Risk factors for early suspected ventilator-associated pneumonia in severe thoracic blunt trauma patient: A French national cohort study.

Background: Ventilator-associated pneumonia (VAP) is the most common infection in severely injured patients requiring mechanical ventilation. Chest trauma has been identified as a significant risk factor for VAP. This study aimed to describe the risk factors for early VAP in patients with severe blunt thoracic trauma admitted to the intensive care unit (ICU) and receiving mechanical ventilation.

Comparison of the lethal triad and the lethal diamond in severe trauma patients: a multicenter cohort.

Background: To reduce the number of deaths caused by exsanguination, the initial management of severe trauma aims to prevent, if not limit, the lethal triad, which consists of acidosis, coagulopathy, and hypothermia. Recently, several studies have suggested adding hypocalcemia to the lethal triad to form the lethal diamond, but the evidence supporting this change is limited. Therefore, the aim of this study was to compare the lethal triad and lethal diamond for their respective associations with 24-h mortality in severe trauma patients receiving transfusion.

Effects of intravascular administration of mesenchymal stromal cells derived from Wharton's Jelly of the umbilical cord on systemic immunomodulation and neuroinflammation after traumatic brain injury (TRAUMACELL): study protocol for a multicentre randomised controlled trial.

Introduction: Traumatic brain injury (TBI) is one of the leading causes of death and disability worldwide. Treatments for TBI patients are limited and none has been shown to provide prolonged and long-term neuroprotective or neurorestorative effects. A growing body of evidence suggests a link between TBI-induced neuro-inflammation and neurodegenerative post-traumatic disorders.

MULTIPLE ORGAN FAILURE FOLLOWING SEVERE BATTLE INJURIES DURING RECENT CONFLICTS: A FRENCH RETROSPECTIVE COHORT STUDY.

Introduction : Improvements in combat casualty care have increased survival rates, but these patients are at particular risk of developing multiple organ failure (MOF). We investigated the incidence and severity of MOF in a cohort of severe combat casualties. Materials and Methods : This retrospective study included all on-duty French land army war casualties with a severe combat injury requiring intensive care unit admission during 2009-2023.

Psychological first aid in operation for military healthcare providers : a study on pre-deployment training.

Introduction: During operational missions, while the management of physical injuries in the field remains the priority, the identification of operational incapacity of psychological origin is necessary as it is equally crucial for the safety of the individual, the group and the mission. The French Military Health Service has developed a Psychological First Aid Training in Operation (PFATO) course based on relational simulations, for military service members. The aim is to identify the early signs of psychological distress in a comrade and to adopt an adapted and protective attitude.

The first two years of the use of low titer group O whole blood during French Military overseas operations: A retrospective study.

Background: On the battlefield, hemorrhage is the main cause of potentially preventable death. To reduce mortality due to hemorrhagic injuries, the French Military Medical Service (FMMS) has deployed low titer group O whole blood (LTOWB) since June 2021 during operation BARKHANE in the Sahel-Saharan strip. Questions persist regarding the circumstances under which the FMMS employs LTOWB during overseas operations.

Reactivation of Epstein-Barr virus among intensive care patients: a prospective observational study.

Purpose: Herpesvirus reactivation has been documented among patients in the intensive care unit (ICU) and is associated with increased morbidity and mortality, particularly for cytomegalovirus (CMV). Epstein-Barr virus (EBV) has been poorly studied despite >95% of the population being seropositive. Our preliminary study suggested an association between EBV reactivation and increased morbidity and mortality.

Evaluation of the Pedagogical Impact of "Traum'Cast" Podcast: A Pilot Study Based on Metacognition.

Introduction: With the evolution of educational tools, the French Military medical service has created a podcast program, Traum'Cast, about the principles of war medicine, accessible online for free.

Method: Our objective was to measure the learning effect of the Traum'Cast program's first episode. A non-randomized pilot trial between July and December 2021 included 80 health care providers: 40 in the video podcast group compared to 40 in a group reading a pdf file providing the same information.

Severe hypocalcemia at admission is associated with increased transfusion requirements: A retrospective study in a level 1 trauma center.

Introduction: In recent years, hypocalcemia has been added to the "lethal triad" of the trauma patient, thus constituting the "lethal diamond". Nevertheless, its proper role remains debated. The aim of this study is to evaluate the association between severe hypocalcemia at admission and 24 h- transfusion requirements in severe trauma patients in a level 1 trauma center.

Comparison of Injuries Associated With Electric Scooters, Motorbikes, and Bicycles in France, 2019-2022.

Importance: Electric scooter (e-scooter) use is increasing in France and in many urban environments worldwide. Yet little is known about injuries associated with use of e-scooters.

Objective: To describe characteristics and outcomes of major trauma involving e-scooters.

Profile of injuries in recent warfare.

Background: The epidemiology of French military severe trauma patients injured during recent military operations remains poorly described, even if French operations, casualties sustained, and care rendered in a different trauma system are distinct from others. This study aimed at describing the characteristics of these patients upon arrival at hospital in France and during hospital stay.

Methods: This 5-year retrospective cohort study included all French military servicemen injured during military operations and admitted to the intensive care unit.

