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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#1
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28492406/routine-computed-tomography-after-recent-operative-exploration-for-penetrating-trauma-what-injuries-do-we-miss
#2
April E Mendoza, Christopher A Wybourn, Anthony G Charles, Andre Campbell, Bruce A Cairns, Margaret M Knudson
BACKGROUND: Patients with penetrating trauma who cannot be stabilized undergo operative intervention without preoperative imaging. In such cases, post-operative imaging may reveal additional injuries not identified during the initial operative exploration. The purpose of this study is to explore the utility of post-operative CT imaging in the setting of penetrating trauma. METHODS: This was a retrospective analysis of patients with penetrating trauma treated at an urban level 1 trauma center between 2010-2015...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28489668/treatment-algorithm-and-management-of-retrohepatic-vena-cava-injuries-management-of-retrohepatic-vena-cava-injuries
#3
James M Bardes, Daniel Grabo, Lydia Lam, Matthew D Tadlock, Aaron Strumwasser, Kenji Inaba
No abstract text is available yet for this article.
May 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28481839/high-ratio-plasma-resuscitation-does-not-improve-survival-in-pediatric-trauma-patients
#4
Jeremy W Cannon, Michael A Johnson, Robert C Caskey, Matthew A Borgman, Lucas P Neff
BACKGROUND: Damage control resuscitation (DCR) including balanced resuscitation with high ratios of plasma (PLAS) and platelets (PLT) to packed red blood cells (PRBC) improves survival in adult patients. We sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric trauma patients (<18 years)...
May 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463939/validation-of-a-non-invasive-monitor-to-continuously-trend-individual-responses-to-hypovolemia
#5
Steven L Moulton, Jane Mulligan, Maria Antoinette Santoro, Khanh Bui, Greg Z Grudic, David MacLeod
BACKGROUND: Humans are able to compensate for significant blood loss with little change in traditional vital signs, limiting early detection and intervention. We hypothesized that the Compensatory Reserve Index (CRI), a new hemodynamic parameter which trends changes in intravascular volume relative to the individual patient's response to hypovolemia, would accurately trend each subject's progression from normovolemia to decompensation (SBP < 80) and back to normovolemia in humans. METHODS: Men and women, ages 19-36 years, underwent stepwise (~333 mL aliquot) removal and replacement of 20% blood volume (males 15 mL/kg; females 13 mL/kg) via a large bore IV...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463938/hemorrhagic-shock-and-tissue-injury-drive-distinct-plasma-metabolome-derangements-in-swine
#6
Nathan Clendenen, Geoffrey R Nunns, Ernest E Moore, Julie A Reisz, Eduardo Gonzalez, Erik Peltz, Christopher C Silliman, Miguel Fragoso, Travis Nemkov, Matthew J Wither, Kirk Hansen, Anirban Banerjee, Hunter B Moore, Angelo DʼAlessandro
BACKGROUND: Tissue injury and hemorrhagic shock induce significant systemic metabolic reprogramming in animal models and critically injured patients. Recent expansions of the classic concepts of metabolomic aberrations in tissue injury and hemorrhage opened the way for novel resuscitative interventions based on the observed abnormal metabolic demands. We hypothesize that metabolic demands and resulting metabolic signatures in pig plasma will vary in response to isolated or combined tissue injury and hemorrhagic shock...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463937/the-anatomy-of-an-article-methods-and-results
#7
Angela Sauaia, Ernest Eugene Moore, Jennifer Crebs, Ronald Maier, David B Hoyt, Steven R Shackford
No abstract text is available yet for this article.
