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Hogarty JP, Comella A, Nanayakkara S, William J, Stub D, Mariani JA, Patel HC, Kistler PM, Kaye DM, Voskoboinik A. Influence of Impaired Conduction on Exercise Hemodynamics in Patients With Preserved Ejection Fraction. JACC Heart Fail 2024; 12:588-590. [PMID: 37921802 DOI: 10.1016/j.jchf.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 11/04/2023]
Affiliation(s)
| | | | | | | | - Dion Stub
- The Alfred Hospital, Melbourne, Australia; Monash University, Melbourne, Australia
| | | | | | - Peter M Kistler
- The Alfred Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - David M Kaye
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia; Monash University, Melbourne, Australia
| | - Aleksandr Voskoboinik
- The Alfred Hospital, Melbourne, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia; Monash University, Melbourne, Australia.
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Hogarty JP, Jones ME, Jassal K, Hogarty DT, Mitra B, Udy AA, Fitzgerald MC. Review article: Early steroid administration for traumatic haemorrhagic shock: A systematic review. Emerg Med Australas 2023; 35:6-13. [PMID: 36347522 PMCID: PMC10100146 DOI: 10.1111/1742-6723.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022]
Abstract
Haemorrhagic shock after trauma is a leading cause of death worldwide, particularly in young individuals. Despite advances in trauma systems and resuscitation strategies, mortality from haemorrhagic shock has not declined over the previous two decades. A proportion of shocked trauma patients may experience a deficiency of cortisol relative to the severity of their injury. The benefit of exogenous steroid administration in patients suffering haemorrhagic shock as a result of injury is unclear. A systematic review of four databases (Ovid Medline, Ovid Embase, Cochrane, Scopus) was undertaken. Inclusion and exclusion criteria were pre-determined and two reviewers independently screened the articles with disagreements arbitrated by a third reviewer. The primary outcome variable was 28-day mortality. Quality of studies were assessed using the Cochrane-risk-of-bias (RoB 2) tool. Of the 2919 studies yielded by the search strategy, 1274 duplicates were removed and 1645 screened on title and abstract. After the full text of 33 studies were assessed, two articles were included. Both studies were over 30 years old with small numbers of participants and with primary outcomes not including mortality. Of the data available, no statistically significant difference in mortality was detected. Hospital length of stay, reversal of shock or adverse events were not reported. Both studies were at risk of bias. There are no high quality or recent studies in the English literature investigating the use of steroids for haemorrhagic shocked trauma patients. PROSPERO: CRD42021239656.
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Affiliation(s)
- Joseph P Hogarty
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,National Trauma Research Institute, Melbourne, Victoria, Australia
| | - Morgan E Jones
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Karishma Jassal
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,National Trauma Research Institute, Melbourne, Victoria, Australia
| | - Daniel T Hogarty
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Biswadev Mitra
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,National Trauma Research Institute, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew A Udy
- Department of Hyperbaric and Intensive Care Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.,Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Mark C Fitzgerald
- Trauma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,National Trauma Research Institute, Melbourne, Victoria, Australia
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