Achieving balanced transfusion early in critically bleeding trauma patients: an observational study exploring the effect of attending trauma surgical presence during resuscitation.

Background: After 15 years of damage control resuscitation (DCR), studies still report high mortality rates for critically bleeding trauma patients. Adherence to massive hemorrhage protocols (MHPs) based on a 1:1:1 ratio of plasma, platelets, and red blood cells (RBCs) as part of DCR has been shown to improve outcomes. We wanted to assess MHP use in the early (6 hours from admission), critical phase of DCR and its impact on mortality.

Improvement in geriatric trauma outcomes in an evolving trauma system.

Background: The elderly trauma patient has increased mortality compared with younger patients. During the last 15 years, initial treatment of severely injured patients at Oslo University Hospital Ulleval (OUHU) has changed resulting in overall improved outcomes. Whether this holds true for the elderly trauma population needs exploration and was the aim of the present study.

Decreased mortality, laparotomy, and embolization rates for liver injuries during a 13-year period in a major Scandinavian trauma center.

Background: Although non-operative management (NOM) has become the treatment of choice in hemodynamically normal patients with liver injuries, the optimal management of Organ Injury Scale (OIS) grades 4 and 5 injuries is still controversial. Oslo University Hospital Ulleval (OUHU) has since 2008 performed angiography only with signs of bleeding. Simultaneously, damage control resuscitation was implemented.

Reduced need for extraperitoneal pelvic packing for severe pelvic fractures is associated with improved resuscitation strategies.

Background: Extraperitoneal pelvic packing (EPP) was introduced at Oslo University Hospital Ulleval (OUHU) in 1994. Published studies from other institutions have advocated its application as a first-line therapy in lieu of angiography. Extraperitoneal pelvic packing is invasive with a high risk of complications, and its role remains an issue of discussion.

[Knee luxation--follow-up after surgery].

Background: Traumatic dislocation is the most severe ligamentous injury of the knee. The traditional definition of knee dislocations has been expanded to include bicruciate knee injuries with one or both lateral ligaments injured, even when the knee is reduced on initial presentation. Surgical treatment is internationally well accepted.