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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/29334571/use-of-french-lyophilized-plasma-transfusion-in-severe-trauma-patients-is-associated-with-an-early-plasma-transfusion-and-early-transfusion-ratio-improvement
#1
Cédric Nguyen, Julien Bordes, Pierre-Julien Cungi, Pierre Esnault, Michael Cardinale, Quentin Mathais, Jean Cotte, Sébastien Beaume, Anne Sailliol, Bertrand Prunet, Eric Meaudre
BACKGROUND: Early transfusion of high ratio of fresh frozen plasma (FFP) and red blood cells (RBC) is associated with mortality reduction. However, time to reach high ratio is limited by the need to thaw the FFP. French lyophilized plasma (FLYP) used by French army and available in military teaching hospital does not need to be thawed and is immediately available. We hypothesize that the use of FLYP may reduce time to reach a plasma:RBC ratio of 1/1. METHODS: A retrospective study performed in a Level 1 trauma center between January 2012 and December 2015...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334570/the-effect-of-prehospital-transport-time-injury-severity-and-blood-transfusion-on-survival-of-us-military-casualties-in-iraq
#2
Russ S Kotwal, Laura L F Scott, Jud C Janak, Bruce W Tarpey, Jeffrey T Howard, Edward L Mazuchowski, Frank K Butler, Stacy A Shackelford, Jennifer M Gurney, Zsolt T Stockinger
BACKGROUND: Reducing time from injury to care can optimize trauma patient outcomes. A previous study of prehospital transport of US military casualties during the Afghanistan conflict demonstrated the importance of time and treatment capability for combat casualty survival. METHODS: A retrospective descriptive analysis was conducted to analyze battlefield data collected on US military combat casualties during the Iraq conflict from March 19, 2003 to August 31, 2010...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#3
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334568/goal-directed-hemostatic-resuscitation-for-trauma-induced-coagulopathy-maintaining-homeostasis
#4
Ernest E Moore, Hunter B Moore, Michael P Chapman, Eduardo Gonzalez, Angela Sauaia
No abstract text is available yet for this article.
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334567/pediatric-vascular-trauma-practice-patterns-and-resource-availability-a-survey-of-acs-designated-pediatric-trauma-centers
#5
Patrick C Bonasso, Lori A Gurien, Samuel D Smith, Marie E Saylors, M Sidney Dassinger
BACKGROUND: Variation exists in pediatric vascular trauma management. We aim to determine practice patterns for vascular trauma management at American College of Surgeons (ACS) verified pediatric trauma centers and evaluate the resources available for management of vascular trauma at both freestanding children's hospitals (FSCH) and pediatric hospitals within general adult hospitals (PHGAH). METHODS: Pediatric surgeons and trauma medical directors at ACS designated pediatric surgery trauma centers completed a survey designed to evaluate anticipated management of traumatic arterial injuries and resource availability...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29300282/meta-analysis-of-surgeon-performed-central-line-placement-real-time-ultrasound-vs-landmark-technique
#6
Lori A Gurien, Martin L Blakely, Marie C Crandall, Cameron Schlegel, Mallikarjuna R Rettiganti, Marie E Saylors, Daniel J France, Shilo Anders, Sheila L Thomas, Melvin S Dassinger
BACKGROUND: Major health care agencies recommend real-time ultrasound (RTUS) guidance during insertion of percutaneous central venous catheters (CVC) based on studies in which CVCs were placed by non-surgeons. We conducted a meta-analysis to compare outcomes for surgeon-performed RTUS-guided CVC insertion versus traditional landmark technique. METHODS: A systematic review of the literature was performed identifying randomized controlled trials (RCT) and prospective "safety studies" of surgeon-performed CVC insertions comparing landmark to RTUS techniques...
January 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29300281/the-ios-have-it-a-prospective-observational-study-of-vascular-access-success-rates-in-patients-in-extremis-using-video-review
#7
Kristen M Chreiman, Ryan P Dumas, Mark J Seamon, Patrick K Kim, Patrick M Reilly, Lewis J Kaplan, Jason D Christie, Daniel N Holena
BACKGROUND: Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral IVs (PIVs) or central venous catheters (CVCs). METHODS: High-definition video recordings of resuscitations for all patients undergoing Emergency Department Thoracotomy (EDT) from 4/2016-7/2017 were reviewed as part of a quality improvement initiative...
