General Surgery & Trauma
M-A | Accuracy of diagnostic tests in cardiac injury after blunt chest trauma
6 Jun, 2023 | 14:15h | UTC
WSES consensus guidelines on sigmoid volvulus management
5 Jun, 2023 | 13:19h | UTCWSES consensus guidelines on sigmoid volvulus management – World Journal of Emergency Surgery
Guideline | Assessment and early management of head injury
23 May, 2023 | 13:11h | UTCHead injury: assessment and early management – NICE
Commentary: NICE head injury guidelines 2023: Now who do we scan? – St Emilyn’s
Consensus Paper | The new timing in acute care surgery (new TACS) classification
16 May, 2023 | 14:56h | UTC
Brief Review | Coagulation support during perioperative bleeding management
15 May, 2023 | 13:01h | UTCCoagulation support during perioperative bleeding management – Intensive Care Medicine
Commentary on Twitter
Coagulation & perioperative bleeding
?fibrinogen source/dose/time
?Ca++: just vs citrated blood products?
?PCCs/factor concentrates
?TXA
?plasma: volume or coagulation?
?PLTs as primary components
?RBCs not just DO2
?targeted coagulation support
?️ https://t.co/lv1i5GoHBg pic.twitter.com/8BtuAE6gt8— Intensive Care Medicine (@yourICM) May 13, 2023
RCT | Early NIV and HFNO therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients
10 May, 2023 | 15:48h | UTC
ESTES recommendation on thoracolumbar spine fractures
10 May, 2023 | 15:40h | UTC
Study shows unenhanced CT shows 30% lower diagnostic accuracy in abdominal pain evaluation
9 May, 2023 | 15:02h | UTCDiagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department – JAMA Surgery (free for a limited period)
Editorial: Intravenous Contrast in Computed Tomography Imaging for Acute Abdominal Pain – JAMA Surgery (free for a limited period)
Commentary: New data suggest clinicians should think twice before foregoing contrast-enhanced imaging – Health Imaging
Commentary on Twitter
In a general population of emergency department patients with abdominal pain, using unenhanced CT to avoid risks of intravenous contrast medium administration is associated with a large diagnostic penalty. https://t.co/CVg04763yd
— JAMA Surgery (@JAMASurgery) May 3, 2023
Pre-post study | Effects of a standardized perioperative management protocol in acute abdominal surgery
5 May, 2023 | 15:10h | UTC
RCT | Craniotomy and decompressive craniectomy yield comparable outcomes in acute subdural hematoma
2 May, 2023 | 13:51h | UTCDecompressive Craniectomy versus Craniotomy for Acute Subdural Hematoma – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: International study recommends replacing skull section after treatment for a brain bleed – University of Cambridge
Commentary on Twitter
Presented at #AANS2023: In an international trial involving 450 patients with acute subdural hematoma, craniotomy (replacing bone flap) and decompressive craniectomy (removing bone flap) yielded similar disability results at 12 months. https://t.co/KoNebwQIsi#neurosurgery pic.twitter.com/t9E9YZeHyq
— NEJM (@NEJM) April 23, 2023
RCT | The effectiveness of early surgical stabilization for multiple rib fractures
26 Apr, 2023 | 14:01h | UTCRelated:
RCT | Operative vs. nonoperative treatment of acute unstable chest wall injuries.
RCT | Rib fixation is not beneficial for non–ventilator-dependent chest wall injuries.
