Splenic Embolization After Trauma: An Opportunity to Improve Best Immunization Practices.

Background: The spleen is the second most commonly injured solid organ during blunt abdominal trauma. Although total splenectomy is frequently performed for injury, splenic rupture can also be managed by splenic embolization. For these patients, current Advisory Committee on Immunization Practices (ACIP) recommendations indicate that if 50% or more of the splenic mass is lost, patients should be treated as though they are asplenic.

Mild hyperglycemia, but not glucagon-like peptide 1 predicts poor outcome after injury.

Background: Loss of glucose homeostasis occurs frequently in injured patients. Glucagon-like peptide-1 (GLP-1) is a gut-derived incretin hormone that stimulates insulin and decreases glucagon secretion. The impact of the incretin system on glycemic control in injured patients has not been extensively studied.

Predicting outcome of patients with chest wall injury.

Background: Rib fractures occur in 10% of injured patients, are associated with morbidity and mortality, and frequently necessitate intensive care unit (ICU) care. A scoring system that identifies the risk for respiratory failure early in the evaluation process may allow early intervention to improve outcomes. The aim of this study was to test the hypothesis that a scoring system based on initial clinical findings can identify patients with rib fractures at greatest risk for morbidity and mortality.

Admission ionized calcium levels predict the need for multiple transfusions: a prospective study of 591 critically ill trauma patients.

Background: Deaths from uncontrolled exsanguinating hemorrhage occur rapidly postinjury. Any successful resuscitation strategy must also occur early, underscoring the importance of rapid identification of patients at risk for multiple transfusions. Previous studies have shown low ionized calcium (iCa) levels to be associated with hypotension and function as a predictor of mortality.