The contemporary use of emergency pericardiocentesis in trauma: A nationwide trend analysis.

Background: Pericardiocentesis is a critical skill taught by the Advanced Trauma Life Support (ATLS®) course, yet substantial knowledge gaps exist regarding recent practice changes and indications for pericardiocentesis. This study aims to characterize contemporary practice patterns and nationwide trends in the use of emergency pericardiocentesis in trauma.

Methods: A retrospective study of the National Trauma Data Bank (2011-2022) identified patients undergoing pericardiocentesis within 48 h of arrival prior to any cardiac repair surgery.

Primary repair versus resection for American Association for the Surgery of Trauma grades I and II colon injuries: Does the management approach really matter? An Eastern Association for the Surgery of Trauma multicenter trial.

Background: The management of traumatic low-grade (American Association for the Surgery of Trauma [AAST] grades I and II) colon injuries has evolved. Recent data suggest that primary repair (PR) or resection over colostomy decreases morbidity and mortality. However, data comparing patients undergoing PR versus resection with anastomosis (RWA) are lacking.

Impact of Systemic Anticoagulation During Traumatic Peripheral Arterial Repair on Re-Intervention and Amputation: An Analysis of 11 Years of PROOVIT Data.

IntroductionSystemic anticoagulation (SAC) is widely used during peripheral arterial repair (PAR) to mitigate thrombotic risks, but its efficacy in trauma patients remains unclear. This study evaluated the association of SAC with re-intervention and amputation rates in traumatic PAR.MethodsThis retrospective study queried the Prospective Observational Vascular Injury Treatment (PROOVIT) database (2012-2023) for traumatic PAR cases.

Hyperfibrinolysis: a crucial phenotypic abnormality of posttraumatic fibrinolytic dysfunction.

Background: Traumatic fibrinolytic dysfunction is often categorized into 3 phenotypes based on the result of thromboelastography (TEG) lysis at 30 minutes (LY30): fibrinolysis shutdown, physiologic fibrinolysis, and hyperfibrinolysis. However, the molecular pathophysiology of fibrinolytic dysfunction and the association with clinical outcomes have not been fully evaluated.

Objectives: To assess whether posttraumatic fibrinolysis phenotypes identified by TEG correlate with levels of key fibrinolysis-related serum markers and with risk of mortality and hospital complications.

Mentorship of Junior Surgical Faculty Across Academic Programs in Surgery.

Importance: Because mentorship is critical for professional development and career advancement, it is essential to examine the status of mentorship and identify challenges that junior surgical faculty (assistant and associate professors) face obtaining effective mentorship.

Objective: To evaluate the mentorship experience for junior surgical faculty and highlight areas for improvement.

Design, Setting, And Participants: This qualitative study was an explanatory sequential mixed-methods study including an anonymous survey on mentorship followed by semistructured interviews to expand on survey findings.

Inadequate Venous Thromboembolism Chemoprophylaxis Is Associated With Higher Venous Thromboembolism Rates Among Trauma Patients With Epidurals.

Introduction: Guidelines encourage higher doses of low molecular weight heparin (LMWH) for prophylaxis in trauma patients. The risks of LMWH must be considered for patients who require an epidural catheter. We compared adequate and inadequate prophylaxis to determine if venous thromboembolism (VTE) and complication rates differed among patients with epidural catheters.

Logistics of managing a trauma whole blood inventory in a civilian level 1 trauma center.

Background: Institutional data on initiating and maintaining a low-titer O positive whole blood (LTOWB) inventory for the civilian trauma sector may help other institutions start a LTOWB program. This study from a level 1 trauma center with a hospital-based donor center highlights challenges faced during the collection, maintenance, and utilization of LTOWB.

Study Design And Methods: Male O positive donors with low (≤1:100) anti-A and anti-B antibody titers were recruited for LTOWB collection.

No Resuscitative Thoracotomy? When to Stop Chest Compressions After Prehospital Traumatic Cardiac Arrest.

Introduction: Although indications and outcomes for trauma patients who require resuscitative thoracotomies are well studied, little is known about how prehospital chest compressions support survival in patients who do not meet criteria for subsequent resuscitative thoracotomy.

Methods: Data from a single institutional retrospective review of trauma patients who required prehospital chest compressions from 1/2015 to 12/2020 were collected. Patients who underwent compressions only were compared to those who underwent subsequent resuscitative thoracotomy.

Complications and Transfusions on Therapeutic Anticoagulation After Trauma.

Introduction: Trauma patients who develop indications for therapeutic anticoagulation (TAC) present a challenge due to concern for bleeding. Transfusion requirement has been described as a common complication of TAC after trauma but its clinical relevance is unclear.

Objective: Determine risk factors for and clinical outcomes associated with transfusion requirement on TAC after trauma.

Which Pelvic Fractures Are Associated With Extravasation on Angiography?

Background: Bleeding from pelvic fractures can result in a high mortality rate unless quickly triaged by the trauma surgeon. Upon presentation, pelvic radiography may identify fractures that require angiography with possible embolization. We sought to address which fracture patterns seen on initial x-ray are associated with extravasation on angiography.

A pilot study of stored low titer group O whole blood + component therapy versus component therapy only for civilian trauma patients.

Background: This pilot assessed transfusion requirements during resuscitation with whole blood followed by standard component therapy (CT) versus CT alone, during a change in practice at a large urban Level I trauma center.

Methods: This was a single-center prospective cohort pilot study. Male trauma patients received up to 4 units of cold-stored low anti-A, anti-B group O whole blood (LTOWB) as initial resuscitation followed by CT as needed (LTOWB + CT).

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA).