Article
Critical Care Medicine
Teodor Svedung Wettervik, Erta Beqiri, Anders Hanell, Stefan Yu Bogli, Michal Placek, Mathew R. Guilfoyle, Adel Helmy, Andrea Lavinio, Ronan O'Leary, Peter J. Hutchinson, Peter Smielewski
Summary: The study examined the impact of threshold insults on brain tissue oxygenation (pbtO(2)) in traumatic brain injury (TBI), and found that lower pbtO(2) levels were associated with unfavorable outcomes and mortality. The study also highlighted the importance of considering concurrent disturbances in cerebral physiological variables when assessing the impact of low pbtO(2). Prospective trials are needed to further investigate the potential benefits of pbtO(2)-directed therapy and determine individualized threshold values.
Article
Neurosciences
Sami Barrit, Mejdeddine Al Barajraji, Salim El Hadweh, Olivier Dewitte, Nathan Torcida, Joachim Andre, Fabio Silvio Taccone, Sophie Schuind, Elisa Gouvea Bogossian
Summary: PbtO(2)-guided therapy can improve the neurological outcome of traumatic brain injury patients. A retrospective analysis was conducted on severe TBI patients, comparing the outcomes of those who received ICP-guided therapy versus those who received ICP/PbtO(2) guided therapy. Significant differences were found in the occurrence of ICP, ICU length of stay, and Glasgow Coma Scale at ICU discharge.
Article
Critical Care Medicine
Teodor Svedung Wettervik, Erta Beqiri, Stefan Yu Boegli, Michal Placek, Mathew R. Guilfoyle, Adel Helmy, Andrea Lavinio, Ronan O'Leary, Peter J. Hutchinson, Peter Smielewski
Summary: The study aimed to explore the association between global cerebral physiological variables and brain tissue oxygenation in traumatic brain injury (TBI). The results showed that pbtO(2) < 20 mmHg was relatively frequent and often occurred independently of disturbances in ICP, PRx, CPP, and increment CPPopt. The findings suggest that hypoxic pbtO2 is a complex and independent pathophysiological event.
Article
Clinical Neurology
Dmitriy Petrov, Stephen P. Miranda, Ramani Balu, Connor Wathen, Alex Vaz, Vinodh Mohan, Christian Colon, Ramon Diaz-Arrastia
Summary: The objective of this study was to develop an algorithm capable of predicting the onset of intracranial pressure (ICP) crises in patients with severe traumatic brain injury (TBI). The random forest model demonstrated the highest accuracy and area under the curve (AUC) in predicting ICP crises. If implemented in clinical workflows, this algorithm can enable earlier intervention and more effective treatment of intracranial hypertension, potentially leading to improved outcomes for patients with severe TBI.
JOURNAL OF NEUROSURGERY
(2023)
Article
Pediatrics
Damla Hanalioglu, Ann Oh, M'Hamed Temkit, P. David Adelson, Brian Appavu
Summary: The study investigated the relationship between partial pressure of brain tissue oxygenation (PbtO(2)) and end-tidal carbon dioxide (EtCO2) after pediatric traumatic brain injury (TBI). The results showed a positive association between PbtO(2) and EtCO2, indicating intact CO2 reactivity. Additionally, the study found different associations between PbtO(2) and intracranial pressure (ICP), arterial blood pressure (ABP), and cerebral regional oximetry (rSO(2)).
Article
Critical Care Medicine
Daniel Agustin Godoy, Francisco Murillo-Cabezas, Jose Ignacio Suarez, Rafael Badenes, Paolo Pelosi, Chiara Robba
Summary: To ensure neuronal survival after severe traumatic brain injury, sufficient oxygen supply is crucial. Cerebral tissue oxygenation, which is determined by multiple physiological parameters, reflects the adequacy of cerebral perfusion. Brain tissue hypoxia occurs when oxygen supply is inadequate or cannot be utilized at the cellular level. Precision medicine and multimodal monitoring are important in individualized therapeutic interventions for specific brain damage.
Article
Clinical Neurology
Gwan Jin Park, Young Sun Ro, Hanna Yoon, Stephen Gyung Won Lee, Eujene Jung, Sung Bae Moon, Sang Chul Kim, Sang Do Shin
Summary: This study evaluated the prognostic value of vitamin E on functional outcomes of TBI patients with intracranial injury. The results showed that low serum vitamin E level was associated with poor prognosis at 1 and 6 months after TBI with intracranial injury.
