The American surgeon
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Trauma complicating pregnancy represents a significant threat to maternal survival and successful pregnancy outcome. Combining trauma center and perinatal center capabilities may provide improved outcome for pregnant trauma victims. The authors report their experience with 39 patients over a 10-year period to identify factors that influenced pregnancy outcome. ⋯ Unsuccessful pregnancy was associated with significantly higher injury severity score (ISS); regional abdominal abbreviated injury scores (AIS) and hospital charges; longer hospital and intensive care unit lengths of stay; a higher incidence of intubation and placenta abruptio; and a lower admission systolic blood pressure. Fetal ultrasound or Doppler were routinely used and contributed to trauma management. These findings support close cooperation and coordination of trauma and perinatal services to achieve optimal maternal and pregnancy outcomes.
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The American surgeon · Sep 1992
Comparative StudyAutotransfusion in trauma: a comparison of two systems.
Autotransfusion is a potentially valuable tool in the resuscitation of hypovolemic trauma patients; its acceptance in this setting has been limited by fears of the induction of coagulopathic and septic complications. It has been inferred that the addition of a cell washing step would obviate these concerns but at the cost of speed. To assess the validity of these concerns, we have retrospectively compared two autotransfusion devices: one without (the modified Bentley device) and one with (the Baylor Rapid Autologous Transfusion system) a cell washing step, over a 48-month period. ⋯ Overall, the device returned 0.82 units of washed, packed red blood cells for every unit of banked blood used. Overall mortality was 26 per cent, and 30 per cent of survivors had complications. While we have been unable to demonstrate an advantage of the cell washing step, there is no evidence that this step in this unit limited the rate or volume of autologous blood replacement.