OBJECTIVE To evaluate the association between pulmonary artery catheter (PAC) use and mortality in a large cohort of injured patients. We hypothesized that PAC use is associated with improved survival in critically injured trauma patients. DESIGN Retrospective database analysis. SETTING A total of 268 level 1 trauma centers from across the United States. PATIENTS A total of 53,312 patient...

Objective: To determine how well neonatal blood base excess and lactate predict outcome following perinatal asphyxia. Study Design: Over 68 months, with around 9000 deliveries, lactate was measured on all blood gases taken from neonatal admissions, as well as mineral base and organic acid whenever electrolytes were required. Infants were classified according to their outcome more than 10 years ...

PURPOSE Sonography provides a fast, portable, and noninvasive method for patient assessment. However, the benefit of providing real-time ultrasound (US) imaging and fluid quantification shortly after patient arrival has not been explored. The objective of this study was to prospectively validate a US hemoperitoneum scoring system developed at our institution and determine whether sonography can...

BACKGROUND Traumatic brain injury (TBI) is believed to cause more profound trauma-induced coagulopathy than other injuries of comparable severity. This has not been reported in a large series of combat casualties in which penetrating injuries predominate. METHODS Among US combat casualties severely injured in Iraq and Afghanistan who received transfused blood products, isolated TBI patients (...

We studied gut mucosal perfusion in 24 neonates requiring cardiopulmonary bypass (CPB). Group A patients (n = 12) had obstruction to their aorta such that gut perfusion before operation was dependent on flow through a ductus arteriosus (DA). Group B neonates were of similar age and size and required a similar duration of CPB, but did not have a DA. An orogastric tonometer allowed intermittent c...

BACKGROUND The trauma and injury severity score (TRISS) and Acute Physiology and Chronic Health Evaluation IV (APACHE IV) are accurate but complex. This study aimed to compare venous glucose, levels of serum lactate, and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients versus (TRISS) and (APACHE IV). METHODS This was a comparative cross-...

Evidence is increasing that oxygen debt and its metabolic correlates are important quantifiers of the severity of hemorrhagic and post-traumatic shock and and may serve as useful guides in the treatment of these conditions. The aim of this review is to demonstrate the similarity between experimental oxygen debt in animals and human hemorrhage/post-traumatic conditions, and to examine metabolic ...