Scand J Trauma Resus
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Scand J Trauma Resus · Nov 2019
Observational StudyOutcome, quality of life and direct costs after out-of-hospital cardiac arrest in an urban region of Switzerland.
Considering the significant morbidity and mortality of out-of-hospital cardiac arrest, only little data on survival or quality of life after successful resuscitation is available in Europe. Additionally, economic aspects of such events are poorly studied. The purpose of this study is to provide data for survival, quality of life and costs directly related to the cardiac arrest for a region of Switzerland served by one emergency medical service (EMS). ⋯ Quality of care for patients with out-of-hospital cardiac arrest in the region of Winterthur is high, including patients in outlying regions. The associated costs are similar to other European countries.
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Scand J Trauma Resus · Nov 2019
Letter Observational StudyComment on epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study.
The aim of this Letter to the Editor was to report some important biases in a recently published Article. We agreed with the notion by Yamamoto et al. that the effects of epinephrine regarding was limited without hemostasis, however, this study had major limitations such as no information on etiology of traumatic cardiac arrest (hemorrhagic or on non-hemorrhagic) and on hemostatic treatment. The results of this study should be interpreted with caution and further analysis is necessary. Finally, we commented on the necessity of future study regarding another vasopressor (ie; vasopressin) on traumatic cardiac arrest based on current evidence.
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Scand J Trauma Resus · Nov 2019
Multicenter Study Observational StudyImpact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry.
Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming have been validated. However, little is known about the association between rewarming rate (RR) and mortality in patients with AH. ⋯ This study showed that slower RR is independently associated with in-hospital mortality.
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Scand J Trauma Resus · Nov 2019
Regional hypothermia attenuates secondary-injury caused by time-out application of tourniquets following limb fragments injury combined with hemorrhagic shock.
Tourniquet is the most widely used and effective first-aid equipment for controlling hemorrhage of injured limb in battlefield. However, time-out application of tourniquets leads to ischemic-necrosis of skeletal muscles and ischemia-reperfusion injury. Regional hypothermia (RH) on wounded limb can relieve the injury on local tissue and distant organs. We aimed to investigate the protective effects of RH on rabbits' limbs injured by a steel-ball combined with hemorrhagic-shock, and then employed tourniquet over-time, tried to identify the optimal treatment RH. ⋯ Transient RH (4 h) had a "long-term mitigation effects" (continued for 6 h) on time-out application of tourniquet with the fluid resuscitation and core temperature maintenance, and the most effective temperature for reducing the side effects on tourniquet time-out application was 10 °C.
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Scand J Trauma Resus · Nov 2019
Multicenter StudyPrognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study.
Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have been established. We clarified the prognostic ability of the Sequential Organ Failure Assessment (SOFA) score in comparison with previously reported prognostic factors among patients with AH. ⋯ The SOFA score demonstrated better discrimination ability as a mortality predictor among all known prognostic factors in patients with AH.