keyword
https://read.qxmd.com/read/38537225/a-randomized-noninferiority-trial-to-compare-enteral-to-parenteral-phosphate-replacement-on-biochemistry-waste-and-environmental-impact-and-healthcare-cost-in-critically-ill-patients-with-mild-to-moderate-hypophosphatemia
#1
JOURNAL ARTICLE
Chinh D Nguyen, Haustine P Panganiban, Timothy Fazio, Amalia Karahalios, Melissa Akravs, Christopher M MacIsaac, Thomas Rechnitzer, Lucy Arno, An Tran-Duy, Scott McAlister, Yasmine Ali Abdelhamid, Adam M Deane
OBJECTIVES: Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste. DESIGN: Prospective, randomized, parallel group, noninferiority clinical trial. SETTING: Single center, 42-bed state trauma, medical and surgical ICUs, from April 20, 2022, to July 1, 2022. PATIENTS: Patients with serum phosphate concentration between 0.3 and 0.75 mmol/L. INTERVENTIONS: We randomized patients to either enteral or IV phosphate replacement using electronic medical record-embedded program...
March 25, 2024: Critical Care Medicine
https://read.qxmd.com/read/38536762/the-impact-of-musculoskeletal-ill-health-on-quality-of-life-and-function-after-critical-care-a-multicentre-prospective-cohort-study
#2
JOURNAL ARTICLE
O D Gustafson, E B King, M M Schlussel, A Arnold, C Wade, P S Nicol, M J Rowland, H Dawes, M A Williams
Physical disability is a common component of post-intensive care syndrome, but the importance of musculoskeletal health in this population is currently unknown. We aimed to determine the musculoskeletal health state of intensive care unit survivors and assess its relationship with health-related quality of life; employment; and psychological and physical function. We conducted a multicentre prospective cohort study of adults admitted to intensive care for > 48 h without musculoskeletal trauma or neurological insult...
March 27, 2024: Anaesthesia
https://read.qxmd.com/read/38536468/traumatic-rhabdomyolysis-rare-but-morbid-potentially-lethal-and-inconsistently-monitored
#3
JOURNAL ARTICLE
Thomas Giles, Kate King, Simone Meakes, Natasha Weaver, Zsolt J Balogh
PURPOSE: Although traumatic rhabdomyolysis (TR) is shown to be associated with acute kidney injury (AKI), there are no large prospective epidemiological studies, interventional trials, official guidelines outlining the appropriate investigation, monitoring, and treatment on this poorly understood condition. We aimed to establish the contemporary epidemiology and describe current practices for TR to power future higher quality studies. We hypothesised that investigation and monitoring occur in an ad hoc fashion...
March 27, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38533699/business-continuity-plan-in-the-management-and-operations-of-hospitals-first-experience-to-certify-the-pdta-processes-with-the-requirements-defined-by-iso-22301-2019-in-emergency-medical-services
#4
JOURNAL ARTICLE
Lucio Dell'Atti, Roberto Papa, Leonardo Incicchitti, Maria Katia Zanni, Andrea Zampa, Michele Caporossi
BACKGROUND: A business continuity plan (BCP) facilitates the performance of primary functions during emergencies or other situations that can disrupt normal operations. If risk management is done analytically, a business impact analysis (BIA), according to ISO 22301 certification, makes it possible to define the best strategy for supporting the company's assets and image, optimizing the operational efficiency of service recovery and redesigning spaces for health. Since 2015, our healthcare company has embarked on a certification process for all sectors and activities through the implementation and development of diagnostic and therapeutic paths for operational diagnos-tic-therapeutic-assistance pathways (PDTAs)...
2024: Journal of Emergency Management: JEM
https://read.qxmd.com/read/38532271/antithrombotics-in-the-fall-patient-appropriateness-and-risk-benefit-analysis
#5
JOURNAL ARTICLE
A J Bethurum, Kevin Zeng, Thaddeus Puzdrakiewicz, Parth Goenka, Hannah Collins, J Bracken Burns, Keelin Roche
Falls are the leading cause of hospitalizations following trauma nationwide, resulting in over 3 million admissions in 2020. This population is typically aged, and many are prescribed antithrombotic (AT) therapy. In this prospective study, we aimed to analyze fall history while assessing appropriateness of AT regimen relative to fall risk. Patients presenting following ground level fall (GLF) and meeting inclusion criteria during the study period were enrolled. Primary outcome was the relationship between AT therapy necessity (CHA2 DS2 -VASc) and fall risk (Morse Fall Risk)...
