The observations of pallor, sweating, agitation and restlessness, at the time of an injured patient's admission to the resuscitation room, were compared with other more complex indices of injury severity and the ability of each observation to predict mortality was observed. The number of positive observations was significantly related to the Revised Trauma Score and the Injury Severity Score, and pallor was significantly related to mortality. The observation that an injured patient is pale is an important index of severity.
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http://dx.doi.org/10.1016/0020-1383(94)90106-6 | DOI Listing |
JAMA Netw Open
January 2025
Translational Research Center for TBI and Stress Disorders, Veterans Affairs Boston Healthcare System, Boston, Massachusetts.
Importance: There has been a great deal of interest in mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) and their association with one another, yet their interaction and subsequent associations with long-term outcomes remain poorly understood.
Objective: To compare the long-term outcomes of mTBI that occurred in the context of psychological trauma (peritraumatic context) with mTBI that did not (nonperitraumatic context).
Design, Setting, And Participants: This cohort study of post-9/11 US veterans used data from the Translational Research Center for Traumatic Brain Injury and Stress Disorders (TRACTS) study at the Veterans Affairs Boston Healthcare System, which began in 2009; the current study utilized data from baseline TRACTS visits conducted between 2009 and 2024.
JAMA Surg
January 2025
Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.
Importance: In the US, traumatic injuries are a leading cause of mortality across all age groups. Patients with severe trauma often require time-sensitive, specialized medical care to reduce mortality; air transport is associated with improved survival in many cases. However, it is unknown whether the provision of and access to air transport are influenced by factors extrinsic to medical needs, such as race or ethnicity.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Traumatic Brain Injury (TBI) is a major cause of death, disability, and healthcare expenses worldwide. Decompressive craniectomy (DC) is a critical surgery used when there is uncontrollable swelling in the brain following a TBI. Research has shown that 27.
View Article and Find Full Text PDFWhile key for pathogen immobilization, neutrophil extracellular traps (NETs) often cause severe bystander cell/tissue damage. This was hypothesized to depend on their prolonged presence in the vasculature, leading to cytotoxicity. Imaging of NETs (histones, neutrophil elastase, extracellular DNA) with intravital microscopy in blood vessels of mouse livers in a pathogen-replicative-free environment (endotoxemia) led to detection of NET proteins attached to the endothelium for months despite the early disappearance of extracellular DNA.
View Article and Find Full Text PDFShock
January 2025
Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas.
Introduction: The understanding of the interaction of closed-loop control of ventilation and oxygenation, specifically fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP), and fluid resuscitation after burn injury and acute lung injury from smoke inhalation is limited. We compared the effectiveness of FiO2, PEEP, and ventilation adjusted automatically using adaptive support ventilation (ASV) and decision support fluid resuscitation based on urine output in a clinically relevant conscious ovine model of lung injury secondary to combined smoke inhalation and major burn injury.
Methods: Sheep were subjected to burn and smoke inhalation injury under deep anesthesia and analgesia.
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