Could machine learning algorithms help us predict massive bleeding at prehospital level?

Objective: Comparison of the predictive ability of various machine learning algorithms (MLA) versus traditional prediction scales (TPS) for massive hemorrhage (MH) in patients with severe traumatic injury (STI).

Design: On a database of a retrospective cohort with prehospital clinical variables and MH outcome, a treatment of the database was performed to be able to apply the different AML, obtaining a total set of 473 patients (80% training, 20% validation). For modeling, proportional imputation and cross validation were performed.

The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database.

Elevated monocyte distribution width in trauma: An early cellular biomarker of organ dysfunction.

Introduction: Traumatic injury elicits an inflammatory response such as the one occurring during systemic infection. Monocyte distribution width (MDW) has been found to distinguish sepsis in a pool of patients with suspected infection. We hypothesized that an elevated MDW in trauma patients would be associated with the development of multiple organ dysfunction syndrome (MODS) and an increased mortality.

[The efficacy of caloric intake in critically ill patients with traumatic pathology].

Background: the effective contribution of enteral nutrition (EN) in intensive care units (ICU) is due to multiple factors.

Objectives: to determine the efficacy of caloric intake in critically ill patients with traumatic pathology receiving enteral nutrition, and to analyze cause and time of interruption of EN.

Method: prospective observational study (November 2015 - August 2016).

[Emergency treatment for traumatic cardiac arrest: prognostic factors and hospital outcome].

Objectives: To identify prehospital and on-arrival factors associated with hospital outcome in patients with traumatic cardiac arrest (TCA) discharged with recovered spontaneous circulation from the emergency department.

Material And Methods: Multipurpose prospective cohort study of patients with TCA who recovered after treatment at a tertiary care hospital emergency department between 2003 and 2016. We gathered data on epidemiologic variables, type and cause of injuries, and prehospital and hospital emergency care.

Do men perform better than women in trauma?

In recent decades, numerous studies have compared survival according to gender of patients admitted to general hospitals and particularly to intensive care units. In a previous issue of Critical Care, Schoeneberg and colleagues presented the results of a German observational study on a sample from a 10 year registry in a Level 1 trauma center. The conclusion is that there is a trend towards a higher mortality in women than in men.

Damage control orthopaedics in severe polytrauma with femur fracture.

Objective: To evaluate the rate of systemic complications and mortality in severe polytrauma patients with associated femur fracture treated by early external fixation of femur.

Patients And Methodology: We made a retrospective cohort study with forty-one adult multitrauma patients (New Injury Severity Score ≥ 19) with femur fracture treated by external fixation following Damage Control Orthopaedic surgery. The mortality rates, TRISS analysis, incidence of ARDS and MOF were analysed.

Kidney in danger: CT findings of blunt and penetrating renal trauma.

Approximately 10% of all significant blunt abdominal traumatic injuries manifest with renal injury, although it is usually minor. However, renal imaging is indicated in cases of gross hematuria, penetrating trauma with gross or microscopic hematuria, and blunt trauma and shock with gross or microscopic hematuria. Contrast material-enhanced computed tomography (CT) is the imaging modality of choice in the evaluation and management of renal trauma.

[Injury pattern in all-terrain vehicle accidents].

Objective: To define the epidemiological and injury profile of patients severely injured due to all-terrain vehicle accidents admitted to the Trauma ICU of a tertiary hospital.

Methods: Descriptive observational study including all patients admitted to our ICU who suffered an all-terrain vehicle accident in the last three years, included prospectively in our data base. We recorded demographic variables, clinical condition at admission, outcome, injury pattern, severity scores and survival probability by TRISS.

[Pressure sores secondary to immobilization with cervical collar: a complication of acute cervical injury].

Cervical collars are essential in the treatment of patients with suspicion or verification of acute cervical spine injury (ACSI). One of the complications of these devices is the development of pressure scores (PS). This study aims to determine its incidence in our unit, the characteristics of patients with ACSI who suffer PS due to the collar and to describe aspects related with these injuries.

[Critical care nursing and continuous renal replacement techniques in the Madrid Community].

The continuous renal replacement techniques (CRRT) aim to substitute the altered renal function during a period of time, presenting advantages compared to conventional hemodialysis (CH). This study aims to determine the situation of the CRRT in the Intensive care units (ICU) of the Madrid Community (MC) using a survey distributed to nurses (n = 131) of 14 ICU. It evaluates four aspects of the CRRT: management model, knowledge, problems and degree of satisfaction.