Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2018
Survival of in-hospital cardiac arrest in men and women in a large Swedish cohort.
Cardiac arrest is more common in men than women and a few studies have shown inferior 30-day survival for men than for women. The difference might relate to patient characteristics, intra arrest factors or post arrest care. ⋯ This cohort study illuminates an almost equal distribution in characteristics and treatment as well as outcome, 30-day survival after IHCA between men and women. However, our study confirms previous findings of disadvantageous prerequisites among women, but also indicates that preceeding vital signs differ which might indicate residual confounding.
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Scand J Trauma Resus · Dec 2018
Meta AnalysisRisks and benefits of hypotensive resuscitation in patients with traumatic hemorrhagic shock: a meta-analysis.
Damage control strategies play an important role in trauma patient management. One such strategy, hypotensive resuscitation, is being increasingly employed. Although several randomized controlled trials have reported its benefits, the mortality benefit of hypotensive resuscitation has not yet been systematically reviewed. ⋯ This meta-analysis revealed significant benefits of hypotensive resuscitation relative to mortality in traumatic hemorrhagic shock patients. It not only reduced the need for blood transfusions and the incidences of ARDS and multiple organ dysfunction, but it caused a non-significant AKI incidence.
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Scand J Trauma Resus · Dec 2018
Review Meta AnalysisPrognostic value of gasping for short and long outcomes during out-of-hospital cardiac arrest: an updated systematic review and meta-analysis.
We systematically reviewed the literature to investigate whether gasping could predict short and long outcomes in patients with out of hospital cardiac arrest (OHCA). ⋯ Current evidence indicates that gasping can predict short and long outcomes in patients with OHCA.In addition, gasping is associated with a high likelihood of initial shockable rhythm,which may contribute to positive outcomes.
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Scand J Trauma Resus · Dec 2018
Factors associated with acute kidney injury in the Helsinki Burn Centre in 2006-2015.
Acute kidney injury (AKI) is a common complication in severe burns and can lead to significantly poorer outcomes. Although the prognosis has improved in recent decades, the mortality of AKI remains considerable. We investigated the factors that increase the risk of AKI and death after severe burn injury. ⋯ Age, TBSA%, and AKI were the strongest independent factors in predicting outcome in severe burns. Even a major burn (> 50% TBSA) has a relatively good prognosis without simultaneous AKI. Prognosis is poorer even in minor burns for patients with AKI.
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Scand J Trauma Resus · Dec 2018
Comparative Study Observational StudyInvestigating the ability of non-invasive measures of cardiac output to detect a reduction in blood volume resulting from venesection in spontaneously breathing subjects.
Monitoring cardiac output (CO) in shocked patients provides key etiological information and can be used to guide fluid resuscitation to improve patient outcomes. Previously this relied on invasive monitoring, restricting its use in the Emergency Department (ED) setting. The development of non-invasive devices (such as LiDCOrapidv2 with CNAP™ and USCOM 1A), and ultrasound based measurements (Transthoracic echocardiography, inferior vena cava collapsibility index (IVCCI), carotid artery blood flow (CABF) and carotid artery corrected flow time (FTc)) enables stroke volume (SV) and CO to be measured non-invasively in the ED. We investigated the ability of these techniques to detect a change in CO resulting from a 500 ml reduction in circulating blood volume (CBV) following venesection in spontaneously breathing subjects. Additionally, we investigated if using incentive spirometry to standardise inspiratory effort improved the accuracy of IVC based measurements in spontaneously breathing subjects. ⋯ In a population of spontaneously breathing patients, TTE is able to consistency detect a reduction in CO associated with venesection.