Scand J Trauma Resus
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Scand J Trauma Resus · Dec 2013
Pulmonary infiltrates during community acquired Gram-negative bacteremia: a retrospective single centre study.
The primary aim of this study was to describe the frequency of pulmonary infiltrates on chest X-ray (CXR) during community acquired Gram-negative bacteremia at a single centre in Denmark. ⋯ In conclusion, the presence of infiltrates during community acquired Gram-negative bacteremia was very frequent in our population.
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Scand J Trauma Resus · Dec 2013
Comparative StudyComparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metabolic responses, and coagulation in pigs after severe hemorrhagic shock.
Ongoing improvements in trauma care now recommend earlier use of blood products as part of damage control resuscitation, but generally these products are not available at far forward battlefield locations. For the military, questions continue to arise regarding efficacy of normal saline (NS) vs. lactated Ringer's (LR). Thus, this study compared the effects of LR and NS after severe hemorrhage in pigs. ⋯ NS may be inferior to LR in resuscitation due to its vasodilator effects and the risks of metabolic acidosis and hyperkalemia.
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Scand J Trauma Resus · Dec 2013
Comment LetterTwisting and ignoring facts on hydroxyethyl starch is not very helpful.
Large randomized trials on critically ill patients have related the use of hydroxyethyl starch (HES) to negative outcomes. In a recent comment we explained in detail why, from our point of view, transferring the results of VISEP, 6S and CHEST into daily ICU practice is as difficult as their extrapolation to perioperative treatment. Haase, Müller and Perner lately challenged this analysis. ⋯ The difference might be that we like to thoroughly discuss all of them, including the main one: VISEP, 6S and CHEST do not capture the initial stabilization of their hemodynamically instable patients. The vast majority, including those patients later assigned to the "crystalloid" groups, had been stabilized with colloids before study onset. This is not a big problem, but has to be discussed carefully and honestly to prevent the data from being misinterpreted by users and official authorities.
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Scand J Trauma Resus · Dec 2013
Observational StudyProspective observational study on tracheal tube cuff pressures in emergency patients--is neglecting the problem the problem?
Inappropriately cuffed tracheal tubes can lead to inadequate ventilation or silent aspiration, or to serious tracheal damage. Cuff pressures are of particular importance during aeromedical transport as they increase due to decreased atmospheric pressure at flight level. We hypothesised, that cuff pressures are frequently too high in emergency and critically ill patients but are dependent on providers' professional background. ⋯ Cuff pressures in the pre-hospital setting and in intensive care units are often too high. Interestingly, there is no significant difference between non-anaesthesia and anaesthesia personnel. Acceptable cuff pressures are best achieved when a cuff pressure manometer has been used. This method seems to be the only feasible one and is recommended for general use.
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Scand J Trauma Resus · Dec 2013
ReviewThe measurement of tissue interface pressures and changes in jugular venous parameters associated with cervical immobilisation devices: a systematic review.
Cervical immobilisation is commonly applied following trauma, particularly blunt head injury, but current methods of immobilisation are associated with significant complications. Semi-rigid disposable cervical collars are known to cause pressure ulcers, and impede effective airway management. These collars may also exacerbate a head injury by increasing intracranial pressure as a result of external compression of the jugular veins. ⋯ Cervical collars have been shown to have a compressive effect on the jugular veins, but it is not yet certain that this is the cause of the increased intracranial pressure observed in association with cervical collar use. This is the first review of its type. It will help guide further research in this area of trauma care, and the development and testing of new cervical immobilisation devices.