March 26, 2024: American Surgeon
https://read.qxmd.com/read/38531812/whole-blood-resuscitation-for-injured-patients-requiring-transfusion-a-systematic-review-meta-analysis-and-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#6
JOURNAL ARTICLE
Jonathan P Meizoso, Bryan A Cotton, Ryan A Lawless, Lisa M Kodadek, Jennifer M Lynde, Nicole Russell, John Gaspich, Adrian Maung, Christofer Anderson, John M Reynolds, Krista L Haines, George Kasotakis, Jennifer J Freeman
INTRODUCTION: Whole blood resuscitation has reemerged as a resuscitation strategy for injured patients. However, the effect of whole blood-based resuscitation on outcomes has not been established. The primary objective of this guideline was to develop evidence-based recommendations on whether whole blood should be considered in civilian trauma patients receiving blood transfusions. METHODS: An EAST working group performed a systematic review and meta-analysis utilizing the GRADE methodology...
March 27, 2024: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/38530411/impact-of-early-follow-up-ct-in-the-conservative-management-of-traumatic-brain-injury-on-surgical-decision-making-a-retrospective-single-center-analysis-with-special-respect-to-coagulopathy
#7
JOURNAL ARTICLE
Mats L Moskopp, Dag Moskopp, Lennart W Sannwald
INTRODUCTION: Initial management of traumatic brain injury (TBI) without immediate need for surgical therapy varies across centers. The additional value of routine repeat cranial computerized tomography (CT) to neurological monitoring is controversial. This retrospective study investigates the impact of routine follow-up CT after 6 h (CT6h) in initially conservatively managed TBI on surgical decision making. Furthermore, the impact of coagulopathy on lesion size and progression was examined...
March 26, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38530410/management-of-pancreatic-and-duodenal-trauma-in-childhood-a-university-hospital-experience-over-a-10-year-period
#8
JOURNAL ARTICLE
Agah Koray Mansiroglu, Emrullah Cesur, Binali Firinci, Ozgur Caglar, Murat Yigiter, Ahmet Bedii Salman
PURPOSE: Duodenal/pancreatic injuries occur in less than 10% of intra-abdominal injuries in pediatric blunt trauma. Isolated duodenal/pancreatic injuries occur in two-thirds of cases, while combined injuries occur in the remaining. This study aimed to investigate pediatric patients with pancreatic and duodenal trauma. METHODS: Data from 31 patients admitted to Atatürk University, Medical Faculty, Department of Pediatric Surgery for pancreatic/duodenal trauma between 2010 and 2019 were retrospectively analyzed...
March 26, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38530409/therapy-aspects-of-peri-implant-femoral-fractures-a-retrospective-analysis-of-64-patients
#9
JOURNAL ARTICLE
Christian Wulbrand, Franz Müller, Bernd Füchtmeier, Alexander Hanke
PURPOSE: The incidence of peri-implant femoral fractures (PIFF) is increasing. Information regarding outcomes, timing of surgery, risk factors, and a clinically applicable treatment algorithm are lacking. The aim of this study was to identify outcome-related risk factors and to derive a treatment algorithm. METHODS: Sixty-four PIFFs treated between 01.01.2006 and 31.12.2020 in a level I trauma centre were evaluated retrospectively for fracture pattern, surgical technique, risk factors, complications, and 1-year mortality...
March 26, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38529316/impact-of-covid-status-and-blood-group-on-complications-in-patients-in-hemorrhagic-shock
#10
JOURNAL ARTICLE
Jason Bradley Brill, Krislynn M Mueck, Madeline E Cotton, Brian Tang, Mariela Sandoval, Lillian S Kao, Bryan A Cotton
OBJECTIVE: Among critically injured patients of various blood groups, we sought to compare survival and complication rates between COVID-19-positive and COVID-19-negative cohorts. BACKGROUND: SARS-CoV-2 infections have been shown to cause endothelial injury and dysfunctional coagulation. We hypothesized that, among patients with trauma in hemorrhagic shock, COVID-19-positive status would be associated with increased mortality and inpatient complications. As a secondary hypothesis, we suspected group O patients with COVID-19 would experience fewer complications than non-group O patients with COVID-19...
2024: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/38529315/treatment-approach-for-coexisting-chest-wall-fractures-and-unstable-thoracolumbar-spine-fractures-in-polytrauma-patients-requiring-prone-spine-surgery
#11
EDITORIAL
Aymen Alqazzaz, Zan Naseer, Carl A Beyer, Jeremy W Cannon, Amrit Khalsa
Concomitant chest wall fractures (sternal and/or rib fractures) with unstable thoracolumbar fractures that require surgical fixation are rare but highly morbid injuries that mandate a multidisciplinary approach to treatment. There is limited evidence in the literature regarding optimal timing and order of surgical fixation of these patients with multiple injuries. Here, we present our experience with two patients at a single institution that demonstrates the challenges that present with this patient population...