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#8
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463935/admission-n-terminal-pro-brain-natriuretic-peptide-nt-probnp-level-predicts-the-development-of-atrial-fibrillation-in-general-surgical-intensive-care-unit-patients
#9
Nalin Chokengarmwong, Daniel Dante Yeh, Yuchiao Chang, Luis Alfonso Ortiz, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc DeMoya, Kathryn Butler, Jarone Lee, George Velmahos, James Louis Januzzi, Elizabeth Lee-Lewandrowski, Kent Lewandrowski
BACKGROUND: New onset atrial fibrillation (AF) in critically ill surgical patients is associated with significant morbidity and increased mortality. N-terminal pro-B type natriuretic peptide (NT-proBNP) is released by cardiomyocytes in response to stress and may predict AF development after surgery. We hypothesized that elevated NT-proBNP level at surgical ICU admission predicts AF development in a general surgical and trauma population. METHODS: From July to October 2015, NT-proBNP concentrations were measured at ICU admission...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28459798/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-for-major-abdominal-venous-injury-in-a-porcine-hemorrhagic-shock-model
#10
Michael S Lallemand, Donald M Moe, John M McClellan, Joshua P Smith, Leo Daab, Shannon Marko, Nam Tran, Benjamin Starnes, Matthew J Martin
BACKGROUND: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a rescue maneuver for unstable patients with non-compressible hemorrhage below the diaphragm. The efficacy of REBOA in the setting a major abdominal venous injury is unknown. Our objective was to examine the use of REBOA in a large animal model of major abdominal venous injury, and characterize any impact on the hemodynamics, rate and volume of hemorrhage, and survival. METHODS: Ten swine (35-55kg) underwent a controlled and validated hemorrhage and ischemia/reperfusion injury protocol to produce shock physiology...
April 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28459797/a-highly-sensitive-and-specific-combined-clinical-and-sonographic-score-to-diagnose-appendicitis
#11
Swathi B Reddy, Michael Kelleher, S A Jamal Bokhari, Kimberly A Davis, Kevin M Schuster
BACKGROUND: CT scanning reduces the negative appendectomy rate however it exposes the patient to ionizing radiation. Ultrasound (US) does not carry this risk but may be non-diagnostic. We hypothesized that a clinical-ultrasound scoring system would improve diagnostic accuracy. METHODS: We conducted a retrospective review of all patients (>15 yo) who presented through the emergency department with suspected appendicitis and underwent initial US. An ultrasound score was developed using odds ratios for appendicitis given appendiceal diameter, compressibility, hyperemia, free fluid and focal or diffuse tenderness...
April 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28459796/splenic-artery-embolization-versus-splenectomy-analysis-for-early-in-hospital-infectious-complications-and-outcomes
#12
Alberto Aiolfi, Kenji Inaba, Aaron Strumwasser, Kazuhide Matsushima, Daniel Grabo, Elizabeth R Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Splenic artery embolization has gained increasing acceptance as an important adjunct in the treatment of splenic injuries. Residual immunologic function of the spleen after embolization and its consequences on early infectious complications still remain intensely debated. The purpose of this study was to compare splenic artery embolization and splenectomy in terms of early in-hospital infectious complications and outcomes. METHODS: Two year retrospective Trauma Quality Improvement Program (TQIP) database prognostic study...
April 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452901/effect-of-pain-and-analgesia-on-compensatory-reserve
#13
Carmen Hinojosa-Laborde, Jessie Renee D Fernandez, Gary W Muniz, Corinne D Nawn, Rebecca K Burns, Thuan H Le, Kathy B Porter, John T Hardy, Victor A Convertino
BACKGROUND: The measurement of the body's capacity to compensate for reduced blood volume can be assessed with a Compensatory Reserve Measurement (CRM). The CRM, which is calculated from changes in features of the arterial waveform, represents the integration of compensatory mechanisms during states of low tissue perfusion and oxygenation such as hemorrhage. This study was designed to test the hypothesis that pain which activates compensatory mechanisms and analgesia that result in reduced blood pressure are associated with lower compensatory reserve...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452900/the-vietnam-vascular-registry-at-50-years-an-historical-perspective-and-continuing-legacy
#14
Norman M Rich, Eric A Elster, Todd E Rasmussen
No abstract text is available yet for this article.