January 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29298242/contemporary-management-of-high-grade-renal-trauma-results-from-the-american-association-for-the-surgery-of-trauma-aast-genitourinary-trauma-study
#8
Sorena Keihani, Yizhe Xu, Angela P Presson, James M Hotaling, Raminder Nirula, Joshua Piotrowski, Christopher M Dodgion, Cullen M Black, Kaushik Mukherjee, Bradley J Morris, Sarah Majercik, Brian P Smith, Ian Schwartz, Sean P Elliott, Erik S DeSoucy, Scott Zakaluzny, Peter B Thomsen, Bradley A Erickson, Nima Baradaran, Benjamin N Breyer, Brandi Miller, Richard A Santucci, Matthew M Carrick, Timothy Hewitt, Frank N Burks, Jurek F Kocik, Reza Askari, Jeremy B Myers
BACKGROUND: The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted towards a non-operative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT. METHODS: From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma [AAST] grades III-V) were collected from 14 participating Level-1 trauma centers...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29298241/is-observation-for-traumatic-hemothorax-safe
#9
Leah Demetri, Myriam M Martinez Aguilar, Jordan D Bohnen, Ryan Whitesell, D Dante Yeh, David King, Marc de Moya
BACKGROUND: EAST guidelines suggest tube thoracostomy (TT) be considered for all traumatic hemothoraces. However, previous research has suggested that some traumatic hemothoraces may be observed safely. We sought to 1) determine the safety of selective observation for traumatic hemothorax, and 2) identify predictors of failed observation. METHODS: All patients with traumatic hemothorax from 2000-2014 at a Level I Trauma Center were identified and categorized by size as small (<300cc) or large (≥300cc) based on chest CT-scan measurements...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29298240/increased-risk-of-fibrinolysis-shutdown-among-severely-injured-trauma-patients-receiving-tranexamic-acid
#10
Jonathan P Meizoso, Roman Dudaryk, Michelle B Mulder, Juliet J Ray, Charles A Karcutskie, Sarah A Eidelson, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: The association between tranexamic acid (TXA) and fibrinolysis shutdown is unknown. We hypothesize that TXA is associated with fibrinolysis shutdown in critically injured trauma patients. METHODS: 218 critically injured adults admitted to the intensive care unit (ICU) at an urban level 1 trauma center from 08/2011-01/2015 who had thromboelastography performed upon ICU admission were reviewed. Groups were stratified based on fibrinolysis shutdown, which was defined as LY30<0...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#11
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta after diverse post-traumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop on-going bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29287059/microfluidics-a-high-throughput-system-for-the-assessment-of-the-endotheliopathy-of-trauma-and-the-effect-of-timing-of-plasma-administration-on-ameliorating-shock-associated-endothelial-dysfunction
#12
Lawrence N Diebel, Jonathan V Martin, David M Liberati
BACKGROUND: Early resuscitation after trauma-hemorrhagic shock (HS) with plasma rather than crystalloid may ameliorate systemic endothelial cell (EC) injury and dysfunction (endotheliopathy of trauma [EOT]). We postulated that endothelial lined microfluidic networks would be a useful platform to study the endothelial cell activation/injury under flow conditions to mimic HS. We then used the microfluidic system to further characterize the protective effects and optimal timing of plasma infusion on the development of "EOT" in our model...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29287058/activities-of-the-thor-aabb-working-party
#13
Mark H Yazer, Philip C Spinella
The AABB (formerly the American Association of Blood Banks) is an international authority on transfusion medicine and tissue banking. The Trauma, Hemostasis and Oxygenation Research (THOR) Network is an international multidisciplinary network of civilian and military providers ranging from first responders and medics to critical care physicians, and from basic scientists to clinical trialists. The THOR Network's vision is to improve outcomes from traumatic hemorrhagic shock by optimizing the acute phase of resuscitation...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29287057/early-diagnosis-using-canonical-discriminant-analysis-of-innate-immune-receptor-gene-expression-profiles-in-a-murine-infectious-or-sterile-systemic-inflammation-model
#14
Goro Tajima, Ayako Tokunaga, Takahiro Umehara, Kazuya Ikematsu, Junya Miyamoto, Shuntaro Sato, Osamu Tasaki
BACKGROUND: Infection in patients with systemic inflammation is difficult to diagnose with a single biomarker. We aimed to clarify the time course of change in the gene expression profile of innate immune receptors in infectious or sterile inflammation and to establish an early diagnostic method using canonical discriminant analysis (CDA) of the gene expression profile. METHODS: To compare infectious and sterile inflammation, we used cecal ligation and puncture (CLP) and 20% full-thickness burn injury (Burn) models...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283971/a-combat-relevant-model-for-the-creation-of-acute-lung-injury-in-swine
#15
Sawyer Smith, Belinda McCully, Aravind Bommiasamy, James Murphy, Brandon Behrens, Shibani Pati, Andrew Goodman, Martin Schreiber
No abstract text is available yet for this article.
