Clinical Impact of a Dedicated Trauma Hybrid Operating Room.
J Am Coll Surg
; 232(4): 560-570, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-33227422
ABSTRACT
BACKGROUND:
Early hemorrhage control is essential to optimal trauma care. Hybrid operating rooms offer early, concomitant performance of advanced angiographic and operative hemostasis techniques, but their clinical impact is unclear. Herein, we present our initial experience with a dedicated, trauma hybrid operating room. STUDYDESIGN:
This retrospective cohort analysis of 292 adult trauma patients undergoing immediate surgery at a Level I trauma center compared patients managed after implementation of a dedicated, trauma hybrid operating room (n = 186) with historic controls (n = 106). The primary outcomes were time to hemorrhage control (systolic blood pressure ≥ 100 mmHg without ongoing vasopressor or transfusion requirements), early blood product administration, and complication.RESULTS:
Patient characteristics were similar between cohorts (age 41 years, 25% female, 38% penetrating trauma). The hybrid cohort had lower initial hemoglobin (10.2 vs 11.1 g/dL, p = 0.001) and a greater proportion of patients undergoing resuscitative endovascular balloon occlusion of the aorta (9% vs 1%, p = 0.007). Cohorts had similar case mixes and intraoperative consultation with cardiothoracic or vascular surgery (13%). Twenty-one percent of all hybrid cases included angiography. The interval between operating room arrival and hemorrhage control was shorter in the hybrid cohort (49 vs 60 minutes, p = 0.005). From 4 to 24 hours after arrival, the hybrid cohort had fewer red cell (0.0 vs 1.0, p = 0.001) and plasma transfusions (0.0 vs 1.0, p < 0.001). The hybrid cohort had fewer infectious complications (15% vs 27%, p = 0.009) and ventilator days (2.0 vs 3.0, p = 0.011), and similar in-hospital mortality (13% vs 10%, p = 0.579).CONCLUSIONS:
Implementation of a dedicated, trauma hybrid operating room was associated with earlier hemorrhage control and fewer early blood transfusions, infectious complications, and ventilator days.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Salas Cirúrgicas
/
Complicações Pós-Operatórias
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Choque Hemorrágico
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Ferimentos e Lesões
/
Hemostasia Cirúrgica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Am Coll Surg
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2021
Tipo de documento:
Article