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Background: The impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) on traumatic brain injuries remains uncertain, with potential outcomes ranging from neuroprotection to exacerbation of the injury. The study aimed to evaluate consciousness recovery in patients with blunt trauma with shock and traumatic brain injuries., Material and Methods: Data were obtained from the American College of Surgeons Trauma Quality Improvement Program from 2017-2019. During the study period, 3,138,896 trauma registries were examined, and 16,016 adult patients with blunt trauma, shock, and traumatic brain injuries were included. Among these, 172 (1.1%) underwent REBOA. Comparisons were conducted between patients with and without REBOA after implementing 1:3 propensity score matching to mitigate disparities. The primary outcome was the highest Glasgow Coma Scale score during admission. The secondary outcomes encompassed the volume of blood transfusion, the necessity for hemostatic interventions and therapeutic neurosurgery, and mortality rate., Results: Through well-balanced propensity score matching, a notable difference in mortality rate was observed, with 59.7% in the REBOA group and 48.7% in the non-REBOA group (P=0.015). In the REBOA group, the median 4-hour red blood cell transfusion was significantly higher (2800 mL [1500, 4908] vs. 1300 mL [600, 2500], P<0.001). The REBOA group required lesser hemorrhagic control surgeries (31.8% vs. 47.7%, P<0.001) but needed more transarterial embolization interventions (22.2% vs 15.9%, P=0.076). The incidence of therapeutic neurosurgery was 5.1% in the REBOA group and 8.7% in the non-REBOA group (P=0.168). Among survivors in the REBOA group, the median highest Glasgow Coma Scale score during admission was significantly greater for both total (11 [8, 14] vs. 9 [6, 12], P=0.036) and motor components (6 [4, 6] vs. 5 [3, 6], P=0.037). The highest GCS score among the survivors with predominant pelvic injuries was not different between the two groups (11 [8, 13] vs. 11 [7, 14], P=0.750)., Conclusions: Patients experiencing shock and traumatic brain injury have high mortality rates, necessitating swift resuscitation and prompt hemorrhagic control. The use of REBOA as an adjunct for bridging definitive hemorrhagic control may correlate with enhanced consciousness recovery., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Aims: This study aimed to assess the effect of zinc supplementation, with or without other antioxidants and trace elements, on clinical outcomes in patients with trauma., Methods: A systematic review was conducted for adult patients with acute trauma who had been admitted to the hospital. Those who sustained burn injuries were excluded. Studies in PubMed, Web of Science, and Embase from 1990 to 2022 regarding the additional nutrition supplementation of zinc to patients, either in a single-agent or combined regimen, were included. Comparisons were made between the zinc supplement group and those who received a placebo or regular treatment., Results: The primary outcomes of the study were mortality rate, length of hospital stay, and incidence of pneumonia. Seven studies qualified for the meta-analysis. Of the 594 patients eligible for analysis, 290 and 304 were in the zinc supplementation and control groups, respectively. The meta-analysis revealed that zinc supplementation was associated with a lower risk of pneumonia in patients with acute trauma than in the control group (odds ratio [OR], 0.506; 95% CI = 0.292-0.877; P = 0.015; heterogeneity, I 2  = 12.7%). Zinc supplementation did not influence the mortality rate (OR, 0.755; 95% CI = 0.492-1.16; P = 0.612; heterogeneity, I 2  = 0%) or the length of hospital stay (standard difference in means, -0.24; 95% CI = -0.544 to 0.063; P = 0.121; heterogeneity, I 2  = 45.0%)., Conclusion: Zinc supplementation, with or without other antioxidants and trace elements, in patients with trauma was associated with a lower incidence of pneumonia., (© 2023 American Society for Parenteral and Enteral Nutrition.)