French practice of emergency resuscitative thoracotomy. A study based on the Traumabase Registry.

Aim Of The Study: Emergency resuscitative thoracotomy (ERT) has been described as a potentially life-saving procedure for trauma patients who have been admitted in refractory shock or with recent loss of sign of life (SOL). This nationwide registry analysis aimed to describe the French practice of ERT.

Patients And Methods: From 2015 to 2021, all severe trauma patients who underwent ERT were extracted from the TraumaBase→ registry.

EuroTrauma, delays in access to bleeding control. A comparison between a conventional and a hybrid trauma center, both European military trauma centers.

Purpose: Comparison of access times to CT and surgical/radiological bleeding control between two European military trauma centers.

Methods: Retrospective and observational study conducted in two military level 1 trauma centers in Toulon (France) and Koblenz (Germany) between 2013 and 2018. Inclusion of severe trauma patients with ISS > 15 with clinical and biological criteria of bleeding.

Independent factors of preventable death in a mature trauma center: a propensity-score analysis.

Introduction: The rate of potentially preventable deaths (PPD) and preventable deaths (PD) can reach more than 20% of overall trauma mortality. Bleeding is the leading cause of preventable mortality. The aim of our study is to define the independent factors of preventable or potentially preventable mortality in our mature trauma system.

Analysis of mortality over 7 years in a mature trauma center: evolution of preventable mortality in severe trauma patients.

Purpose: The study of preventable trauma deaths is one mechanism used to examine the quality of care and outcomes of a trauma system. The present study aims to define the rate of preventable (PD) and potentially preventable death (PPD) in our mature trauma center, determine its leading causes, and evaluate the evolution of this rate over the years.

Methods: We performed a retrospective observational study in the Sainte Anne Military Teaching Hospital, Toulon (Var), France.

Lung-Dependent Areas Collapse, Monitored by Electrical Impedance Tomography, May Predict the Oxygenation Response to Prone Ventilation in COVID-19 Acute Respiratory Distress Syndrome.

Objectives: ICUs have had to deal with a large number of patients with acute respiratory distress syndrome COVID-19, a significant number of whom received prone ventilation, which is a substantial consumer of care time. The selection of patients that we have to ventilate in prone position seems interesting. We evaluate the correlation between the percentage of collapsed dependent lung areas in the supine position, monitoring by electrical impedance tomography and the oxygenation response (change in Pao2/Fio2 ratio) to prone position.

Early packed red blood cell transfusion in major trauma patients: Evaluation and comparison of different prediction scores for massive transfusion.

Background And Objectives: Our study sought to evaluate and compare different prediction scores for massive transfusion in-hospital packed red blood cell (PRBC) transfusions.

Materials And Methods: Between January 2013 and December 2018, 1843 trauma patients were enrolled in the registry of a level-1 trauma centre. All prehospital and in-hospital variables needed to calculate the Shock Index and RED FLAG, Assessment of Blood Consumption (ABC) and Trauma Associated Severe Hemorrhage (TASH) scores were prospectively collected in the registry.

A REBOA Complication: EtCO Is Not Just a Marker of Cardiac Output.

We describe an as yet undescribed complication, namely, the perforation of the balloon at a distance from its introduction and the use of EtCO to suspect the diagnosis. Following a high-kinetic motorcycle accident, a 25-year-old patient was admitted in our level 1 trauma center, and benefited from a resuscitation thoracotomy followed by a REBOA catheter in zone 3. The use of a small caliber introducer could be responsible for balloon injury.

Civilian prehospital transfusion - experiences from a French region.

Background And Objectives: Haemorrhagic shock is a leading cause of avoidable mortality in prehospital care. For several years, our centre has followed a procedure of transfusing two units of packed red blood cells outside the hospital. Our study's aim was twofold: describe the patient characteristics of those receiving prehospital blood transfusions and analyse risk factors for the 7-day mortality rate.

Fibrin monomers and association with significant hemorrhage or mortality in severely injured trauma patients.