FRONTIERS IN NEUROLOGY
(2022)
Article
Surgery
Cassie A. Barton, Heath J. Oetken, Nicolas L. Hall, Andrew J. Webb, Heather E. Hoops, Martin Schreiber
Summary: After demonstrating bleeding stability on the initial interval scan, tICH patients rarely experience expansion. Patients may be considered for discharge from the ICU when there is no progression on the initial interval scan.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Critical Care Medicine
Jaskaran Rakkar, Justin Azar, Jonathan H. Pelletier, Alicia K. Au, Michael J. Bell, Dennis W. Simon, Patrick M. Kochanek, Robert S. B. Clark, Christopher M. Horvat
Summary: This study aimed to identify the temporal patterns of brain tissue oxygen partial pressure (PbtO(2)), arterial oxygen partial pressure (PaO2), and PbtO(2)/PaO2 ratio associated with mortality in children with severe traumatic brain injury (TBI). The results showed that lower PbtO(2), higher PaO2, and lower PbtO(2)/PaO2 ratio were associated with mortality in this cohort of children with severe TBI.
NEUROCRITICAL CARE
(2023)
Article
Medicine, General & Internal
Hansen Deng, David J. Puccio, Sharath K. Anand, John K. Yue, Joseph S. Hudson, Andrew D. Legarreta, Zhishuo Wei, David O. Okonkwo, Ava M. Puccio, Enyinna L. Nwachuku
Summary: Invasive neuromonitoring is a crucial procedure in neurosurgery and neurocritical care to monitor intracranial hypertension. This study evaluated the safety and efficacy of a disposable power drill compared to the manual twist drill for bedside neurosurgical practices. The power drill was successfully implemented with acceptable safety profile for ventriculostomies.
Article
Neurosciences
Mecca B. A. R. Islam, Booker T. Davis IV, Mary J. Kando, Qinwen Mao, Daniele Procissi, Craig Weiss, Steven J. Schwulst
Summary: The study found that young adult mice showed more severe neuropathology and greater loss of white matter connectivity after TBI compared to aged mice. Differential functional outcomes were also observed in anxiety response, learning, and memory between young adult and aged mice after TBI.
EXPERIMENTAL NEUROLOGY
(2021)
Article
Critical Care Medicine
Truman J. Milling, Steven Warach, S. Claiborne Johnston, Byron Gajewski, Todd Costantini, Michelle Price, Jo Wick, Simin Roward, Dinesh Mudaranthakam, Adrienne N. Dula, Ben King, Alexander Muddiman, Gregory Y. H. Lip
Summary: Anticoagulants are beneficial in preventing thrombosis and death in patients with atrial fibrillation and venous thromboembolism, but they also come with an increased risk of bleeding. Deciding when to restart anticoagulation in patients who experience bleeding complications, such as traumatic intracranial hemorrhage, presents challenges as it involves balancing the risks of bleeding worsening versus thrombotic events due to delayed anticoagulation. Uncertainty among clinicians about when to restart anticoagulation can lead to significant delays and potentially preventable strokes and VTE.
JOURNAL OF NEUROTRAUMA
(2021)
Article
Surgery
David S. Plurad, Glenn Geesman, Ahmed Mahmoud, Nicholas Sheets, Bhani Chawla-Kondal, Napatkamon Ayutyanont, Samer Ghostine
Summary: The implementation of the 2014 version of the ACS resources manual is associated with improved TBI associated mortality in ACS Level II centers relative to their Level I counterparts, as shown by a study comparing TBI outcomes at ACS Level I vs. Level II centers using data from the Trauma Quality Program Participant Use File for 2017.
AMERICAN JOURNAL OF SURGERY
(2021)
Article
Clinical Neurology
Jon Perez-Barcena, Catalina Crespi, Guillem Frontera, Juan Antonio Llompart-Pou, Osman Salazar, Victor Goliney, Javier Ibanez, M. Ross Bullock, Juan Pablo de Rivero Vaccari
Summary: This study found that in patients with TBI, the protein levels of caspase-1 in CSF are positively correlated with high ICP and poor prognosis. Especially on the 2nd and 3rd day after injury, the levels of caspase-1 in CSF are higher. Early levels of caspase-1 in CSF are not only higher in absolute value, but also associated with poor outcomes.