Study of the Relationship Between Liver Function Markers and Traumatic Rhabdomyolysis: A Retrospective Study of Hemorrhagic Patients Admitted to Intensive Care Unit in a Level I Trauma Center.

Background: Traumatic rhabdomyolysis (RM) is common and contributes to the development of medical complications, of which acute renal failure is the best described. Some authors have described an association between elevated aminotransferases and RM, suggesting the possibility of associated liver damage. Our study aims to evaluate the relationship between liver function and RM in hemorrhagic trauma patients.

Learning trauma surgery through cytoreductive surgery.

Objectives: Regarding war surgery (WS), the initial and continuing education of French military gastrointestinal surgeons (FMGIS) is considered flawed and inappropriate. This results from the low incidence of gastrointestinal (GI) trauma, its predominantly non-surgical management, and a daily surgical practice that strongly differs from WS. Conversely, cytoreductive surgery (CRS) of peritoneal metastases has similarities with WS which led us to assess its potential contribution to the initial and continuing education of FMGIS in WS.

Analysis of mortality over 7 years in a mature trauma center: evolution of preventable mortality in severe trauma patients.

Purpose: The study of preventable trauma deaths is one mechanism used to examine the quality of care and outcomes of a trauma system. The present study aims to define the rate of preventable (PD) and potentially preventable death (PPD) in our mature trauma center, determine its leading causes, and evaluate the evolution of this rate over the years.

Methods: We performed a retrospective observational study in the Sainte Anne Military Teaching Hospital, Toulon (Var), France.

Who's Who in the Trauma Bay? Association between Wearing of Identification Jackets and Trauma Teamwork Performance: A Simulation Study.

Introduction: Trauma is the leading cause of under-45 mortality worldwide, and the leading cause of years of life lost. To manage the severe trauma patients, trauma teams require both improved technical and nontechnical skills, such as communication, leadership, teamwork, and team resource management. The objective of this study was to measure the impact of the identification of trauma team members on teamwork performance.

Level of Onboard Care for Critical Patients: Analysis of the French Armed Forces Air Medical Evacuations From the Sahel Since 2013.

Objective: Since 2013, the French Armed Forces have been engaged in the Sahel. The aim of our work was to study the characteristics of severe patients evacuated according to the composition of the air medical staff (ie, an anesthesiologist/intensive care physician [AICP] or an emergency physician [EP]).

Methods: This was a retrospective cohort analysis including all French service members repatriated from the Sahel with a speedy evacuation priority between 2013 and 2019.

Machine learning-based prediction of emergency neurosurgery within 24 h after moderate to severe traumatic brain injury.

Background: Rapid referral of traumatic brain injury (TBI) patients requiring emergency neurosurgery to a specialized trauma center can significantly reduce morbidity and mortality. Currently, no model has been reported to predict the need for acute neurosurgery in severe to moderate TBI patients. This study aims to evaluate the performance of Machine Learning-based models to establish to predict the need for neurosurgery procedure within 24 h after moderate to severe TBI.

Step by step transfusion timeline and its challenges in trauma: A retrospective study in a level one trauma center.

Background: Hemorrhagic shock is the leading cause of preventable early death in trauma patients. Transfusion management is guided by international guidelines promoting early and aggressive transfusion strategies. This study aimed to describe transfusion timelines in a trauma center and to identify key points to performing early and efficient transfusions.

Risk Analysis by Failure Modes, Effects and Criticality Analysis and Biosafety Management During Collective Air Medical Evacuation of Critically Ill Coronavirus Disease 2019 Patients.

In March 2020, coronavirus disease 2019 (COVID-19) caused an overwhelming pandemic. To relieve overloaded intensive care units in the most affected regions, the French Ministry of Defence triggered collective air medical evacuations (medevacs) on board an Airbus A330 Multi Role Tanker Transport of the French Air Force. Such a collective air medevac is a big challenge regarding biosafety; until now, only evacuations of a single symptomatic patient with an emergent communicable disease, such as Ebola virus disease, have been conducted.

Withholding and withdrawal of life-sustaining therapy in 8569 trauma patients: A multicentre, analytical registry study.

Background: This study aimed to determine the prevalence of withholding or withdrawal of life-sustaining therapy (WLST) decisions in trauma ICU patients, using a large registry. We hypothesised that this prevalence is similar to that of the general population admitted to an ICU. As secondary aims, it sought to describe the trauma patients for whom the decision was made for WLST and the factors associated with this decision.

Blunt Traumatic Aortic Injury Management, a French TraumaBase Analytic Cohort.

Objective: Blunt traumatic aortic injury (BTAI) in severe trauma patients is rare but potentially lethal. The aim of this work was to perform a current epidemiological analysis of the clinical and surgical management of these patients in a European country.

Methods: This was a multicentre, retrospective study using prospectively collected data from the French National Trauma Registry and the National Uniform Hospital Discharge Database from 10 trauma centres in France.

Learning from terrorist mass casualty incidents: a global survey.

Background: Reports published directly after terrorist mass casualty incidents frequently fail to capture difficulties that may have been encountered. An anonymised consensus-based platform may enable discussion and collaboration on the challenges faced. Our aim was to identify where to focus improvement for future responses.