The Incidence of Fever in US Critical Care Air Transport Team Combat Trauma Patients Evacuated from the Theater between March 2009 and March 2010
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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Introduction Most critically ill injured patients are transported out of the theater by Critical Care Air Transport Teams CCATTs. Fever after trauma is correlated with surgical complications and infection. The purposes of this study are to identify the incidence of elevated temperature in patients managed in the CCATT environment and to describe the complications reported and the treatments used in these patients. Methods We performed a retrospective review of available records of trauma patients from the combat theater between March 1, 2009, and March 31, 2010, who were transported by the US Air Force CCATT and had an incidence of hyperthermia. We then divided the cohort into 2 groups, patients transported with an elevation in temperature greater than 100.4 F and patients with no documented elevation in temperature. We used a standardized, secure electronic data collection form to abstract the outcomes. Descriptive data collected included injury type, temperature, use of a mechanical ventilator, cooling treatment modalities, antipyretics, intravenous fluid administration, and use of blood products. We also evaluated the incidence of complications during the transport in patients who had a recorded elevation in temperature greater than 100.4 F. Results A total of 248 trauma patients met the inclusion criteria, and 101 trauma patients 40 had fever. The mean age was 28 years, and 98 of patients were men. The mechanism of injury was an explosion in 156 patients 63, blunt injury in 11 4, and penetrating injury in 45 18, whereas other trauma-related injuries accounted for 36 patients 15. Of the patients, 209 84 had battle-related injuries and 39 16 had non battle-related injuries. Traumatic brain injury was found in 24 patients 24 with an incidence of elevated temperature. The mean temperature was 101.6 F range, 100.5 F-103.9 F.
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