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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/29140953/contemporary-management-of-rectal-injuries-at-level-i-trauma-centers-the-results-of-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#1
Carlos V R Brown, Pedro G Teixeira, Elisa Furay, John P Sharpe, Tashinga Musonza, John Holcomb, Eric Bui, Brandon Bruns, H Andrew Hopper, Michael S Truitt, Clay C Burlew, Morgan Schellenberg, Jack Sava, John VanHorn, Brian Eastridge, Alicia M Cross, Richard Vasak, Gary Vercruysse, Eleanor E Curtis, James Haan, Raul Coimbra, Phillip Bohan, Stephen Gale, Peter G Bendix
INTRODUCTION: Rectal injuries have been historically treated with a combination of modalities including direct repair, resection, proximal diversion, presacral drainage, and distal rectal washout. We hypothesized that intraperitoneal rectal injuries may be selectively managed without diversion and the addition of distal rectal washout and pre-sacral drainage in the management of extraperitoneal injuries are not beneficial. METHODS: This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004-2015 of all patients who sustained a traumatic rectal injury and were admitted to one of the 22 participating centers...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140952/-don-t-lose-hope-early-hemorrhagic-diffuse-axonal-injury-on-head-ct-is-not-associated-with-poor-outcome-in-moderate-severe-tbi-patients
#2
Nils Henninger, Rebecca A Compton, Muhammad W Khan, Raphael Carandang, Wiley Hall, Susanne Muehlschlegel
BACKGROUND: Diffuse axonal injury (DAI) on MRI has been associated with poor functional outcome after moderate-severe traumatic brain injury (msTBI). Yet, DAI assessment with highly-sensitive MRI-techniques is unfeasible in the acute trauma setting, and CT remains the key diagnostic modality despite its lower sensitivity. We sought to determine whether CT-defined-hemorrhagic-DAI (hDAI) is associated with discharge and favorable 3-and 12-month functional outcome (Glasgow Outcome Score ≥4) after msTBI...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140951/platelet-aggregation-after-blunt-trauma-is-associated-with-the-acute-respiratory-distress-syndrome-and-altered-by-cigarette-smoke-exposure
#3
Farzad Moazed, Carolyn Hendrickson, Mary Nelson, Amanda Conroy, Mitchell J Cohen, Carolyn S Calfee
BACKGROUND: The risk of the acute respiratory distress syndrome (ARDS) is increased in passive and active smokers after blunt trauma. However, the mechanisms responsible, including the role of platelet aggregation, for this association are unknown. METHODS: We analyzed 215 patients with severe blunt trauma from a prospective observational cohort at a Level 1 trauma center between 2010 - 2015. Subjects underwent impedance-based platelet aggregometry in response to platelet agonists arachidonic acid (ASPI), adenosine diphosphate (ADP), collagen (COL) and thrombin receptor activating peptide-6 (TRAP)...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140950/development-of-clinical-process-measures-for-pediatric-burn-care-understanding-variation-in-practice-patterns
#4
Lewis E Kazis, Robert L Sheridan, Gabriel D Shapiro, Austin F Lee, Matthew H Liang, Colleen M Ryan, Jeffrey C Schneider, Martha Lydon, Marina Soley-Bori, Lily A Sonis, Emily C Dore, Tina Palmieri, David Herndon, Walter Meyer, Petra Warner, Richard Kagan, Frederick J Stoddard, Michael Murphy, Ronald G Tompkins
BACKGROUND: There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140949/predictive-ability-and-interobserver-reliability-of-computed-tomography-findings-for-angioembolization-in-patients-with-pelvic-fracture
#5
Shunsuke Yoshikawa, Atsushi Shiraishi, Mitsuhiro Kishino, Makiko Honda, Nao Urushibata, Kosuke Sekiya, Tomohisa Shoko, Yasuhiro Otomo
BACKGROUND: The purpose of this study was to identify computed tomography (CT) findings that predict the need for angioembolization in patients with pelvic fracture. METHODS: This retrospective cross-sectional study was performed between April 2006 and October 2015 at two urban emergency medical centers in Japan. The study included patients who underwent CT within 3 hours of arrival and were diagnosed with a pelvic fracture. The study outcome was undergoing angioembolization within 24 hours of arrival...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#6
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29117026/the-american-association-for-the-surgery-of-trauma-severity-grade-is-valid-and-generalizable-in-adhesive-small-bowel-obstruction
#7
Martin D Zielinski, Nadeem N Haddad, Asad Choudhry, Matthew C Hernandez, Daniel C Cullinane, David Turay, Ji-Ming Yune, Salina Wydo, Kenji Inaba, D Dante Yeh, Therese M Duane, Andrea Pakula, Ruby Skinner, Jill Watras, Carlos J Rodriguez, Kenneth A Widom, John Cull, Julie Dunn, Eric A Toschlog, Valerie G Sams, John C Graybill
INTRODUCTION: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma (EAST) multi-institutional SBO prospective observational study. METHODS: Adults (age≥18) with (ASBO) were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), labs (lactate, hemoglobin, creatinine, leukocytosis), imaging findings, operative details, length of stay, and Clavien-Dindo complications were collected...
