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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/27893647/cervical-spine-mri-in-patients-with-negative-ct-a-prospective-multicenter-study-of-the-research-consortium-of-new-england-centers-for-trauma-reconect
#1
Adrian A Maung, Dirk C Johnson, Kimberly Barre, Thomas Peponis, Thomas Mesar, George C Velmahos, Daniel McGrail, George Kasotakis, Ronald I Gross, Michael S Rosenblatt, Kristen C Sihler, Robert J Winchell, Walter Cholewczynski, Kathryn L Butler, Stephen R Odom, Kimberly A Davis
BACKGROUND: Although cervical spine CT (CSCT) accurately detects bony injuries, it may not identify all soft tissue injuries. While some clinicians rely exclusively on a negative CT to remove spine precautions in unevaluable patients or patients with cervicalgia, others use MRI for that purpose. The objective of this study was to determine the rates of abnormal MRI after a negative CSCT. METHODS: Blunt trauma patients who either were unevaluable or had persistent midline cervicalgia and underwent an MRI of the C-spine after a negative CSCT were enrolled prospectively in 8 Level I and II New England trauma centers...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893646/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#2
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. iNO lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure. METHODS: A hemorrhagic shock and pneumonectomy model was developed using sheep...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#3
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893644/western-trauma-association-critical-decisions-in-trauma-management-of-adult-blunt-splenic-trauma-2016-updates
#4
Susan E Rowell, Walter L Biffl, Martin A Schreiber, Roxie A Albrecht, Mitchell J Cohen, Marc DeMoya, Riyad Karmy-Jones, Ernest E Moore, Nicholas Namias, David V Shatz, Frederick A Moore, Karen Brasel
No abstract text is available yet for this article.
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893643/early-percutaneous-dilational-tracheostomy-does-not-lead-to-an-increased-risk-of-surgical-site-infection-following-anterior-spinal-surgery
#5
Chris Kaczmarek, Mirko Aach, Martin F Hoffmann, Emre Yilmaz, Christian Waydhas, Thomas A Schildhauer, Uwe Hamsen
BACKGROUND: Most patients suffering cervical spinal cord injuries require tracheostomy. The optimal timing is still a matter of debate. Previous studies showed that patients receiving early tracheostomy had fewer ventilator days, decreased rates of pneumonia, and were mobilized earlier. Due to the proximity of the anterior approach to the tracheostoma, there is concern about an increased risk of surgical site infection related to tracheostomy. METHODS: Retrospective analysis at a Level 1 trauma center of patient records from 2008-2014, identifying all patients with spinal cord injury who received anterior cervical spinal surgery and had early percutaneous dilational tracheostomy...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893642/comparison-of-nonoperative-and-surgial-management-of-renal-trauma-can-we-predict-when-nonoperative-management-fails
#6
Marc A Bjurlin, Richard Jacob Fantus, Richard Joseph Fantus, Dana Villines
BACKGROUND: Limited data exists on risk factors for the failure of nonoperative management of renal trauma. Our study objective was to determine the incidence, salvage procedure, and risk factors for failure of nonoperative management of renal trauma. METHODS: The National Trauma Data Bank research datasets admission year 2010 - 2014 were queried for renal injury by Abbreviated Injury Score (AIS) code. Patients were stratified by interventional therapy (renal procedure code <24 hrs from admission) and nonoperative management (no surgical renal procedure <24 hrs)...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-following-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#7
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography following PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) following PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a three-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893640/a-position-paper-the-convergence-of-aging-and-injury-and-the-need-for-a-geriatric-trauma-coalition-geritrac
#8
Zara Cooper, Cathy A Maxwell, Samir M Fakhry, Bellal Joseph, Nancy Lundejberg, Peter Burke, Robert Baracco
No abstract text is available yet for this article.
