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https://www.readbyqxmd.com/read/29760965/age-and-other-risk-factors-influencing-long-term-mortality-in-patients-with-traumatic-cervical-spine-fracture
#1
Matthew Bank, Katie Gibbs, Cristina Sison, Nawshin Kutub, Angelos Paptheodorou, Samuel Lee, Adam Stein, Ona Bloom
Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29744242/non-invasive-mechanical-ventilation-in-critically-ill-trauma-patients-a-systematic-review
#2
REVIEW
Annia Schreiber, Fatma Yıldırım, Giovanni Ferrari, Andrea Antonelli, Pablo Bayoumy Delis, Murat Gündüz, Marcin Karcz, Peter Papadakos, Roberto Cosentini, Yalım Dikmen, Antonio M Esquinas
There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29744222/chest-wall-stabilization-in-trauma-patients-why-when-and-how
#3
REVIEW
Jose Ribas Milanez de Campos, Thomas W White
Blunt trauma to the chest wall and rib fractures are remarkably frequent and are the basis of considerable morbidity and possible mortality. Surgical remedies for highly displaced rib fractures, especially in cases of flail chest, have been undertaken intermittently for more than 50 years. Rib-specific plating systems have started to be used in the last 10 years. These have ushered in the modern era of rib repair with chest wall stabilization (CWS) techniques that are safer, easier to perform, and more efficient...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29742591/duration-of-respiratory-failure-after-trauma-is-not-associated-with-increased-long-term-mortality
#4
Mackenzie R Cook, Kathleen O'Connell, Qian Qiu, Andrew J Riggle, Thomas H Shoultz, Rebecca G Maine, Saman Arbabi, Grant E O'Keefe, Joseph Cuschieri, Ronald V Maier, Bryce R H Robinson
OBJECTIVES: Although 1-year survival in medically critically ill patients with prolonged mechanical ventilation is less than 50%, the relationship between respiratory failure after trauma and 1-year mortality is unknown. We hypothesize that respiratory failure duration in trauma patients is associated with decreased 1-year survival. DESIGN: Retrospective cohort of trauma patients. SETTING: Single center, level 1 trauma center. PATIENTS: Trauma patients admitted from 2011 to 2014; respiratory failure is defined as mechanical ventilation greater than or equal to 48 hours, excluded head Abbreviated Injury Score greater than or equal to 4...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742216/pain-assessment-of-traumatic-brain-injury-victims-using-the-brazilian-version-of-the-behavioral-pain-scale
#5
Caíque Jordan Nunes Ribeiro, Andra Carla Santos de Araújo, Saulo Barreto Brito, Daniele Vieira Dantas, Mariangela da Silva Nunes, José Antonio Barreto Alves, Maria do Carmo de Oliveira Ribeiro
OBJECTIVE: To evaluate the validity and reliability of the Brazilian version of the Behavioral Pain Scale (BPS-Br) in victims of traumatic brain injury. METHODS: Observational prospective study with paired and repeated measures conducted at two intensive care units (clinical and surgical) of a large general hospital. The convenience sample consisted of adult victims of moderate or severe penetrating or blunt craniocerebral trauma who were sedated and mechanically ventilated...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29741076/monitoring-of-hospital-acquired-pneumonia-in-patients-with-severe-brain-injury-on-first-access-to-intensive-neurological-rehabilitation-first-year-of-observation
#6
Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina
Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3...