November 7, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29112095/cardiac-repair-in-a-patient-who-had-a-previous-clamshell-thoracotomy
#8
Daniel Ricaurte, Renee Aboushi, Brian Myer, Thomas M Scalea
No abstract text is available yet for this article.
November 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29112094/thrombelastography-early-amplitudes-in-bleeding-and-coagulopathic-trauma-patients-results-from-a-multicenter-study
#9
Thomas H Laursen, Martin A S Meyer, Anna Sina P Meyer, Tina Gaarder, Paal A Naess, Jakob Stensballe, Sisse R Ostrowski, Pär I Johansson
BACKGROUND: Early amplitudes in the viscoelastic hemostatic assays Thrombelastography (TEG) and Rotation Thromboelastometry (ROTEM) provide fast results, which is critical in resuscitation of bleeding patients. This study investigated associations between TEG early amplitudes and standard TEG variables in a large multicenter cohort of moderately to severely injured trauma patients admitted at three North European level 1 Trauma Centers. METHODS: Prospective observational study of 404 trauma patients with clinical suspicion of severe injury from London, UK, Copenhagen, Denmark and Oslo, Norway...
November 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29112093/all-animals-are-equal-but-some-animals-are-more-equal-than-others-plasma-lactate-and-succinate-in-hemorrhagic-shock-a-comparison-in-rodents-swine-non-human-primates-and-injured-patients
#10
Julie A Reisz, Matthew J Wither, Ernest E Moore, Anne L Slaughter, Hunter B Moore, Arsen Ghasabyan, James Chandler, Leasha J Schaub, Miguel Fragoso, Geoffrey Nunns, Christopher C Silliman, Kirk C Hansen, Anirban Banerjee, Forest R Sheppard, Angelo D'alessandro
BACKGROUND: Plasma levels of lactate and succinate are predictors of mortality in critically injured patients in military and civilian settings. In relative terms, these metabolic derangements have been recapitulated in rodent, swine and non-human primate models of severe hemorrhage. However, no direct absolute quantitative comparison has been evaluated across these species. METHODS: Ultra-high pressure liquid chromatography-mass spectrometry with stable isotope standards was used to determine absolute concentrations of baseline and post-shock levels of lactate and succinate in rats, pigs, macaques, and injured patients...
November 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29077678/is-it-safe-nonoperative-management-of-blunt-splenic-injuries-in-geriatric-trauma-patients
#11
Marc D Trust, Pedro Teixeira, Lawrence Brown, Sadia Ali, Ben Coopwood, Jayson Aydelotte, Carlos V R Brown
BACKGROUND: Due to increased failure rates of non-operative management (NOM) of blunt splenic injuries (BSI) in the geriatric population, dogma dictated that this management was unacceptable. Recently, there has been an increased use of this treatment strategy in the geriatric population. However, published data assessing the safety of NOM of BSI in this population is conflicting and well-powered multicenter data is lacking. METHODS: We performed a retrospective analysis of data from the National Trauma Data Bank (NTDB) from 2014 and identified young (age < 65) and geriatric (age ≥ 65) patients with a BSI...