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452899/cytochrome-c-and-resveratrol-preserve-platelet-function-during-cold-storage
#15
Michael L Ekaney, Martin A Grable, William F Powers, Iain H McKillop, Susan L Evans
BACKGROUND: Donated platelets are stored at 22°C and discarded within 5 days because of diminished function and risk of bacterial contamination. Decline of platelet function has been attributed to decreased mitochondrial function and increased oxidative stress. Resveratrol (Res) and cytochrome c (Cyt c), in combination with hypothermic storage, may extend platelet viability. METHODS: Platelets from 20 donors were pooled into 4-independent sets and stored at 22°C or 4°C in the absence or presence of Res (50μM) or Cyt c (100μM) for up to 10d...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452898/accuracy-of-prehospital-triage-protocols-in-selecting-major-trauma-patients-a-systematic-review
#16
Eveline A J van Rein, Roderick M Houwert, Amy C Gunning, Rob Lichtveld, Luke P H Leenen, Mark van Heijl
BACKGROUND: Prehospital trauma triage ensures proper transport of patients at risk of severe injury to hospitals with an appropriate corresponding level of trauma care. Incorrect triage results in undertriage and overtriage. The American College of Surgeons Committee on Trauma recommends an undertriage rate below 5% and an overtriage rate below 50% for prehospital trauma triage protocols. In order to find the most accurate prehospital trauma triage protocol, a clear overview of all currently available protocols and corresponding outcomes is necessary...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452897/are-goods-for-guns-good-for-the-community-an-update-of-a-community-gun-buyback-program
#17
Jonathan Green, Rachelle N Damle, Rebecca E Kasper, Pina Violano, Mariann Manno, Pradeep P Nazarey, Jeremy T Aidlen, Michael P Hirsh
BACKGROUND: Gun violence remains a leading cause of death in the United States. Community gun buyback programs provide an opportunity to dispose of extraneous firearms. The purpose of this study was to understand the demographics, motivation, child access to firearms and household mental illness of buyback participants in hopes of improving the program's effectiveness. METHODS: A 2015 Injury Free Coalition for Kids gun buyback program which collaborated with local police departments was studied...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452896/evaluating-trauma-team-performance-in-a-level-i-trauma-center-validation-of-the-trauma-team-communication-assessment-ttca-24
#18
Stephanie DeMoor, Shady A Rehim, Richard Olmsted, John G Myers, Jessica Parker-Raley
OBJECTIVE: Non-technical skills (NTS) such as team communication are well recognized determinants of trauma team performance and good patient care. Measuring these competencies during trauma resuscitations is essential, yet few valid and reliable tools are available. We aimed to demonstrate that the TTCA-24 is a valid and reliable instrument that measures communication effectiveness during activations. METHODS: Two tools with adequate psychometric strength (T-NOTCHES, TEAM) were identified during a systematic review of medical literature and compared with TTCA-24...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452895/c-peptide-attenuates-acute-lung-inflammation-in-a-murine-model-of-hemorrhagic-shock-and-resuscitation-by-reducing-gut-injury
#19
Raymond Lc Kao, Xuemei Xu, Anargyros Xenocostas, Neil Parry, Tina Mele, Claudio M Martin, Tao Rui
BACKGROUND: The study aims to evaluate whether C-peptide can reduce gut injury during hemorrhagic shock and resuscitation (HS/R) therefore attenuate shock-induced inflammation and subsequent acute lung injury. METHODS: Twelve-week-old male mice (C57/BL6) were hemorrhaged (mean arterial blood pressure maintained at 35 mmHg for 60 minutes) and then resuscitated with Ringer's lactate, followed by red blood cell transfusion with (HS/R) or without C-peptide (HS/R+C-peptide)...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452894/severe-trauma-and-chronic-stress-activates-extramedullary-erythropoiesis
#20
Ines G Alamo, Kolenkode B Kannan, Tyler J Loftus, Harry Ramos, Philip A Efron, Alicia M Mohr
BACKGROUND: Severe traumatic injury is associated with bone marrow dysfunction that manifests as impaired erythropoiesis and prolonged hematopoietic progenitor cell (HPC) mobilization from the bone marrow. Extramedullary erythropoiesis, the development of red blood cells outside the bone marrow, has not been studied following severe injury and critical illness. This study examined the influence of lung contusion/hemorrhagic shock (LCHS) followed by chronic stress (CS) on the rodent spleen and to investigate the involvement of the splenic erythropoietin/erythropoietin receptor and BMP4 signaling...
April 27, 2017: Journal of Trauma and Acute Care Surgery
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