Publications by authors named "Arman Dagal"
Objectives: To determine the association between closed suction drainage and postoperative infection in patients with tibial plateau or pilon fractures. Secondarily, this study assessed if intrawound vancomycin powder modified the association of closed surgical drains with infection.
Methods: Design: Secondary analysis of the Effect of Intrawound Vancomycin Powder in Operatively Treated High-risk Tibia Fractures: A Randomized Clinical Trial (VANCO) trial.
Article Synopsis
- - The study analyzed the OXYGEN trial, which compared high levels of oxygen (80% FiO2) vs. lower levels (30% FiO2) for preventing infections in patients with specific types of fractures and aimed to see if using an "as-treated" approach changed the results compared to the "intention-to-treat" method.
- - Conducted at 29 trauma centers, 1,231 patients with tibial plateau, tibial pilon, or calcaneus fractures were randomly assigned to either oxygen treatment; adherence was evaluated using two specific criteria based on the percentage of surgery time at different oxygen levels.
- - Results showed no significant differences in primary and deep infection rates, but the treatment group had fewer
Introduction: Operating room (OR) efficiency is a key factor in determining surgical healthcare costs. To enable targeted changes for improving OR efficiency, a comprehensive quantification of the underlying sources of variability contributing to OR efficiency is needed. Previous literature has focused on select stages of the OR process or on aggregate process times influencing efficiency.
View Article and Find Full Text PDFBackground: Postoperative hemiparesis following frontal lobe lesion resection is alarming, and predicting motor function recovery is challenging. Supplementary motor area (SMA) syndrome following resection of frontal lobe lesions is often indistinguishable from postoperative motor deficit due to surgical injury of motor tracts. We aimed to describe the use of intraoperative transcranial electrical stimulation (TES) with motor evoked potential monitoring data as a diagnostic tool to distinguish between SMA syndrome and permanent motor deficit (PMD).
View Article and Find Full Text PDFWhen is it safe to resume anticoagulation in traumatic brain injury?
Curr Opin Anaesthesiol
April 2022
Purpose Of Review: When to resume or initiate anticoagulation therapy following traumatic brain injury (TBI) is controversial. This summary describes the latest evidence to guide best practice.
Recent Findings: Following trauma, prophylactic, and therapeutic anticoagulation (TAC) have been widely encouraged to prevent major comorbidities such as pulmonary embolism and deep venous thrombosis.
Article Synopsis
- Pain from rib fractures can lead to serious lung issues, and both epidural/paravertebral blocks (EPVBs) and serratus anterior plane blocks (SAPBs) are used for pain management but have different challenges in an ICU setting.
- A study compared the effectiveness of SAPB versus EPVB in critically injured patients with multiple rib fractures, finding that both approaches reduced pain and improved breathing index without showing a significant difference in overall outcomes, although SAPB was easier to perform.
- The study concludes that while both methods were effective, the small sample size limits definitive conclusions and suggests further research is needed to establish the best pain management approach in these cases.
To minimize risk of spinal cord injury, airway management providers must understand the anatomic and functional relationship between the airway, cervical column, and spinal cord. Patients with known or suspected cervical spine injury may require emergent intubation for airway protection and ventilatory support or elective intubation for surgery with or without rigid neck stabilization (i.e.
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