Pro-Con Debate | Peripheral nerve blockade should be provided routinely in extremity trauma
25 Apr, 2023 | 14:31h | UTCPro-Con Debate: Peripheral Nerve Blockade Should Be Provided Routinely in Extremity Trauma, Including in Patients At Risk for Acute Compartment Syndrome – Anesthesia & Analgesia (free for a limited period)
Prehospital guidelines for the management of traumatic brain injury
24 Apr, 2023 | 13:45h | UTC
Cohort Study | Prehospital end-tidal CO2 levels and mortality in suspected severe traumatic brain injury patients
24 Apr, 2023 | 13:35h | UTCEditorial: Prehospital ventilation targets in severe traumatic brain injury – Intensive Care Medicine
Commentary on Twitter
Prehospital etCO2 in severe #TBI, BRAIN-PROTECT study
? L-shaped association with mortality
? 35-45 mmHg seems reasonable target: lower ETCO2? sharp mortality ⬆️
?️ https://t.co/DC0DoHa00NWith editorial on MV targets & reliability of available data
?️ https://t.co/jVZ4zZVHxv pic.twitter.com/74vKxjyGpA— Intensive Care Medicine (@yourICM) April 20, 2023
RCT | Peri-intubation hypoxia after delayed vs. rapid sequence intubation in critically injured patients on arrival to trauma triage
24 Apr, 2023 | 13:04h | UTCPeri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial – Anesthesia & Analgesia (link to abstract – $ for full-text)
Review | The management of pregnant trauma patients
24 Apr, 2023 | 13:01h | UTCThe Management of Pregnant Trauma Patients: A Narrative Review – Anesthesia & Analgesia (free for a limited period)
See also: Infographic (free for a limited period)
RCT | Effectiveness of nail bed repair in children with vs. without replacing the fingernail
4 Apr, 2023 | 13:33h | UTCNews Release: New approach to nail bed injury surgery could significantly cut NHS costs – University of Oxford
Review | Acute respiratory distress syndrome, mechanical ventilation, and inhalation injury in burn patients
3 Apr, 2023 | 13:38h | UTC
M-A | Incidence of multiple organ failure in adult polytrauma patients
30 Mar, 2023 | 13:30h | UTC
Practice Guidance | On-site treatment of avalanche victims
28 Mar, 2023 | 14:48h | UTC
Position Paper | Prehospital hemorrhage control and treatment by clinicians
27 Mar, 2023 | 13:20h | UTC
Phase 2b RCT | Efficacy and safety of PL-5 (Peceleganan) spray for wound infections
27 Mar, 2023 | 13:08h | UTC
Cohort Study | Association between motor vehicle crashes and adverse maternal outcomes in pregnancy
24 Mar, 2023 | 12:54h | UTCMaternal outcomes in association with motor vehicle crashes during pregnancy: a nationwide population-based retrospective study – Injury Prevention (link to abstract – full text may be available here)
News Release: Pregnant women in traffic collisions at heightened risk of birth complications – BMJ Newsroom
M-A | Efficacy of intraosseous access for trauma resuscitation
23 Mar, 2023 | 12:52h | UTC
RCT | 4F-PCC fails to reduce blood product consumption and raises thromboembolic events in trauma patients
22 Mar, 2023 | 13:41h | UTCSummary: The PROCOAG Randomized Clinical Trial aimed to investigate the efficacy and safety of 4-factor prothrombin complex concentrate (4F-PCC) in trauma patients at risk of massive transfusion. Conducted in 12 French trauma centers, this double-blind, randomized, placebo-controlled superiority trial involved 324 patients. All patients were treated according to European traumatic hemorrhage guidelines and received early ratio-based transfusion (packed red blood cells:fresh frozen plasma ratio of 1:1 to 2:1). The primary outcome measured was 24-hour blood product consumption (efficacy), while arterial or venous thromboembolic events were assessed as a secondary outcome (safety).
The trial revealed no significant difference in 24-hour blood product consumption between the 4F-PCC and placebo groups, with median consumption of 12 units and 11 units, respectively. However, the study identified a statistically significant higher risk of thromboembolic events in the 4F-PCC group, with 35% of patients experiencing at least one event compared to 24% in the placebo group.
In conclusion, the study found no beneficial effect of incorporating 4F-PCC into a ratio-based transfusion strategy for patients with severe trauma at risk of massive transfusion. Furthermore, the higher rate of thromboembolic events in the 4F-PCC group indicated potential harm. The findings do not support the routine use of 4F-PCC in patients experiencing trauma who are at risk for extensive transfusion.
Article: Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
