European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2023
Observational StudyDOAC plasma concentration upon hospital admission in a cohort of trauma patients. An observational real-life study.
Due to a better safety profile, direct oral anticoagulants (DOACs) are increasingly prescribed for prevention of thromboembolic events. However, little is known about DOAC plasma concentrations in trauma patients upon hospital admission. Thus, we investigated the frequency and extent of DOAC possible over- and underdosing in trauma patients upon hospital admission. ⋯ The current study revealed that patients on dabigatran and rivaroxaban were prone to higher DOAC plasma levels upon hospital admission in comparison with apixaban and edoxaban. DOAC plasma level measurement in trauma patients might be warranted due to unpredictively low or high plasma concentrations. However, the clinical impact of altered plasma levels on both, bleeding and thromboembolic events, remains to be determined by future studies.
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Eur J Trauma Emerg Surg · Dec 2023
Characteristics of injury mechanisms in children and differences between urban and rural areas in central China.
Some studies lack detailed analyses of the differences and characteristics of pediatric injury mechanisms between urban and rural areas. ⋯ Our findings revealed that in different age groups, the injury mechanisms are different in urban and rural areas. Burns are the second leading cause of trauma in children. A decrease in pediatric trauma over the past 10 years indicates targeted measures and preventive intervention may effectively prevent pediatric trauma.
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Eur J Trauma Emerg Surg · Dec 2023
Ultrasound assessment is useful for evaluating balloon volume of resuscitative endovascular balloon occlusion of the aorta.
Endovascular balloon occlusion of the aorta (EBOA) increases proximal arterial pressure but may also induce life-threatening ischemic complications. Although partial REBOA (P-REBOA) mitigates distal ischemia, it requires invasive monitoring of femoral artery pressure for titration. In this study, we aimed to titrate P-REBOA to prevent high-degree P-REBOA using ultrasound assessment of femoral arterial flow. ⋯ The diastolic peak velocity in the femoral artery disappeared when %BV was > 80%. Evaluation of the femoral artery pressure by pulse wave Doppler may predict the degree of P-REBOA without invasive arterial monitoring.