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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/28723841/military-civilian-partnership-in-device-innovation-development-commercialization-and-application-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#1
Todd E Rasmussen, Jonathan L Eliason
Noncompressible torso hemorrhage (NCTH) and shock is a leading cause of trauma-related mortality and evidence suggests that survival from this injury pattern has not improved in decades. As such, innovating new approaches and devices, including technologies which can be used by providers within a short of time after severe injury, is a priority for the military. Guided by wartime observations, and through partnerships with civilian academia and private investment, the military has led an effort to define resuscitative endovascular balloon occlusion of the aorta (REBOA) and assess its potential to address this problem...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28723840/cervical-spine-evaluation-and-clearance-in-the-intoxicated-patient-a-prospective-western-trauma-association-multi-institutional-trial-and-survey
#2
Matthew J Martin, Lisa D Bush, Kenji Inaba, Saskya Byerly, Martin Schreiber, Kimberly A Peck, Galinos Barmparas, Jay Menaker, Joshua P Hazelton, Raul Coimbra, Martin D Zielinski, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Julie Dunn, C Todd Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades, William Long
INTRODUCTION: Intoxication often prevents clinical clearance of the cervical spine (Csp) after trauma leading to prolonged immobilization even with a normal CT scan. We evaluated the accuracy of CT at detecting clinically significant Csp injury, and surveyed participants on related opinions and practice. METHODS: A prospective multicenter study (2013-2015) at 17 centers. All adult blunt trauma patients underwent structured clinical examination and imaging including a Csp CT, with follow-up thru discharge...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28723839/buddy-aid-battlefield-pain-management
#3
Nicolas Vertu, Mélanie Nacimento, Pierre Pasquier
No abstract text is available yet for this article.
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715363/decompressive-craniectomy-vs-craniotomy-only-for-intracranial-hemorrhage-evacuation-a-propensity-matched-study
#4
Faisal Jehan, Asad Azim, Peter Rhee, Muhammad Khan, Lynn Gries, Terence OʼKeeffe, Narong Kulvatunyou, Andrew Tang, Bellal Joseph
BACKGROUND: Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established, however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing decompressive craniectomy (DC) vs. craniotomy only (CO) for the evacuation of intracranial hemorrhage...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715362/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-placenta-percreta-previa
#5
Michael W Parra, Carlos Alberto Ordonez, Juan P Herrera-Escobar, Adolfo Gonzalez-Garcia, Jon Guben
No abstract text is available yet for this article.
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715361/trauma-systems-around-the-world-a-systematic-overview
#6
Suzan Dijkink, Charlie Nederpelt, Pieta Krijnen, George C Velmahos, Inger B Schipper
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000-2016 was conducted following the PRISMA guidelines. Pre-hospital care, acute hospital care and quality assurance were classified using the WHO Trauma System Maturity Index in four levels from I (least mature) to IV (most mature)...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715360/contemporary-management-of-subclavian-and-axillary-artery-injuries-a-western-trauma-association-multicenter-review
#7
Christine J Waller, Thomas H Cogbill, Kara J Kallies, Luis D Ramirez, Justin M Cardenas, S Rob Todd, Kayla J Chapman, Marshall A Beckman, Jason L Sperry, Vincent P Anto, Evert A Eriksson, Stuart M Leon, Rahul J Anand, Maura Pearlstein, Lisa Capano-Wehrle, Clay Cothren Burlew, Charles J Fox, Daniel C Cullinane, Jennifer C Roberts, Paul B Harrison, Gina M Berg, James M Haan, Kelly Lightwine
BACKGROUND: Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. METHODS: A multicenter, retrospective review of patients with subclavian or axillary artery injuries from 1/1/2004-12/31/2014 was completed at 11 participating Western Trauma Association institutions...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715359/attempting-to-validate-the-over-under-triage-matrix-at-a-level-i-trauma-center
#8
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different and Matrix does not discriminate the needs or outcomes of these different groups of patients...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700414/evaluation-of-gut-blood-barrier-gbb-dysfunction-in-various-models-of-trauma-haemorrhagic-shock-and-burn-injury
#9
Lisa Wrba, Annette Palmer, Christian Karl Braun, Markus Huber-Lang
Dysfunction of the gut-blood barrier (GBB) plays a pivotal role in various diseases, including trauma, haemorrhagic shock (HS) and burn injury, as well as inflammatory bowel diseases (IBD). Whereas GBB disruption significantly contributes to IBD, the exact extent and consequences of GBB failure and its reliable determination in the clinical course following trauma remain rather unclear. A compromised GBB function seems to contribute to remote organ injury after trauma by generation of inflammatory mediators and biologically active lymph, which in turn augments the inflammatory response...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700413/venous-thromboembolism-after-major-venous-injuries-competing-priorities
#10
Brian Frank, Zoё Maher, Joshua P Hazelton, Shelby Resnick, Elizabeth Dauer, Anna Goldenberg, Andrea L Lubitz, Brian P Smith, Noelle N Saillant, Patrick M Reilly, Mark J Seamon
BACKGROUND: Venous thromboembolism (VTE) after major vascular injury (MVI) is particularly challenging as the competing risk of thrombosis and embolization after direct vessel injury must be balanced with risk of bleeding after surgical repair. We hypothesized that venous injuries, repair type and intraoperative anticoagulation would influence VTE formation after MVI. METHODS: A multi-institution, retrospective cohort study of consecutive MVI patients was conducted at 3 urban, level-I centers (2005-2013)...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700412/parathyroid-hormone-as-a-marker-for-hypoperfusion-in-trauma-a-prospective-observational-study
