American journal of surgery
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Outcomes in adults who undergo resuscitative thoracotomy are poor. Few studies have examined the procedure's use in pediatric trauma. ⋯ Resuscitative thoracotomy was rarely performed in children in Illinois emergency departments. Survival is low for thoracotomy in the emergency department, but some patients who presented with penetrating injuries did have positive outcomes, supporting a continued role for the procedure in select cases.
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No guidelines exist for credentialing extracorporeal membrane oxygenation (ECMO) physicians despite variable training backgrounds. We aim to identify national patterns of institutional credentialing for ECMO physicians. ⋯ Not all physicians managing ECMO are credentialed and only about half of US centers have established credentialing programs. Standardization of ECMO credentialing may increase training rates and improve variability in credentialing practices across the United States.
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Patients with pre-injury coagulopathy have worse outcomes than those without coagulopathy. This article investigated the risk-adjusted effect of pre-injury coagulopathy on outcomes after splenic injuries. ⋯ Pre-injury coagulopathy in patients with splenic injury has a negative impact on cardiac arrest, sepsis, acute respiratory distress syndrome, acute renal failure, and mortality. The higher likelihood of myocardial infarction did not reach statistical significance.