JOURNAL OF NEUROSURGERY
(2021)
Review
Chemistry, Multidisciplinary
George R. E. Bradley, Maria Roldan, Panayiotis A. Kyriacou
Summary: This systematic review aimed to predict intracranial pressure (ICP) crises in patients with severe traumatic brain injury (TBI) in order to prevent secondary brain injury and improve patient outcomes. The review identified three effective approaches: long short-term memory (LSTM), Gaussian processes (GP), and logistic regression models, with area under the receiver operating characteristics curve (AUC-ROC) ranging from 0.86 to 0.95. The review also highlighted the lack of consensus on the definition of an ICP crisis, the most clinically relevant prediction horizon, and the clinical intelligibility, improvement of patient care, and ethical concerns of algorithms.
APPLIED SCIENCES-BASEL
(2023)
Article
Pharmacology & Pharmacy
Lindsay P. Deloney, Melanie Smith Condeni, Cassandra Carter, Alicia Privette, Stuart Leon, Evert A. Eriksson
Summary: This study found that adding methocarbamol to the pain control regimen can significantly reduce cumulative opioid exposure for patients with rib fractures, shorten hospital length of stay, and no significant differences in the incidence of pneumonia or adverse effects were observed.
ANNALS OF PHARMACOTHERAPY
(2021)
Article
Critical Care Medicine
Jonne T. H. Prins, Esther M. M. Van Lieshout, Francis Ali-Osman, Zachary M. Bauman, Eva-Corina Caragounis, Jeff Choi, D. Benjamin Christie, Peter A. Cole, William B. DeVoe, Andrew R. Doben, Evert A. Eriksson, Joseph D. Forrester, Douglas R. Fraser, Brendan Gontarz, Claire Hardman, Daniel G. Hyatt, Adam J. Kaye, Huan-Jang Ko, Kiara N. Leasia, Stuart Leon, Silvana F. Marasco, Allison G. McNickle, Timothy Nowack, Temi D. Ogunleye, Prakash Priya, Aaron P. Richman, Victoria Schlanser, Gregory R. Semon, Ying-Hao Su, Michael H. J. Verhofstad, Julie Whitis, Fredric M. Pieracci, Mathieu M. E. Wijffels
Summary: In patients with multiple rib fractures and TBI, there was no difference in mechanical ventilation-free days between the SSRF and nonoperative groups. SSRF was associated with significantly lower risk of pneumonia and 30-day mortality. Outcome was similar in patients with moderate TBI, but a lower 30-day mortality was observed in patients with severe TBI after SSRF. A low SSRF-related complication risk suggests a potential role for SSRF in select patients with TBI.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2021)
Article
Surgery
Miriam Y. Neufeld, Wayne Bauerle, Evert Eriksson, Faris K. Azar, Heather L. Evans, Meredith Johnson, Ryan A. Lawless, Lawrence Lottenberg, Sabrina E. Sanchez, Vlad V. Simianu, Christopher S. Thomas, F. Thurston Drake
Summary: The study found that there was a 29% decrease in mean biweekly appendicitis presentations after the pandemic declaration, with a more significant decrease in uncomplicated cases. However, changes in complicated cases were not significant. This suggests that individual health care-use behaviors may have played a role in the differences observed.
Article
Critical Care Medicine
Fredric M. Pieracci, Kiara Leasia, Matthew C. Hernandez, Brian Kim, Emily Cantrell, Zachary Bauman, Scott Gardner, Sarah Majercik, Thomas White, Sean Dieffenbaugher, Evert Eriksson, Matthew Barns, D. Benjamin Christie, Erika Tay Lasso, Sebastian Schubl, Angela Sauaia, Andrew R. Doben
Summary: Surgical stabilization of rib fractures (SSRF) may be associated with decreased mortality in trauma patients aged 80 years or older, despite an increased risk of pneumonia, longer mechanical ventilation duration, and longer intensive care unit stay. Careful patient selection is important when considering SSRF as a treatment option for octogenarians and nonagenarians.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2021)
Article
Critical Care Medicine
Melanie Smith Condeni, Alyson T. Basting, Patrick G. Costello, Ashley DePriest, Evert A. Eriksson, Heather Evans, Kristie Hertel, Andre L. Holder, Alyssa N. Kester, Kinsey R. Kowalski, Carolyn Magee Bell, Barbara McLean, Michael Reichert, Melissa Santibanez, Patrick M. Wieruszewski, Andrea Sikora Newsome
Summary: This review summarizes selected meta-analyses and trials related to critical care pharmacotherapy published in 2019, covering areas such as cardiac arrest and delirium, including clinical practice guidelines, meta-analyses, and original research trials.
