniques are summarized. We also present an integrated conceptual framework for how these emerging technologies may be used in the future care of trauma patients in both resource-rich and austere environments.
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J Trauma Acute Care Surg · Aug 2020
Multicenter StudyRepeat computed tomography head scan is not indicated in trauma patients taking novel anticoagulation: A multicenter study.
The number of trauma patients on prehospital novel oral anticoagulants (NOACs) is increasing. After an initial negative computed tomography of the head (CTH), practice patterns are variable for obtaining repeat CTH to evaluate for delayed intracranial hemorrhage (ICH-d). However, the risks and outcomes of ICH-d for patients on NOACs are unclear. We hypothesized that, for these patients, the incidence of ICH-d is low, similar to that of warfarin, and when it occurs, it does not result in clinically significant worse outcomes. ⋯ Prognostic/epidemiologic study, level III.Therapeutic, level IV.
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J Trauma Acute Care Surg · Aug 2020
Historical ArticleThe Israel Defense Forces Trauma Registry: 22 years of point-of-injury data.
Trauma is the leading cause of death among casualties between 1 and 44 years. A large proportion of trauma deaths occurs even before arriving at a medical facility. The paucity of prehospital data is a major reason for the lagging development of prehospital trauma care research. This study aims to describe the Israel Defense Forces Prehopistal Trauma Registry, the steps taken to improve data collection and quality, the resulting trends, and the registry's contribution to policymaking. ⋯ Retrospective study, level III.
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J Trauma Acute Care Surg · Aug 2020
Nationwide analysis of whole blood hemostatic resuscitation in civilian trauma.
Renewed interest in whole blood (WB) resuscitation in civilians has emerged following its military use. There is a paucity of data on its role in civilians where balanced component therapy (CT) resuscitation is the standard of care. The aim of this study was to assess nationwide outcomes of using WB as an adjunct to CT versus CT alone in resuscitating civilian trauma patients. ⋯ Therapeutic, level IV.