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893639/surgical-rescue-the-next-pillar-of-acute-care-surgery
#9
Matthew E Kutcher, Jason L Sperry, Matthew R Rosengart, Deepika Mohan, Marcus K Hoffman, Matthew D Neal, Louis H Alarcon, Gregory A Watson, Juan Carlos Puyana, Graciela M Bauzá, Vaishali D Schuchert, Anisleidy Fombona, Tianhua Zhou, Samuel Zolin, Robert D Becher, Timothy R Billiar, Raquel M Forsythe, Brian S Zuckerbraun, Andrew B Peitzman
BACKGROUND: The evolving field of Acute Care Surgery (ACS) traditionally includes trauma, emergency general surgery, and critical care. However, the critical role of ACS in the rescue of patients with a surgical complication has not been explored. We here describe the role of 'surgical rescue' in the practice of Acute Care Surgery (ACS). METHODS: A prospective, electronic medical record-based ACS registry spanning January 2013 to May 2014 at a large urban academic medical center was screened by ICD-9 codes for acute surgical complications of an operative or interventional procedure...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893638/arteriovenous-fistula-between-the-common-femoral-artery-and-vein-secondary-to-transpelvic-gunshot-wound
#10
Juan A Asensio, Oluwaseye A Ogun, Michel Wagner, Charles J Fox
No abstract text is available yet for this article.
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27820555/sarcopenia-as-a-predictor-of-mortality-in-elderly-blunt-trauma-patients-comparing-the-masseter-to-the-psoas-using-computed-tomography
#11
James D Wallace, Richard Y Calvo, Paul R Lewis, Jason B Brill, Steven R Shackford, Michael J Sise, C Beth Sise, Vishal Bansal
BACKGROUND: Sarcopenia, or age-related loss of muscle mass, is measureable by computed tomography (CT). In elderly trauma patients, increased mortality is associated with decreased psoas muscle cross-sectional area (P-Area) on abdominal CT. Fall is the leading cause of injury in the elderly and head CT is more often obtained. Masseter muscle cross-sectional area (M-Area) is readily measured on head CT. Hypothesizing that M-Area is a satisfactory surrogate for P-Area, we compared the two as markers of sarcopenia and increased mortality in elderly trauma patients...
November 4, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27806000/roscoe-r-graham-an-enduring-legacy-in-the-21st-century
#12
Alexandra C Istl, Daryl K Gray
BACKGROUND: Modern advancements in surgery have led to a climate in which many classical techniques are becoming obsolete. However, the Graham patch technique for duodenal repair continues to be widely employed as originally described in Dr Roscoe Reid Graham's 1937 article: an omental graft held in position over a duodenal perforation by three interrupted sutures. METHODS: Primary documents including original newspaper articles and war documentation were retrieved from the University of Toronto Archives and Records...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805999/ultrasound-optimization-for-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#13
James N Bogert, Bhavesh M Patel, Daniel J Johnson
No abstract text is available yet for this article.
