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Trauma patient critical care

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https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#1
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#2
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28506455/trauma-morning-report-is-the-ideal-environment-to-teach-and-evaluate-resident-communication-and-sign-outs-in-the-80-hour-work-week
#3
Mary E Ottinger, Sean F Monaghan, Shea C Gregg, Andrew H Stephen, Michael D Connolly, David T Harrington, Charles A Adams, William G Cioffi, Daithi S Heffernan
BACKGROUND: The 80h work week has raised concerns that complications may increase due to multiple sign-outs or poor communication. Trauma Surgery manages complex trauma and acute care surgical patients with rapidly changing physiology, clinical demands and a large volume of data that must be communicated to render safe, effective patient care. Trauma Morning Report format may offer the ideal situation to study and teach sign-outs and resident communication. MATERIALS AND METHODS: Surgery Residents were assessed on a 1-5 scale for their ability to communicate to their fellow residents...
May 1, 2017: Injury
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#4
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28486327/tourniquets-in-trauma-care-a-review-of-application
#5
Brian Cornelius, Ryan Campbell, Pat McGauly
Traumatic hemorrhage has been identified as the leading cause of battlefield death in recent conflicts. Although injury patterns are not directly reproducible to the civilian world, treatment advancements can be used to provide care to patients worldwide. Long-standing dogma regarding the use of tourniquets has been disproved, and there is now recognition of the critical role that tourniquets play in trauma care. The history and evolution of tourniquets, including the identification of previous faults in application, will lead to an examination of the current devices in use along with evidence-based recommendations for use...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28483610/decision-making-on-withholding-or-withdrawing-life-support-in-the-icu-a-worldwide-perspective
#6
Suzana M Lobo, Flávio Henrique Barros de Simoni, Stephan M Jakob, Angel Estella, Sonali Vadi, Andreas Bluethgen, Ignacio Martin-Loeches, Yasser Sakr, Jean-Louis Vincent
BACKGROUND: Many critically ill patients who die will do so after a decision has been made to withhold/withdraw life-sustaining therapy. Our objective was to document the characteristics of intensive care unit (ICU) patients with a decision to withhold/withdraw life-sustaining treatment, including the types of supportive treatments used, patterns of organ dysfunction, and international differences, including gross national income (GNI). METHODS: In this observational cohort study conducted in 730 ICUs in 84 countries, all adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance, were included...
May 5, 2017: Chest
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#7
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28465715/non-iatrogenic-esophageal-injury-a-retrospective-analysis-from-the-national-trauma-data-bank
#8
Alberto Aiolfi, Kenji Inaba, Gustavo Recinos, Desmond Khor, Elizabeth R Benjamin, Lydia Lam, Aaron Strumwasser, Emanuele Asti, Luigi Bonavina, Demetrios Demetriades
BACKGROUND: Traumatic, non-iatrogenic esophageal injuries, despite their rarity, are associated with significant morbidity and mortality. The optimal management of these esophageal perforations remains largely debated. To date, only a few small case series are available with contrasting results. The purpose of this study was to examine a large contemporary experience with traumatic esophageal injury management and to analyze risk factors associated with mortality. METHODS: This National Trauma Data Bank (NTDB) database study included patients with non-iatrogenic esophageal injuries...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28464969/utilization-criteria-for-prehospital-ultrasound-in-a-canadian-critical-care-helicopter-emergency-medical-service-determining-who-might-benefit
#9
Domhnall O'Dochartaigh, Matthew Douma, Chris Alexiu, Shell Ryan, Mark MacKenzie
Introduction Prehospital ultrasound (PHUS) assessments by physicians and non-physicians are performed on medical and trauma patients with increasing frequency. Prehospital ultrasound has been shown to be of benefit by supporting interventions. Problem Which patients may benefit from PHUS has not been clearly identified. METHODS: A multi-variable logistic regression analysis was performed on a previously created retrospective dataset of five years of physician- and non-physician-performed ultrasound scans in a Canadian critical care Helicopter Emergency Medical Service (HEMS)...
May 3, 2017: Prehospital and Disaster Medicine
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
#10
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/28452898/accuracy-of-prehospital-triage-protocols-in-selecting-major-trauma-patients-a-systematic-review
#11
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/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#12
Nathan T Mowery, Brandon R Bruns, Heather MacNew, Suresh Agarwal, Toby Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew Lissauer, Therese M Duane, Amy N Hildreth, Peter Pappas, Lynn Gries, Meghann Kaiser, Bryce Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#13
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28443269/epidemiology-and-risk-assessment-of-pediatric-venous-thromboembolism
#14
REVIEW
Arash Mahajerin, Stacy E Croteau
The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07-0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#15
Aziz S Alali, Victoria A McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP) to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
May 17, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#16
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#17
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430068/caring-for-patients-or-organs-new-therapies-raise-new-dilemmas-in-the-emergency-department
#18
Arjun Prabhu, Lisa S Parker, Michael A DeVita
Two potentially lifesaving protocols, emergency preservation and resuscitation (EPR) and uncontrolled donation after circulatory determination of death (uDCDD), currently implemented in some U.S. emergency departments (EDs), have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to "buy time": one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28429475/common-carotid-artery-sonography-versus-transthoracic-echocardiography-for-cardiac-output-measurements-in-intensive-care-unit-patients
#19
Qian-Yi Peng, Li-Na Zhang, Mei-Lin Ai, Li Li, Cheng-Huan Hu, Yan-Xin Zhang, Wei Liu, Qing Feng, Yu Zou, Yu-Hang Ai
OBJECTIVES: This study was designed to test the effectiveness of common carotid artery sonography in comparison with transthoracic echocardiography (TTE) for cardiac output measurements to provide an easier alternative for cardiac output monitoring in the intensive care unit. METHODS: This study included 148 patients who had common carotid artery Doppler examinations and TTE performed within 8 hours of each other, and the cardiac output measurement results were compared with each other...
April 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28424799/role-of-psychological-resilience-on-health-outcomes-in-hospitalized-patients-with-acute-illness-a-scoping-review
#20
Elen Marged Bradley-Roberts, Christian P Subbe
Recovery from Acute Illness is dependent on severity of illness. We aimed to investigate whether resilience as the 'ability to bounce back' might also affect recovery. We conducted a scoping review to identify gaps in the existing literature. We used emergency care, intensive care, critical care and trauma as surrogates for acute illness. We mapped synonyms for resilience and selected 'resilience' and 'robustness'. The search was limited to adult patients admitted to hospitals. We found strong evidence for psychological sequelae of acute illness but no research focusing specifically on the concepts of resilience or robustness and no interventional studies in the acute hospital setting...
2017: Acute Medicine
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