Arch Surg Chicago
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Clinical Trial
Factors affecting early postoperative feeding following elective open colon resection.
If factors accounting for the inability to tolerate early postoperative feeding after elective open colon resection can be identified, then perhaps these factors can be modified to decrease future failures. ⋯ In patients undergoing elective open colon resection, early postoperative feeding is safe and effective, and produces a brief hospital stay compared with patients fed by traditional means. However, men and patients undergoing total abdominal colectomy are more likely to be intolerant of early postoperative feeding.
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Survival following massive transfusion in patients who have undergone trauma has improved during the past 10 years. ⋯ Survival following massive transfusion has significantly (P = .03) increased during the past 10 years. Factors that may have contributed to this include more effective and efficient rewarming procedures, improved application of damage control techniques, more aggressive correction of coagulopathy, and improved blood banking procedures.
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Laparoscopic management of perforated duodenal ulcers is safe and effective. ⋯ Laparoscopic repair for perforated ulcers is safe and maintains benefits of the minimally invasive approach. Laparoscopy is not beneficial in patients with shock.
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Real-time ultrasound guidance should increase the success rate and lower the complication rate of central venous access in patients with relative contraindications to having the procedure performed. ⋯ Ultrasound-guided central venous access is a helpful technique to gain venous access in difficult cases. Surgeons who perform central venous access procedures should become acquainted with the techniques involved. The techniques should be incorporated into currently developing ultrasound instruction courses for surgeons.
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Trauma patients who are pulseless at the scene of injury and whose electrical cardiac activity is less than 40 beats/min cannot be revived. ⋯ Trauma victims who are pulseless and have asystole or agonal electrical cardiac activity (heart rate <40 beats/min) should be pronounced dead at the scene of injury.