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283970/prehospital-spine-immobilization-spinal-motion-restriction-in-penetrating-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-east
#16
Catherine G Velopulos, Hasan M Shihab, Lawrence Lottenberg, Marcie Feinman, Ali Raja, Jeffrey Salomone, Elliott R Haut
BACKGROUND: Spine immobilization in trauma has remained an integral part of most emergency medical services (EMS) protocols despite a lack of evidence for efficacy and concern for associated complications, especially in penetrating trauma patients. We reviewed the published evidence on the topic of prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma to structure a Practice Management Guideline. METHODS: We conducted a Cochrane style systematic review and meta-analysis, and applied GRADE methodology to construct recommendations...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283969/development-of-a-trauma-system-and-optimal-placement-of-trauma-centers-using-geospatial-mapping
#17
Michael A Horst, Shreya Jammula, Brian W Gross, Eric H Bradburn, Alan D Cook, Juliet Altenburg, Madison Morgan, Danielle Von Nieda, Frederick B Rogers
BACKGROUND: The care of patients at individual trauma centers (TCs) has been carefully optimized, but not the placement of TCs within the trauma systems. We sought to objectively determine the optimal placement of trauma centers in Pennsylvania using geospatial mapping. METHODS: We used the Pennsylvania Trauma Systems Foundation (PTSF) and Pennsylvania Health Care Cost Containment Council (PHC4) registries for adult (age ≥15) trauma between 2003-2015 (n=377,540 and n=255,263)...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283968/transfer-and-non-transfer-patients-in-isolated-low-grade-blunt-pediatric-solid-organ-injury-implications-for-regionalized-trauma-systems
#18
Robert A Tessler, Vivian H Lyons, Judith C Hagedorn, Monica S Vavilala, Adam Goldin, Saman Arbabi, Frederick P Rivara
BACKGROUND: Regionalization of trauma care is a national priority and hospitalization for blunt abdominal trauma, that may include transfer, is common among children. The objective of this study was to determine whether there were differences in mortality, treatment, or length of stay between patients treated at or transferred to a higher level trauma center and those not transferred and admitted to a lower level trauma center. METHODS: Cohort from Washington state trauma registry from 2000-2014 of patients 16 years or younger with isolated Grade I-III spleen, liver, or kidney injury...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283967/pediatric-appendicitis-is-referral-to-a-regional-pediatric-center-necessary
#19
Maggie M Hodges, Clay Cothren Burlew, Shannon N Acker, Ernest E Moore, Genie E Roosevelt, Anna Schubert, Lauren R S Hill, David A Partrick, Denis Bensard
BACKGROUND: Acute appendicitis is the most common emergent surgical procedure performed among children in the US, with an incidence exceeding 80,000 cases per year. Appendectomies are often performed by both pediatric surgeons and adult general/trauma acute care surgeons (TACS surgeons). We hypothesized that children undergoing appendectomy for acute appendicitis have equivalent outcomes whether a pediatric surgeon or a TACS surgeon performs the operation. METHODS: A retrospective chart review was performed for patients 6-18 years of age, who underwent appendectomy at either a regional children's hospital (CHCO, n=241) or an urban safety net hospital (n=347) between July 2010 and June 2015...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283966/under-triage-in-trauma-does-an-organized-trauma-network-capture-the-major-trauma-victim-a-statewide-analysis
#20
Michael A Horst, Shreya Jammula, Brian W Gross, Alan D Cook, Eric H Bradburn, Juliet Altenburg, Danielle Von Nieda, Madison Morgan, Frederick B Rogers
BACKGROUND: Proper triage of critically injured trauma patients to accredited trauma centers (TCs) is essential for survival and patient outcomes. We sought to determine the percentage of patients meeting trauma criteria who received care at non-trauma centers (NTCs) within the statewide trauma system that exists in the state of Pennsylvania. We hypothesized that a substantial proportion of the trauma population would be undertriaged to NTCs with undertriage rates (UTR) decreasing with increasing severity of injury...
December 28, 2017: Journal of Trauma and Acute Care Surgery
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