Modifiable Risk Factors for Delirium in Critically Ill Trauma Patients: A Multicenter Prospective Study (Kolli)

Duceppe MA, Williamson DR, Elliott A, Para M, Poirier MC, Delisle MS, Deckelbaum D, Razek T, Desjardins M, Bertrand JC, Bernard F, Rico P, Burry L, Frenette AJ, Perreault M. Modifiable Risk Factors for Delirium in Critically Ill Trauma Patients: A Multicenter Prospective Study. J Intensive Care Med. 2019 Apr;34(4):330-336. PMID: 28335673.

OBJECTIVE: Intensive care unit (ICU)-acquired delirium has been associated with increased morbidity and mortality. Prevention strategies including modification of delirium risk factors are emphasized by practice guidelines. No study has specifically evaluated modifiable delirium risk factors in trauma ICU patients. Our goal was to evaluate modifiable risk factors for delirium among trauma patients admitted to the ICU.

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Goal-directed platelet transfusions correct platelet dysfunction and may improve survival in patients with severe traumatic brain injury. (Newman)

Furay E, et al. Goal-directed platelet transfusions correct platelet dysfunction and may improve survival in patients with severe traumatic brain injury. J Trauma Acute Care Surg. 2018 Nov;85(5):881-887.

BACKGROUND: Platelet dysfunction, defined as adenosine diphosphate inhibition greater than 60% on thromboelastogram, is an independent predictor of increased mortality in patients with severe traumatic brain injury (TBI). We changed our practice to transfuse platelets for all patients with severe TBI and platelet dysfunction. We hypothesized that platelet transfusions would correct platelet dysfunction and improve mortality in patients with severe TBI.

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Improvement of Blood-Brain Barrier Integrity in Traumatic Brain Injury and Hemorrhagic Shock Following Treatment With Valproic Acid and Fresh Frozen Plasma. (Lima)

Nikolian VC, et al. Improvement of Blood-Brain Barrier Integrity in Traumatic Brain Injury and Hemorrhagic Shock Following Treatment With Valproic Acid and Fresh Frozen Plasma. Crit Care Med. 2018 Jan; 46(1):e59-e66.

OBJECTIVE: Combined traumatic brain injury and hemorrhagic shock are highly lethal. Following injuries, the integrity of the blood-brain barrier can be impaired, contributing to secondary brain insults. The status of the blood-brain barrier represents a potential factor impacting long-term neurologic outcomes in combined injuries. Treatment strategies involving plasma-based resuscitation and valproic acid therapy have shown efficacy in this setting. We hypothesize that a component of this beneficial effect is related to blood-brain barrier preservation.

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Critical Care Resource Utilization and Outcomes of Children With Moderate Traumatic Brain Injury. (Carroll)

Chandee T, et al. Critical Care Resource Utilization and Outcomes of Children With Moderate Traumatic Brain Injury. Pediatr Crit Care Med. 2017 Dec;18(12):1166-1174.

OBJECTIVES: To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury. Continue reading