Bruce W Bonnell

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PURPOSE To examine whether duty-hour restrictions have been consequential for various aspects of the work of surgical faculty and if those consequences differ for faculty in academic and nonacademic general surgery residency programs. METHOD Questionnaires were distributed in 2004 to 233 faculty members in five academic and four nonacademic U.S. residency(More)
BACKGROUND This study's purpose was to determine if early tracheostomy (ET) of severely injured patients reduces days of ventilatory support, the frequency of ventilator-associated pneumonia (VAP), and surgical intensive care unit (SICU) length of stay (LOS). METHODS This 2-year retrospective review included 185 SICU patients with acute injuries requiring(More)
Recent studies suggest that significant physiologic derangements can occur during laparoscopic surgery. Eighteen patients admitted for laparoscopic cholecystectomy were studied. The mean age was 46.7 (range 19-78). A standard anesthetic technique, reverse Trendelenburg positioning, and an abdominal insufflation pressure of 15 mmHg with CO2 were used with(More)
BACKGROUND This study was designed to evaluate the effect of intensive insulin control (IIT) on outcomes for traumatically injured patients as a function of injury severity score (ISS) and age. PATIENTS AND METHODS A retrospective review of 2028 adult trauma patients admitted to the surgical intensive care unit (SICU) in a Level I trauma center was(More)
BACKGROUND The aim of this study was to determine the dose of recombinant factor VIIa (rFVIIa) that has been used in our institution to successfully control hemorrhage in trauma and postoperative patients. METHODS This was an 8-month retrospective cohort study of 13 patients with acute hemorrhage and no known history of coagulopathic disorders. RESULTS(More)
OBJECTIVE Utilization of brain tissue oxygenation (pBtO(2)) is an important but controversial variable in the treatment of traumatic brain injury (TBI). We evaluated the correlation between pBtO(2)/CPP and pBtO(2)/ICP and determined the parameter most closely related to survival. METHODS Consecutive, adult patients with severe TBI and pBtO(2) monitors(More)
BACKGROUND Utilization of brain tissue oxygenation (pBtO(2)) is an important but controversial variable in the treatment of traumatic brain injury. We hypothesize that pBtO(2) values over the first 72 hours of monitoring are predictive of mortality. METHODS Consecutive, adult patients with severe traumatic brain injury and pBtO(2) monitors were(More)
The role of early operative fixation in polytrauma patients with long bone fractures was analyzed by comparing length of stay, intensive care unit days and ventilator days, incidence of pulmonary complications, infectious complications, orthopedic complications, and mortality in three groups: traction only, operative fixation later than 48 hours after(More)
Primary appendiceal adenocarcinoma is rare, with fewer than 300 reported cases. This report reviews 23 cases of appendiceal adenocarcinoma at Butterworth Hospital from 1968 to 1985. Clinical presentation, operative findings, treatment, and length of survival were recorded. Common clinical presentations included acute appendicitis and progressive abdominal(More)
BACKGROUND This study examined how surgical residents and faculty assessed the first year of the Accreditation Council for Graduate Medical Education duty-hour restrictions. METHODS Questionnaires were administered in 9 general-surgery programs during the summer of 2004; response rates were 63% for faculty and 58% for residents (N = 259). Questions probed(More)