The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyVentilator-associated pneumonia rates at major trauma centers compared with a national benchmark: a multi-institutional study of the AAST.
Ventilator-associated pneumonia (VAP) rates reported by the National Healthcare Safety Network (NHSN) are used as a benchmark and quality measure, yet different rates are reported from many trauma centers. This multi-institutional study was undertaken to elucidate VAP rates at major trauma centers. ⋯ III, prognostic study.
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J Trauma Acute Care Surg · May 2012
Comparative StudySelective angiographic embolization of blunt splenic traumatic injuries in adults decreases failure rate of nonoperative management.
To determine whether angioembolization (AE) in hemodynamically stable adult patients with blunt splenic trauma (BST) at high risk for failure of nonoperative management (NOM) (contrast blush [CB] on computed tomography, high-grade IV-V injuries, or decreasing hemoglobin) results in lower failure rates than reported. ⋯ III, therapeutic study.
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J Trauma Acute Care Surg · May 2012
Review Meta AnalysisSubglottic secretion drainage for preventing ventilator-associated pneumonia: an updated meta-analysis of randomized controlled trials.
Subglottic secretion drainage (SSD) has been shown to be associated with a lower incidence of ventilator-associated pneumonia (VAP) in a previous meta-analysis. However, a number of randomized controlled trials (RCTs) have been published since then, and so we aimed to conduct an updated meta-analysis. ⋯ I, meta-analysis.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative Study Controlled Clinical TrialSerum levels of ubiquitin C-terminal hydrolase distinguish mild traumatic brain injury from trauma controls and are elevated in mild and moderate traumatic brain injury patients with intracranial lesions and neurosurgical intervention.
This study compared early serum levels of ubiquitin C-terminal hydrolase (UCH-L1) from patients with mild and moderate traumatic brain injury (TBI) with uninjured and injured controls and examined their association with traumatic intracranial lesions on computed tomography (CT) scan (CT positive) and the need for neurosurgical intervention (NSI). ⋯ II, prognostic study.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyEffectiveness of clinical guidelines for deep vein thrombosis prophylaxis in reducing the incidence of venous thromboembolism in critically ill children after trauma.
Historically, 6% of critically ill children developed clinically apparent venous thromboembolism (VTE) after trauma at our Level I pediatric trauma center. We hypothesized that implementation of clinical guidelines for thrombosis prophylaxis incorporating both VTE risk and bleeding risk would reduce VTE incidence without increased bleeding. ⋯ II, therapeutic study.