Background: Post-traumatic hemorrhage is still the leading cause of potentially preventable death in patients with severe trauma. Traumatic-induced coagulopathy has been described as a risk factor for significant hemorrhage and mortality in this population. Fibrin monomers (FMs) are a direct marker of thrombin action, and thus reflect coagulation activation.

In COPD, Nocturnal Noninvasive Ventilation Reduces the FIO2 Delivered Compared With Long-Term Oxygen Therapy at the Same Flow.

Background: Nocturnal noninvasive ventilation is recommended for patients with hypercapnic COPD. Long-term oxygen therapy improves survival in patients with hypoxemic disease. However, leaks during noninvasive ventilation are likely to reduce the fraction of inspired oxygen.

Monte Carlo dosimetry of a realistic multicellular model of follicular lymphoma in a context of radioimmunotherapy.

Purpose: Small-scale dosimetry studies generally consider an artificial environment where the tumors are spherical and the radionuclides are homogeneously biodistributed. However, tumor shapes are irregular and radiopharmaceutical biodistributions are heterogeneous, impacting the energy deposition in targeted radionuclide therapy. To bring realism, we developed a dosimetric methodology based on a three-dimensional in vitro model of follicular lymphoma incubated with rituximab, an anti-CD20 monoclonal antibody used in the treatment of non-Hodgkin lymphomas, which might be combined with a radionuclide.

Maintaining a high inspired oxygen fraction with the Elisée 350 turbine transport ventilator connected to two portable oxygen concentrators in an austere environment.

Background: Management of critically ill patients requiring mechanical ventilation in austere environments or during disaster response is a logistic challenge. Availability of oxygen cylinders for mechanically ventilated patient may be difficult in such a context. A solution to ventilate patients requiring high fraction of inspired oxygen (FiO2) is to use a ventilator able to be supplied by a low-pressure oxygen source connected with two oxygen concentrators (OCs).

Acute respiratory distress syndrome in the forward environment. Retrospective analysis of acute respiratory distress syndrome cases among French Army war casualties.

Background: According to the Joint Theater Trauma Registry, 26% to 33% of war casualties develop acute respiratory distress syndrome (ARDS), with high mortality. Here, we aimed to describe ARDS incidence and severity among patients evacuated from war zones and admitted to French intensive care units (ICUs).

Methods: We performed an observational retrospective multicentric review of all patients evacuated from war zones and admitted to French ICUs between 2003 and 2018.

The Site of Oxygen Delivery Into a Home Ventilator Affects Recorded Volumes.

Background: Long-term home mechanical ventilation is increasingly used by patients with chronic respiratory failure. Storage of medical data in the cloud is expanding, and ventilation can be monitored remotely. The aim of this bench study was to determine whether tidal volume (V) can be affected by the location of supplemental oxygen placement.

Rapid sequence induction traceability in an ICU dedicated patient data management system: a multicentric retrospective study.

Purpose: Patient data management systems (PDMS) are widely used in intensive care units (ICUs) to improve care traceability. Verbal orders are still used for prescriptions requiring immediate execution but should be subsequently recorded in the system. We assessed the rapid sequence induction (RSI) traceability for endotracheal intubation in an ICU dedicated PDMS.

Anesthesia during deployment of a military forward surgical unit in low income countries: A register study of 1547 anesthesia cases.

Background: Military anesthesia meets unique logistical, technical, tactical, and human constraints, but to date limited data have been published on anesthesia management during military operations.

Objective: This study aimed to describe and analyze French anesthetic activity in a deployed military setting.

Methods: Between October 2015 and February 2018, all patients managed by Sainte-Anne Military Hospital anesthesiologists deployed in mission were included.

Correlation between field triage criteria and the injury severity score of trauma patients in a French inclusive regional trauma system.

Background: In France, the pre-hospital field triage of trauma patients is currently based on the Vittel criteria algorithm. This algorithm was originally created in 2002 before the stratification of trauma centers and, at the national level, has not been revised since. This could be responsible for the overtriage of trauma patients in Level I Trauma Centers.