JOURNAL OF CRITICAL CARE
(2021)
Article
Critical Care Medicine
William Head, Neha Kumar, Christopher Thomas, Stuart Leon, Sean Dieffenbaugher, Evert Eriksson
Summary: This study found a high likelihood of significant offset in rib fractures in the acute trauma setting, especially in patients with multiple fractures in the mid-to-upper ribs localized to the posterolateral region. These findings may help identify trauma patients with worse outcomes and guide the development of improved management strategies for rib fractures.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2021)
Article
Critical Care Medicine
Marissa Di Napoli, Andrew R. Doben, William B. DeVoe, Evert Eriksson
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2021)
Article
Emergency Medicine
Jonne T. H. Prins, Esther M. M. Van Lieshout, Francis Ali-Osman, Zachary M. Bauman, Eva-Corina Caragounis, Jeff Choi, D. Benjamin Christie, Peter A. Cole, William B. DeVoe, Andrew R. Doben, Evert A. Eriksson, Joseph D. Forrester, Douglas R. Fraser, Brendan Gontarz, Claire Hardman, Daniel G. Hyatt, Adam J. Kaye, Huan-Jang Ko, Kiara N. Leasia, Stuart Leon, Silvana F. Marasco, Allison G. McNickle, Timothy Nowack, Temi D. Ogunleye, Prakash Priya, Aaron P. Richman, Victoria Schlanser, Gregory R. Semon, Ying-Hao Su, Michael H. J. Verhofstad, Julie Whitis, Fredric M. Pieracci, Mathieu M. E. Wijffels
Summary: The literature on outcomes after SSRF, stratified for rib fracture pattern, is scarce in moderate to severe traumatic brain injury (TBI) patients. This study found that SSRF was associated with reduced pneumonia risk in TBI patients with non-flail rib fracture pattern, and with shorter ICU length of stay in TBI patients with flail chest. SSRF was considered safe and did not impede neurological recovery in both groups.
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
(2022)
Article
Critical Care Medicine
William B. DeVoe, Matthew Abourezk, Brent J. Goslin, Nirvana Saraswat, Brandon Kiel, John A. Bach, Kwang Suh, Evert A. Eriksson
Summary: Chest wall injuries following CPR are common and surgical stabilization can promote ventilator liberation and rehabilitation. Careful patient selection is crucial, with surgery offered to those with reversible causes of arrest and good functional and neurological outcome. Further investigation is needed as experience is limited.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2022)
Letter
Respiratory System
Joseph D. Forrester, Zachary M. Bauman, Andrew R. Doben, Evert A. Eriksson
JOURNAL OF THORACIC DISEASE
(2021)
Article
Critical Care Medicine
Jonne T. H. Prins, Esther M. M. Van Lieshout, Evert A. Eriksson, Matthew Barnes, Taco J. Blokhuis, Eva-Corina Caragounis, D. Benjamin Christie, Erik R. De Loos, William B. DeVoe, Henk A. Formijne Jonkers, Brandon Kiel, Huan-Jang Ko, Silvana F. Marasco, Willem R. Spanjersberg, Ying-Hao Su, Robyn G. Summerhayes, Pieter J. Van Huijstee, Jefrey Vermeulen, Dagmar Vos, Michael H. J. Verhofstad, Mathieu M. E. Wijffels
Summary: In patients with multiple rib fractures following cardiopulmonary resuscitation (CPR), surgical stabilization of rib fractures (SSRF) did not show significant benefits in terms of hospital outcomes compared to nonoperative management. However, patients who underwent SSRF had more severe chest wall injury and longer ICU stay.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2022)
Article
Critical Care Medicine
Mujahed Laswi, Rich Lesperance, Adam Kaye, Zachary Bauman, Adam Hansen, Jennifer Achay, Steven Kubalak, Evert Eriksson
Summary: An anatomical study revealed that the ninth rib is commonly attached to the eighth rib, while the tenth rib is often not attached to the ninth rib. Internal subluxation of the tenth rib and the presence of a hooked tip may predispose individuals to slipped rib syndrome.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2022)
Article
Critical Care Medicine
Evert A. Eriksson, Amanda M. Waite, Shaune D. Shivers
Summary: The development of a Chest Wall Injury and Reconstruction Clinic (CWIRC) aimed to treat patients with chest wall pain and rib fractures has resulted in increased productivity and improved patient care and experience. The number of clinic interactions decreased over time but productivity increased, with CWIRC patient visits and telehealth visits showing significant growth. The initiation of CWIRC has led to an overall growth in wRVU production and has identified an underserved population of chest wall pathology patients, warranting further investigation.
