Christine S Cocanour

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BACKGROUND Primary abdominal compartment syndrome (ACS) is a known complication of damage control. Recently secondary ACS has been reported in patients without abdominal injury who require aggressive resuscitation. The purpose of this study was to compare the epidemiology of primary and secondary ACS and develop early prediction models in a high-risk cohort(More)
BACKGROUND Acidosis, hypothermia, and coagulopathy were identified more than 20 years ago as a deadly triad for patients presenting with exsanguinating hemorrhage. This led to fundamental changes in initial management of severely injured patients. Despite major advances, hemorrhage remains a leading cause of early death in trauma patients. Recent studies(More)
HYPOTHESIS Normal resuscitation (oxygen delivery index [DO2I] >/=500 mL/min per square meter), compared with supranormal trauma resuscitation (DO2I >/=600 mL/min per square meter), requires less crystalloid volume, thus decreasing the incidence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). DESIGN Retrospective analysis of(More)
BACKGROUND The successful treatment of intraabdominal infection requires a combination of anatomical source control and antibiotics. The appropriate duration of antimicrobial therapy remains unclear. METHODS We randomly assigned 518 patients with complicated intraabdominal infection and adequate source control to receive antibiotics until 2 days after the(More)
This is a recommended management algorithm from the Western Trauma Association addressing the diagnostic evaluation and management of blunt cerebrovascular injuries (BCVI) in adult patients. Because there are no published prospective randomized clinical trials that have generated class I data, the recommendations herein are based on published observational(More)
BACKGROUND This study reviews the efficacy of vacuum-assisted wound closure (VAWC) to obtain primary fascial closure of open abdomens after severe trauma. METHODS The study population included shock resuscitation patients who had open abdomens treated with VAWC. The VAWC dressing was changed at 2- to 3-day intervals and downsized as fascial closure was(More)
BACKGROUND The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. METHODS Our prospective database for standardized shock(More)
BACKGROUND The incidence of ventilator-associated pneumonia ranges from 10 to 25%, with mortality of 10 to 40%. It prolongs hospital stay and drives up hospital costs. Our Intensive Care Unit (ICU) ventilator-associated pneumonia (VAP) rates were hovering at the National Nosocomial Infection Surveillance (NNIS) 90th percentile (22.3-32.7 infections per(More)
OBJECTIVE To determine the incidence and type of delayed complications from nonoperative management of adult splenic injury. DESIGN Retrospective medical record review. SETTING University teaching hospital, level I trauma center. PATIENTS Two hundred eighty patients were admitted to the adult trauma service with blunt splenic injury during a 4-year(More)
This is a recommended algorithm of the Western Trauma Association for the management of blunt hepatic injuries. Because there are no published prospective randomized trials, the recommendations are based on available published prospective, observational, and retrospective data and expert opinion of Western Trauma Association members. The algorithm (Fig. 1)(More)