2024: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/38528277/pre-hospital-emergency-medicine-a-spectrum-of-imaging-findings
#12
REVIEW
Ryan T Whitesell, Aaron M Burnett, Sean K Johnston, Douglas H Sheafor
The goal of emergency medical services (EMS) is to provide urgent medical care and stabilization prior to patient transport to a healthcare facility for definitive treatment. The number and variety of interventions performed in the field by EMS providers continues to grow as early management of severe injuries and critical illness in the pre-hospital setting has been shown to improve patient outcomes. The sequela of many field interventions, including those associated with airway management, emergent vascular access, cardiopulmonary resuscitation (CPR), patient immobilization, and hemorrhage control may be appreciated on emergency department admission imaging...
March 26, 2024: Emergency Radiology
https://read.qxmd.com/read/38526928/an-overview-of-the-methodology-used-to-develop-clinical-practice-guidelines-for-the-management-of-acute-and-intraoperative-spinal-cord-injury
#13
JOURNAL ARTICLE
Lindsay A Tetreault, Andrea C Skelly, Mohammed Ali Alvi, Brian K Kwon, Nathan Evaniew, Michael G Fehlings
STUDY DESIGN: An overview of the methods used to develop clinical practice guidelines (CPGs). OBJECTIVES: Acute spinal cord injury (SCI) and intraoperative SCI (ISCI) can have devastating physical and psychological consequences for patients and their families. To date, there are several studies that have discussed the diagnostic and management strategies for both SCI and ISCI. CPGs in SCI help to distill and translate the current evidence into actionable recommendations, standardize care across centers, optimize patient outcomes, and reduce costs and unnecessary interventions...
March 2024: Global Spine Journal
https://read.qxmd.com/read/38526926/the-2023-ao-spine-praxis-guidelines-in-acute-spinal-cord-injury-what-have-we-learned-what-are-the-critical-knowledge-gaps-and-barriers-to-implementation
#14
JOURNAL ARTICLE
Michael G Fehlings, Ali Moghaddamjou, Nathan Evaniew, Lindsay A Tetreault, Mohammed Ali Alvi, Andrea C Skelly, Brian K Kwon
STUDY DESIGN: Narrative summary of the 2023 AO Spine-Praxis clinical practice guidelines for management in acute spinal cord injury (SCI). OBJECTIVES: The objective of this article is to summarize the key findings of the clinical practice guidelines for the optimal management of traumatic and intraoperative SCI (ISCI). This article will also highlight potential knowledge translation opportunities for each recommendation and discuss important knowledge gaps and areas of future research...
March 2024: Global Spine Journal
https://read.qxmd.com/read/38526922/an-update-of-a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-role-and-timing-of-decompressive-surgery
#15
JOURNAL ARTICLE
Michael G Fehlings, Lindsay A Tetreault, Laureen Hachem, Nathan Evaniew, Mario Ganau, Stephen L McKenna, Chris J Neal, Narihito Nagoshi, Vafa Rahimi-Movaghar, Bizhan Aarabi, Christoph P Hofstetter, Valerie Ter Wengel, Hiroaki Nakashima, Allan R Martin, Steven Kirshblum, Ricardo Rodrigues Pinto, Rex A W Marco, Jefferson R Wilson, David E Kahn, Virginia F J Newcombe, Carl M Zipser, Sam Douglas, Shekar N Kurpad, Yi Lu, Rajiv Saigal, Uzma Samadani, Paul M Arnold, Gregory W J Hawryluk, Andrea C Skelly, Brian K Kwon
STUDY DESIGN: Clinical practice guideline development. OBJECTIVES: Acute spinal cord injury (SCI) can result in devastating motor, sensory, and autonomic impairment; loss of independence; and reduced quality of life. Preclinical evidence suggests that early decompression of the spinal cord may help to limit secondary injury, reduce damage to the neural tissue, and improve functional outcomes. Emerging evidence indicates that "early" surgical decompression completed within 24 hours of injury also improves neurological recovery in patients with acute SCI...