May 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29738402/is-first-rib-fracture-a-culprit-or-a-sign-of-injury-severity-it-is-both
#7
Alexander Fokin, Joanna Wycech, Eric Picard, Russell Weisz, Ivan Puente
OBJECTIVES: First rib fractures (1 RFX) have been correlated with increased morbidity and mortality. Whether this is due to the fracture of the rib itself or due to an increased number of associated injuries remains debatable. DESIGN: Retrospective cohort study SETTING:: Level 1 trauma center PATIENTS:: 1089 patients with rib fractures divided into 3 groups: Group A (n=44) with isolated 1 RFX, Group B (n=116) with 1 RFX combined with other rib fractures, and Group C (n=929) with rib fractures without 1 RFX...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29729771/in-harm-s-way-unintentional-firearm-injuries-in-young-children
#8
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Brian Kenney
PURPOSE: Firearm-related trauma represents a major source of preventable injury and death. Many firearm injuries in young children are unintentional, and the true incidence may be underestimated. We sought to characterize the morbidity of unintentional firearm injuries. METHODS: National Trauma Data Bank data from 2007 to 2014 was obtained for patients aged 0-14 sustaining gunshot wounds (GSW). We analyzed demographics, injury severity score, hospital and ICU length of stay (LOS), ventilator days, discharge to rehab, and mortality...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29722334/antibiotics-de-escalation-in-the-treatment-of-ventilator-associated-pneumonia-in-trauma-patients-a-retrospective-study-on-propensity-score-matching-method
#9
Hu Li, Chun-Hui Yang, Li-Ou Huang, Yu-Hui Cui, Dan Xu, Chun-Rong Wu, Jian-Guo Tang
Background: Antimicrobial de-escalation refers to starting the antimicrobial treatment with broad-spectrum antibiotics, followed by narrowing the drug spectrum according to culture results. The present study evaluated the effect of de-escalation on ventilator-associated pneumonia (VAP) in trauma patients. Methods: This retrospective study was conducted on trauma patients with VAP, who received de-escalation therapy (de-escalation group) or non-de-escalation therapy (non-de-escalation group)...
May 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29716619/the-impact-of-blood-type-o-on-mortality-of-severe-trauma-patients-a-retrospective-observational-study
#10
Wataru Takayama, Akira Endo, Hazuki Koguchi, Momoko Sugimoto, Kiyoshi Murata, Yasuhiro Otomo
BACKGROUND: Recent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. In this study, we evaluated the impact of the difference in the ABO blood type on mortality in patients with severe trauma. METHODS: A retrospective observational study was conducted in two tertiary emergency critical care medical centers in Japan. Patients with trauma with an Injury Severity Score (ISS) > 15 were included...
May 2, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29715257/evaluation-of-richmond-agitation-sedation-scale-rass-in-mechanically-ventilated-in-the-emergency-department
#11
Marianne K Pop, Katelyn R Dervay, Mary Dansby, Carolina Jones
The purpose of this study was to assess Richmond Agitation Sedation Scale (RASS) goal implementation in mechanically ventilated patients sedated in the emergency department (ED), compliance with RASS, and goal achievement. This study was a retrospective chart review at a large Level I trauma academic medical center. Patients who were intubated in the ED or en route to the ED between October 1, 2013, and October 1, 2014, were eligible for inclusion if they met the following criteria: aged 18 years or older, 24 hr or more on mechanically ventilated support receiving continuous sedation and/or analgesia during the first 48 hr of admission, and a hospital stay of 6 days or more...
April 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29708920/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#12
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29708848/clostridium-difficile-infection-in-trauma-surgery-and-medical-patients-admitted-to-the-intensive-care-unit
#13
Richard R Watkins, Caroline Mangira, Farid Muakkassa, Curtis J Donskey, Nairmeen A Haller
BACKGROUND: Clostridium difficile infection (CDI) causes significant morbidity and mortality rates, especially for patients in the intensive care unit (ICU). Data comparing trauma and surgery patients with CDI in the ICU with medical patients with CDI in the ICU are limited. METHODS: In a single-center study, we analyzed retrospective data from 25 trauma patients and 13 surgery patients aged 18 years or older who had CDI and had been admitted to the ICU. A comparison group of 156 medical patients aged 18 years or greater who had CDI and were admitted to the ICU also was identified...