#11
Scott C Fligor, Katie M Love, Bryan R Collier, Daniel I Lollar, Mark E Hamill, Andrew D Benson, Eric H Bradburn
BACKGROUND: Hyperparathyroidism is common in critical illness. Intact parathyroid hormone has a half-life of 3 to 5 minutes due to rapid clearance by the liver, kidneys, and bone. In hemorrhagic shock, decreased clearance may occur, thus making parathyroid hormone a potential early marker for hypoperfusion. We hypothesized that early hyperparathyroidism predicts mortality and transfusion in trauma patients. METHODS: A prospective observational study was performed at a Level 1 trauma center in consecutive adult patients receiving the highest level of trauma team activation...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700411/role-of-autophagy-and-its-molecular-mechanisms-in-mice-intestinal-tract-after-severe-burn
#12
DuanY Zhang, Wei Qiu, PeiS Jin, Peng Wang, Yong Sun
BACKGROUND: Severe burn can lead to hypoxia/ischemia of intestinal mucosa. Autophagy is the process of intracellular degradation, which is essential for cell survival under stresses such as hypoxia/ischemia and nutrient deprivation. The present study was designed to investigate whether there were changes in intestinal autophagy after severe burn in mice and further to explore the effect and molecular mechanisms of autophagy on intestinal injury. METHODS: This study includes three experiments...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700410/quantifying-and-exploring-the-recent-national-increase-in-surgical-stabilization-of-rib-fractures
#13
Erica Kane, Elan Jeremitsky, Fredric M Pieracci, Sarah Majercik, Andrew R Doben
INTRODUCTION: Surgical Stabilization of Rib Fractures (SSRF) has become pivotal in the management of severe chest injuries. Recent literature supports improved outcomes and mortality in severe fracture and flail chest patients who undergo SSRF compared to non-operative management (NOM). A 2014 National Trauma Data Bank (NTDB) review provided a point prevalence of 0.7% SSRF in flail patients. We hypothesize that this prevalence is increasing and that temporal, regional, and American College of Surgeons (ACS) trauma designation vary in SSRF utilization...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700409/indication-and-survival-bias-threats-to-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-outcomes-research
#14
Ramiro Manzano Nunez, Maria Paula Naranjo, Carlos A Ordoñez
No abstract text is available yet for this article.
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700408/three-versus-four-factor-prothrombin-complex-concentrates-for-factor-based-resuscitation-in-a-porcine-hemorrhagic-shock-model
#15
Donald Michael Moe, Michael Scott Lallemand, John Mason McClellan, Joshua Porter Smith, Shannon T Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: Bleeding is a leading cause of preventable death following severe injury. Prothrombin complex concentrates (PCC) treat inborn coagulation disorders and reverse oral anticoagulants, but are proposed for use in "factor-based" resuscitation strategies. Few studies exist for this indication in acidosis, or that compare 3-factor (3PCC) versus 4-factor (4PCC) products. We aimed to assess and compare their safety and efficacy in a porcine model of severe hemorrhagic shock and coagulopathy...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697027/impact-of-venous-thromboembolism-chemoprophylaxis-on-postoperative-hemorrhage-following-operative-stabilization-of-spine-fractures
#16
John P Sharpe, Wade C Gobbell, Maranda Pahlkotter, Michael S Muhlbauer, Francis X Camillo, Timothy C Fabian, Martin A Croce, Louis J Magnotti
BACKGROUND: Prophylactic anticoagulation may decrease the risk of venous thromboembolism (VTE) in patients with spine fractures following blunt trauma, but comes with the threat of postoperative bleeding in patients requiring stabilization of these fractures. The purpose of this study was to evaluate the impact of preoperative anticoagulation on VTE and bleeding complications in patients with blunt spine fractures requiring operative stabilization. METHODS: All patients with blunt spine fractures requiring operative stabilization over a 6-year period were identified...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#17
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697025/reboa-for-the-ivc-resuscitative-balloon-occlusion-of-the-inferior-vena-cava-rebovc-to-abate-massive-hemorrhage-in-retro-hepatic-vena-cava-injuries
#18
Cassandra L Reynolds, Adam C Celio, Lindsay C Bridges, Catalina Mosquera, Brian O'Connell, Michael R Bard, Connie M DeLa'o, Eric A Toschlog
BACKGROUND: The use of resuscitative endovascular balloon occlusion as a maneuver for occlusion of the aorta is well described. This technique has life-saving potential in other cases of traumatic hemorrhage. Retro-hepatic inferior vena cava (IVC) injuries have a high rate of mortality, in part, due to the difficulty in achieving total vascular isolation. This studies purpose was to investigate the ability of resuscitative balloon occlusion of the IVC (REBOVC) to control supra-hepatic IVC hemorrhage in a swine model of trauma...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697024/bayesian-clinical-trial-designs-another-option-for-trauma-trials
#19
Jan O Jansen, Philip Pallmann, Graeme MacLennan, Marion K Campbell
Conducting clinical trials in trauma care is challenging. As new treatments become available, we are faced with the dilemma of how to confirm their effectiveness, and strengthen the evidence base. Randomized controlled trials are the gold standard, but target groups in trauma care are often small and specialized, making the classical approach to trial design difficult. Bayesian designs represent an innovative means of increasing trial efficiency, and conducting trials with more realistic sample sizes. This article examines the design of such trials, using the UK-REBOA Trial as an example...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697023/clot-dynamics-and-mortality-the-ma-r-ratio
#20
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing TEG to identify those at risk for subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
July 8, 2017: Journal of Trauma and Acute Care Surgery
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