March 2024: Global Spine Journal
https://read.qxmd.com/read/38524047/predictors-of-acute-compartment-syndrome-in-patients-with-forearm-fractures-a-systematic-review
#16
REVIEW
Ahmed AlHussain, Nouf A Almagushi, Fay Alowid, Bashayer AlObaid, Nawaf A Almagushi, Sultan N Alotaibi, Mohammad S Almosa, Mashari A Alhossan, Saif S Alanazi, Faisal Alhuwairini, Musaad M Bin Dukhi
Acute compartment syndrome (ACS) is a critical orthopedic and traumatology emergency arising from elevated pressure within a confined osteofascial compartment, leading to compromised blood circulation and tissue ischemia. This systematic review aims to comprehensively identify and analyze the most predictable risk factors associated with ACS development in patients with forearm fractures. Published articles on ACS were meticulously searched and evaluated on reputable medical databases such as PubMed. The keywords "risk factors associated with the ACS in patients who have sustained forearm fractures"were used to create the search syntax on various databases...
February 2024: Curēus
https://read.qxmd.com/read/38523141/identifying-factors-predicting-outcomes-after-major-trauma-in-older-patients-prognostic-systematic-review-and-meta-analysis
#17
JOURNAL ARTICLE
Mayura Thilanka Iddagoda, Michelle Trevenen, Claire Meaton, Christopher Etherton-Beer, Leon Flicker
INTRODUCTION: Trauma is the most common cause of morbidity and mortality in older people and it is important to determine the predictors of outcomes after major trauma in older people. METHODS: MEDLINE, Embase, Web of Science and manual search of relevant papers since 1987 to February 2023 was searched. Random effects meta-analyses were performed. The primary outcome of interest was mortality and secondary outcomes were medical complications, length of stay, discharge destination, readmission, and intensive care requirement...
March 25, 2024: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/38523134/american-association-for-the-surgery-of-trauma-american-college-of-surgeons-committee-on-trauma-clinical-protocol-for-post-discharge-venous-thromboembolism-prophylaxis-after-trauma
#18
JOURNAL ARTICLE
Allison E Berndtson, Alisa Cross, Brian K Yorkgitis, Ryan Kennedy, Matthew P Kochuba, Christopher Tignanelli, Gail T Tominaga, David G Jacobs, Dennis W Ashley, Eric J Ley, Lena Napolitano, Todd W Costantini
Trauma patients are at an elevated risk for developing venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis. In the inpatient setting, prompt pharmacologic prophylaxis is utilized to prevent VTE. For patients with lower extremity fractures or limited mobility, VTE risk does not return to baseline levels post-discharge. Currently, there are limited data to guide post-discharge VTE prophylaxis in trauma patients. The goal of these post-discharge VTE prophylaxis guidelines are to identify patients at the highest risk of developing VTE after discharge and to offer pharmacologic prophylaxis strategies to limit this risk...
March 25, 2024: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/38523132/exposure-to-statin-therapy-decreases-the-incidence-of-venous-thromboembolism-after-trauma
#19
JOURNAL ARTICLE
Kelly E Sanders, Gabrielle E Hatton, Atharwa R Mankame, Addison C Allen, Sarah Cunningham, Jan Michael Van Gent, Erin E Fox, Xu Zhang, Charles E Wade, Bryan A Cotton, Jessica C Cardenas
INTRODUCTION: Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in trauma patients, despite chemoprophylaxis. Statins have been shown capable of acting upon the endothelium. We hypothesized that statin therapy in the pre- or in-hospital settings leads to a decreased incidence of VTE. METHODS: We conducted a retrospective cohort study of injured patients who received statin therapy pre- or in-hospital. Adult, highest-level trauma activation patients admitted January 2018 - June 2022 were included...
March 25, 2024: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/38523131/thoracic-cavity-irrigation-prevents-retained-hemothorax-and-decreases-surgical-intervention-in-trauma-patients
#20
JOURNAL ARTICLE
Abdul Hafiz Al Tannir, Elise A Biesboer, Simin Golestani, Morgan Tentis, Morgan Maring, Jaclyn Gellings, Jacob R Peschman, Patrick B Murphy, Rachel S Morris, Anuoluwapo Elegbede, Marc A de Moya, Thomas W Carver
INTRODUCTION: Retained hemothorax (HTX) is a common complication following thoracic trauma. Small studies demonstrate the benefit of thoracic cavity irrigation at the time of tube thoracostomy for the prevention of retained HTX. We sought to assess the effectiveness of chest irrigation in preventing retained HTX leading to a secondary surgical intervention. METHODS: We performed a single-center retrospective study from 2017-2021 at a Level I trauma center comparing bedside thoracic cavity irrigation via tube thoracostomy (TT) versus no irrigation...
March 25, 2024: Journal of Trauma and Acute Care Surgery
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