April 30, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29694993/new-ventilator-strategies-high-frequency-oscillatory-ventilation-combined-with-volume-guarantee
#14
M Sánchez-Luna, N González-Pacheco, J Belik, M Santos, F Tendillo
High-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV-volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29687659/effectiveness-and-safety-of-nasal-mask-versus-binasal-prongs-for-providing-continuous-positive-airway-pressure-in-preterm-infants-a-systematic-review-and-meta-analysis
#15
REVIEW
Bonny Jasani, Abu Ismail, Shripada Rao, Sanjay Patole
Continuous positive airway pressure (CPAP) delivered via binasal prongs has been the cornerstone of respiratory management in preterm infants. Though effective, the use of binasal prongs is associated with nasal trauma, and CPAP failure. To overcome these issues, nasal masks are increasingly used to deliver CPAP in preterm infants. The aim was to conduct a systematic review of randomized controlled trials (RCTs) comparing nasal mask versus binasal prongs to deliver CPAP in preterm infants. Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing, and Allied Health Literature, and E-abstracts from the Pediatric Academic Society meetings were searched in May 2017...
April 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29677057/newborn-resuscitation-skills-in-health-care-providers-at-a-zambian-tertiary-center-and-comparison-to-world-health-organization-standards
#16
Sara C Mistry, Richard Lin, Hazel Mumphansha, Laura C Kettley, Janaki A Pearson, Sonia Akrimi, David J Mayne, Wonder Hangoma, M Dylan Bould
BACKGROUND: Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower-middle income country...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29668810/predictors-of-chest-drainage-complications-in-trauma-patients
#17
Cecília Araújo Mendes, Elcio Shiyoiti Hirano
OBJECTIVE: to identify predictors of chest drainage complications in trauma patients attended at a University Hospital. METHODS: we conducted a retrospective study of 68 patients submitted to thoracic drainage after trauma, in a one-year period. We analyzed gender, age, trauma mechanism, trauma indices, thoracic and associated lesions, environment in which the procedure was performed, drainage time, experience of the performer, complications and evolution. RESULTS: the mean age of the patients was 35 years and the male gender was the most prevalent (89%)...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29668565/the-effects-of-genetic-3-mercaptopyruvate-sulfurtransferase-deficiency-in-murine-traumatic-hemorrhagic-shock
#18
Michael Gröger, Martin Wepler, Ulrich Wachter, Tamara Merz, Oscar McCook, Sandra Kress, Britta Lukaschewski, Sebastian Hafner, Markus Huber-Lang, Enrico Calzia, Michael Georgieff, Noriyuki Nagahara, Csaba Szabó, Peter Radermacher, Clair Hartmann
INTRODUCTION: Hemorrhagic shock is a major cause of death after trauma. An additional blunt chest trauma independently contributes to mortality upon the development of an acute lung injury (ALI) by aggravating pathophysiological consequences of hemorrhagic shock. The maintenance of hydrogen sulfide availability is known to play an important role during hemorrhage and ALI. We therefore tested the impact of a genetic 3-mercaptopyruvate sulfurtransferase mutation (Δ3-MST) in a resuscitated murine model of traumatic-hemorrhagic shock...
April 17, 2018: Shock
https://www.readbyqxmd.com/read/29664891/reinventing-the-wheel-impact-of-prolonged-antibiotic-exposure-on-multi-drug-resistant-ventilator-associated-pneumonia-in-trauma-patients
#19
Richard H Lewis, John P Sharpe, Joseph M Swanson, Timothy C Fabian, Martin A Croce, Louis J Magnotti
INTRODUCTION: Multi-drug resistant (MDR) strains of both Acinetobacter baumannii (AB) and Pseudomonas aeruginosa (PA) as causative VAP pathogens are becoming increasingly common. Still, the risk factors associated with this increased resistance have yet to be elucidated. The purpose of this study was to examine the changing sensitivity patterns of these pathogens over time and determine which risk factors predict MDR in trauma patients with VAP. METHODS: Patients with either AB or PA VAP over 10 years were stratified by pathogen sensitivity (sensitive (SEN) and MDR), age, severity of shock and injury severity...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#20
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
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