J Trauma
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The 372 cases of crush syndrome that followed the 1995 Hanshin-Awaji earthquake have provided a unique opportunity to investigate the long-term physical outcomes and to establish indications for specific treatments in such patients. The objectives of this study were to identify independent predictors of physical outcome in patients suffering from crush syndrome and to clarify the influence of fasciotomy on outcomes. ⋯ Secondary compartment syndrome affects physical outcome in crush syndrome patients. We obtained no evidence that fasciotomy improves outcome. Delayed rescue, delayed fasciotomy, and radical debridement may worsen the physical prognosis. Indications for fasciotomy in crush syndrome during the acute phase need further deliberation.
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Apoptosis in organs of rats in early stage after polytrauma combined with shock was researched. ⋯ Apoptosis was induced in thymus, spleen, liver, lung, and intestine in early stage after polytrauma combined with shock, which may play partial roles in the development of multiple organ failure.
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Multicenter Study
Helicopter transport and blunt trauma mortality: a multicenter trial.
Despite many studies addressing potential impact of helicopter transport on trauma mortality, debate as to the efficacy of air transport continues. ⋯ The results of this study are consistent with an association between helicopter transport mode and increased survival in blunt trauma patients.
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This study assessed patients with traumatic brain injury (TBI) to determine whether prehospital and community hospital providers employed hyperventilation therapy inconsistent with consensus recommendation against its routine use. ⋯ Prehospital and community hospital hyperventilation practices are not consistent with consensus recommendations for limitation of hyperventilation therapy.
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The ability to rapidly and accurately triage, evacuate, and utilize appropriate interventions can be problematic in the early decision-making process of trauma care. With current methods of prehospital data collection and analysis, decisions are often based upon single data points. This information may be insufficient for reliable decision-making. To date, no studies have attempted to utilize data at multiple time points for purposes of enhancing prediction, nor have studies attempted to synthesize prediction models with data reflecting both large-vessel venous and arterial injuries. Therefore, we performed a retrospective study to examine the potential utility of dynamic neural networks in predicting mortality using highly discretized uncontrolled hemorrhagic shock data. ⋯ This study demonstrates that PNN models can effectively harness the dynamic nature of uncontrolled hemorrhagic shock data, despite utilizing data from large-vessel arterial and venous injuries. Utilizing the dynamic nature of hemorrhagic shock data in PNNs may ultimately allow the development of novel decision assist devices.