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
(2022)
Article
Medicine, General & Internal
James C. Glasbey, Tom E. F. Abbott, Adesoji Ademuyiwa, Adewale Adisa, Ehab AlAmeer, Sattar Alshryda, Alexis P. Arnaud, Brittany Bankhead-Kendall, M. K. Abou Chaar, Daoud Chaudhry, Ainhoa Costas-Chavarri, Miguel F. Cunha, Justine I. Davies, Anant Desai, Muhammed Elhadi, Marco Fiore, J. Edward Fitzgerald, Maria Fourtounas, Alex James Fowler, Kay Futaba, Gaetano Gallo, Dhruva Ghosh, Rohan R. Gujjuri, Rebecca Hamilton, Parvez Haque, Ewen M. Harrison, Peter Hutchinson, Gabriella Hyman, Arda Isik, Umesh Jayarajah, Haytham M. A. Kaafarani, Bryar Kadir, Ismail Lawani, Hans Lederhuber, Elizabeth Li, Markus W. Loffler, Maria Aguilera Lorena, Harvinder Mann, Janet Martin, Dennis Mazingi, Craig D. McClain, Kenneth A. McLean, John G. Meara, Antonio Ramos-De La Medina, Mengistu Mengesha, Ana Minaya, Maria Marta Modolo, Rachel Moore, Dion Morton, Dmitri Nepogodiev, Faustin Ntirenganya, Francesco Pata, Rupert Pearse, Maria Picciochi, Thomas Pinkney, Peter Pockney, Gabrielle H. van Ramshorst, Toby Richards, April Camilla Roslani, Sohei Satoi, Raza Sayyed, Richard Shaw, Joana Filipa Ferreira Simoes, Neil Smart, Richard Sulliva, Malin Sund, Sudha Sundar, Stephen Tabiri, Elliott H. Taylor, Mary L. Venn, Dakshitha Wickramasinghe, Naomi Wright, Sebastian Bernardo Shu Yip, Aneel Bhangu
Summary: This study developed and validated a novel index (SPI) to support the strengthening of local elective surgical systems and address growing backlogs. The findings showed that hospitals with a higher SPI were associated with an increased planned surgical volume ratio, independent of income status, COVID-19 burden, and hospital type. Annual self-assessment of surgical preparedness is recommended to identify areas for improvement and enhance the resilience of local surgical systems.
Article
Emergency Medicine
Evert Austin Eriksson, Mathieu Mathilde Eugene Wijffels, Adam Kaye, Joseph Derek Forrester, Manuel Moutinho, Sarah Majerick, Zachary Mitchel Bauman, Christopher Francis Janowak, Bhavik Patel, Martin Wullschleger, Leanna Clevenger, Esther M. M. Van Lieshout, Jamie Tung, Michelle Woodfall, Thomas Russell Hill, Thomas William White, Andrew Ross Doben
Summary: This study aimed to describe the incidence and epidemiology of surgical stabilization of rib fractures (SSRF), and found that patients aged 50-69 with AIS-Chest 3 and patients aged 50-79 with AIS-Chest > 3 had higher rates of SSRF, which warrants further investigation.
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
(2023)