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805998/big-children-or-little-adults-a-statewide-analysis-of-adolescent-isolated-severe-traumatic-brain-injury-outcomes-at-pediatric-versus-adult-trauma-centers
#14
Brian W Gross, Mathew M Edavettal, Alan D Cook, Cole D Rinehart, Caitlin A Lynch, Eric H Bradburn, Daniel Wu
BACKGROUND: The appropriate managing center for adolescent trauma patients is debated. We sought to determine whether outcome differences existed for adolescent severe traumatic brain injury (sTBI) patients treated at pediatric versus adult trauma centers. We hypothesized that no difference in mortality, functional status at discharge (FSD) or overall complication rate would be observed between center types. METHODS: All adolescent trauma patients (aged 15-17 years) presenting with isolated sTBI (head Abbreviated Injury Scale [AIS] score ≥3; all other AIS body region scores ≤2) to accredited level I-II trauma centers in Pennsylvania from 2003-2015 were extracted from the Pennsylvania Trauma Outcome Study database...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805997/this-too-shall-pass-a-study-of-ingested-sharp-foreign-bodies
#15
Kirellos R Zamary, James W Davis, Emily E Ament, Rachel C Dirks, John E Garry
BACKGROUND: Gastrointestinal foreign body (GFB) ingestion is a common problem and often results in surgical consultation. Current literature is limited to case reports and fails to provide data regarding the management of sharp GFB ingestion. We hypothesized that patients who ingest sharp objects rarely have perforation or obstruction requiring surgical intervention. METHODS: Patients presenting with GFBs from 1/05-12/15 at a level 1 trauma center with an acute care surgery program were retrospectively reviewed...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805996/increased-anatomic-severity-predicts-outcomes-validation-of-the-american-association-for-the-surgery-of-trauma-s-emergency-general-surgery-score-in-appendicitis
#16
Matthew Hernandez, Johnathan M Aho, Elizabeth B Habermann, Asad Choudhry, David Morris, Martin Zielinski
BACKGROUND: Determination and reporting of disease severity in emergency general surgery (EGS) lacks standardization. Recently, the American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system. We aimed to validate this system in patients with appendicitis, and determine if cross sectional imaging correlates with disease severity at operation. METHODS: Patients 18 years or older undergoing treatment for acute appendicitis between 2013 and 2015 were identified...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805995/rapid-thrombelastography-r-teg-thresholds-for-goal-directed-resuscitation-of-patients-at-risk-for-massive-transfusion
#17
Peter M Einersen, Ernest E Moore, Michael P Chapman, Hunter B Moore, Eduardo Gonzalez, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Uncontrolled hemorrhage is a leading cause of mortality following trauma accounting for up to 40% of deaths. Massive transfusion protocols (MTPs) offer a proven benefit in resuscitation of these patients. Recently, the superiority of thrombelastography (TEG)-guided resuscitation over strategies guided by conventional clotting assays (CCA) has been established. We seek to determine optimal thresholds for r-TEG driven resuscitation. METHODS: R-TEG data were reviewed for 190 patients presenting to our Level 1 Trauma Center from 2010 to 2015...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805994/re-neutrophil-to-lymphocyte-ratio-in-trauma-patients
#18
Evren Dilektaşli
No abstract text is available yet for this article.
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805993/there-s-an-app-for-that-a-handheld-smartphone-based-infrared-imaging-device-to-assess-adequacy-and-level-of-aortic-occlusion-during-reboa
#19
Kyle K Sokol, George E Black, Sandra B Willey, Kevin Kniery, Shannon T Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: Advances in thermal imaging devices have made them an appealing non-invasive point-of-care imaging adjunct in the trauma setting. We sought to assess whether a smartphone-based infrared imaging device (SBIR) could determine presence and location of aortic occlusion in a swine model. We hypothesized that various levels of aortic occlusion would transmit significantly different heat signatures a various anatomical points. METHODS: Six swine (35-50kg) underwent sequential zone I (Z1) aortic cross clamping as well as zone III (Z3) aortic balloon occlusion (REBOA)...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27805992/volumetric-analysis-of-day-of-injury-computed-tomography-is-associated-with-rehabilitation-outcomes-after-traumatic-brain-injury
#20
Sarah Majercik, Joseph Bledsoe, David Ryser, Ramona O Hopkins, Joseph E Fair, R Brock Frost, Joel MacDonald, Ryan Barrett, Susan Horn, David Pisani, Erin D Bigler, Scott Gardner, Mark Stevens, Michael J Larson
INTRODUCTION: Day-of-injury (DOI) brain lesion volumes in traumatic brain injury (TBI) patients are rarely used to predict long-term outcomes in the acute setting. The purpose of this study was to investigate the relationship between acute brain injury lesion volume and rehabilitation outcomes in patients with TBI at a Level One Trauma Center. METHODS: Patients with TBI who were admitted to our rehabilitation unit after the acute care trauma service from February 2009-July 2011 were eligible for the study...
October 31, 2016: Journal of Trauma and Acute Care Surgery
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