J Trauma
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The clinical features and successful management of a patient with right main bronchus disruption after blunt chest trauma are described. The presentation was one of bilateral tension pneumothoraces. A high index of suspicion, coupled with appropriate airway management at presentation, was vital for the successful treatment of this patient. Surgical resection using a sleeve lobectomy, an operation rarely used in trauma patients, was highly effective in this patient, and the technique is described in this report.
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Review Case Reports
Aortic dissection after trauma: case report and review of the literature.
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Comparative Study
Diaspirin cross-linked hemoglobin resuscitation improves cerebral perfusion after head injury and shock.
Shock associated with traumatic brain injury (TBI) doubles the mortality of TBI alone by inducing a secondary ischemic injury. Rapid correction of cerebral perfusion pressure (CPP) is thought to be essential to improving outcome. Diaspirin cross-linked hemoglobin (DCLHb) has been shown to improve cerebral blood flow, increase mean arterial pressure (MAP), and reduce lesion size in models of occlusive cerebral ischemia but has not been evaluated in a model of TBI combined with hemorrhagic shock. ⋯ These data suggest that DCLHb is beneficial in the early resuscitation of head injury and shock and that further investigation is warranted. Key Words: Diaspirin cross-linked hemoglobin, Head injury, Shock, Cerebral perfusion pressure.
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To determine the nature and causes of gun violence among urban young people. ⋯ Handgun availability and use are high among urban youth; gun carrying is mostly related to safety concerns and easy access, rather than to hunting or sport. This may be a cause of high handgun injury rates in this group. Gun injury prevention programs must address youth safety concerns along with handgun availability.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of volume control and pressure control ventilation: is flow waveform the difference?
To examine the hypothesis that a decelerating inspiratory flow waveform is responsible for improvements in gas exchange during pressure control ventilation for acute lung injury. ⋯ Both pressure control ventilation and volume control ventilation with a decelerating flow waveform provided better oxygenation at a lower peak inspiratory pressure and higher mean airway pressure compared to volume control ventilation with a square flow waveform. The results of our study suggest that the reported advantages of pressure control ventilation over volume control ventilation with a square flow waveform can be accomplished with volume control ventilation with a decelerating flow waveform.