October 25, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29077677/a-multicenter-evaluation-of-the-optimal-timing-of-surgical-stabilization-of-rib-fractures
#12
Fredric M Pieracci, Julia Coleman, Francis Ali-Osman, Alicia Mangram, Sarah Majercik, Thomas W White, Elan Jeremitsky, Andrew R Doben
INTRODUCTION: The optimal timing of surgical stabilization of rib fractures (SSRF) remains debated. We hypothesized that 1) demographic, radiologic, and clinical variables are associated with time to surgery and 2), shorter time to SSRF improves acute outcomes. METHODS: Prospectively collected SSRF databases from four trauma centers were merged and analyzed (2006-2016). The independent variable was days from hospital admission to SSRF [early (< 1 day), mid (1-2 days), and late (3-10 days)]...
October 25, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29077676/stop-the-bleed-education-consortium-education-program-content-delivery-recommendations
#13
Craig Goolsby, Richard C Hunt, Eric Goralnick, Eunice M Singletary, Matthew J Levy, Jeffrey Goodloe, Jonathan L Epstein, Kandra Strauss-Riggs, Samuel R Seitz, Jon R Krohmer, Ira Nemeth, Dennis Wayne Rowe, Richard N Bradley, Mark Gestring, Thomas D Kirsch
No abstract text is available yet for this article.
October 25, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040207/trauma-pneumonectomy-for-major-thoracic-bleeding-when-should-we-consider-about-it
#14
Martin L Tonglet, Didier Moens, Vincenzo D'Orio, Alexandre Ghuysen
No abstract text is available yet for this article.
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040206/the-life-saving-effect-of-adenosine-lidocaine-and-magnesium-cocktail-during-hypovolemic-shock-one-stone-three-birds
#15
Lusha Xiang, Harold G Klemcke, Kathy L Ryan
No abstract text is available yet for this article.
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040205/spleen-preserving-distal-pancreatectomy-in-trauma
#16
Morgan Schellenberg, Kenji Inaba, Vincent Cheng, James M Bardes, Lydia Lam, Elizabeth Benjamin, Kazuhide Matsushima, Demetrios Demetriades
BACKGROUND: Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy vs spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. METHODS: All patients who underwent distal pancreatectomy (01/01/2007-12/31/2014) were identified from the NTDB...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040204/perioperative-glycemic-control-and-postoperative-complications-in-patients-undergoing-emergency-general-surgery-what-is-the-role-of-hba1c
#17
Faisal Jehan, Muhammad Khan, Joseph V Sakran, Mohammad Khreiss, Terence O'Keeffe, Albert Chi, Narong Kulvatunyou, Arpana Jain, El Rasheid Zakaria, Bellal Joseph
BACKGROUND: Plasma Hemoglobin A1c (HbA1c) reflects quality of glucose control in diabetic patients. Literature reports that patients undergoing surgery with an elevated HbA1c level are associated with increased postoperative morbidity and mortality. The aim of our study was to evaluate the impact of HbA1c level on outcomes after emergency general surgery (EGS). METHODS: We performed a 3-year analysis of our prospectively maintained EGS database. Patients who had HbA1c levels measured within 3-months before surgery were included...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040203/the-temporal-response-and-mechanism-of-action-of-tranexamic-acid-in-endothelial-glycocalyx-degradation
#18
Mark E Diebel, Jonathan V Martin, David M Liberati, Lawrence N Diebel
BACKGROUND: The endothelial glycocalyx (GCX) plays an important role in vascular barrier function. Damage to the GCX occurs due to a variety of causes including hypoxia, ischemia-reperfusion, stress related sympathoadrenal activation, and inflammation. Tranexamic acid (TXA) may prevent GCX degradation. The therapeutic window for TXA administration and the mechanism of action has been under review. Membrane-anchored proteases (sheddases) are key components in endothelial cell biology including the regulation of vascular permeability...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#19
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040201/don-t-call-me-crazy-delirium-occurs-outside-of-the-icu
#20
Anthony Cahill, Christopher Pearcy, Khalid Almahmoud, Vaidehi Agrawal, Usha Mani, Phillip Sladek, Michael S Truitt
INTRODUCTION: Delirium has been well studied among patients in the Intensive Care Unit (ICU); however, data beyond the ICU is limited. The purpose of this study is to prospectively evaluate the incidence and associated risk factors for delirium in non-critical care areas (NCCA). METHODS: After IRB approval, a prospective cohort study was conducted at our urban Level I Trauma Center from December 2015 to February 2016. All patients admitted to the designated study area by a trauma surgeon were included...
October 16, 2017: Journal of Trauma and Acute Care Surgery
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