Weekly digest
Week of 21 September 2026
26 papers collected from PubMed, last swept 21 September 2026.
Top 10
Ranked by study design, journal and study size.
Venous thromboembolism in pediatric traumatic brain injury: A systematic review and meta-analysis.
Pooled VTE frequency in severe pediatric TBI was 7% (rising to 20% with central venous lines), driven by injury severity and multimodality treatment — arguing that VTE is an under-recognized risk warranting standardized surveillance and prophylaxis consideration in children.
Clinical practice guidelines for moderate to severe paediatric traumatic brain injury in Australasia: A scoping review.
Of nine Australasian guidelines for moderate-to-severe paediatric TBI, only the PREDICT guideline rated high quality; hospital-based guidelines were methodologically weak, exposing a regional consensus gap for severe paediatric TBI.
Use of landiolol in septic shock patients with new onset of atrial fibrillation: a European Delphi consensus.
A European expert panel endorsed the ultra-short-acting β1-blocker landiolol for rate control in selected septic-shock patients with new-onset AF — correct reversible triggers first, assess hemodynamics before rate control, start without a bolus at low doses titrated to an initial HR target <110 bpm under echo/hemodynamic monitoring. No consensus was reached on optimal duration or use with severe LV dysfunction.
Whole-blood point-of-care GFAP and UCH-L1 biomarkers after traumatic brain injury: prospective diagnostic prediction of intracranial injury on head CT.
In 970 adult ED patients with suspected TBI (GCS 13-15), a 15-minute whole-blood POC GFAP/UCH-L1 test predicted CT intracranial injury with 96.5% sensitivity and 96.5% NPV; the FDA-cleared platform supports rapid triage and CT sparing at the bedside.
Acute cholecystitis in high-risk patients: a systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma (EAST).
New EAST guideline (25 studies) conditionally favors antibiotics alone over percutaneous cholecystostomy plus antibiotics in high-risk patients with acute calculous cholecystitis, and supports removing a cholecystostomy catheter without interval cholecystectomy once inflammation resolves and cystic duct patency is confirmed.
Digital Stop The Bleed training compared with in-person Stop The Bleed training: Human instructors needed to demonstrate psychomotor skills.
Digital Stop the Bleed training was non-inferior to instructor-led training for knowledge, but laypersons performed wound packing (80% vs 100%) and tourniquet application (52% vs 86%) worse than the in-person group — supporting digital training as a supplement to, not replacement for, hands-on instruction.
Evaluating Delivery of Trauma-Informed Care in the Trauma Bay.
Trauma-informed care practices (introductions, verbal/physical reassurance, complete exam) were delivered inconsistently during acute resuscitation, and Spanish-speaking patients received markedly less trauma-informed communication and fewer complete exams than English speakers — flagging an equity gap now that TIC is in ATLS recommendations.
Cooler by cooler - Forecasting transfusion demand and volumes in trauma.
A machine-learning triage tool (FAIT) using only early EMS/ED vitals and field-visible injuries predicted trauma transfusion need with high accuracy — AUC 0.91 for ruling out any transfusion, and 0.91-0.95 for transfusion, massive (>4 U/4h) and ultra-massive thresholds (0.87-0.91 on EMS vitals alone) — supporting prehospital forecasting of blood-product demand across blunt, penetrating and burn injury, pending prospective validation.
Out-of-Hospital Cardiac Arrest from Foreign Body Airway Obstruction: A Population-Based Study in Victoria, Australia.
In a 4-year Victorian OHCA registry, 0.8% of arrests were caused by foreign-body airway obstruction. Magill's forceps and intubation were the most effective interventions for restoring ventilation (73% each), whereas laryngeal mask airways were commonly used but rarely effective (7%). Survival was dismal (3.6% overall; zero survivors among patients >65), reinforcing the primacy of prompt bystander relief and the need to assess futility.
Comprehensive Review of Pigtail Catheter Management.
Practical review of small-bore "pigtail" chest catheters as first-line for many pleural conditions — Seldinger insertion, imaging confirmation, daily system checks, and uncoiling before removal to avoid tissue injury — with a rundown of placement and indwelling complications.
By category
New Research9 papers
Disparities in traumatic brain injury-related deaths — United States, 2023.
Of 68,663 US TBI-related deaths in 2023, suicide (36%) was the leading cause ahead of unintentional falls (32%); rates were highest among adults ≥75, males, and American Indian/Alaska Native individuals. Directs prevention toward falls, firearm-suicide, and the highest-risk populations.
The role of artificial intelligence in the diagnosis and prognosis of traumatic brain injury based on brain CT scans: a systematic review.
Across 22 studies, AI models on non-contrast brain CT achieved strong diagnostic accuracy (many AUCs ≥0.90) for TBI findings but more variable prognostic performance; only 9 had external validation and prognostic models were all high risk of bias, so prospective multicenter validation is needed before clinical use.
Nurse-led respiratory care bundle and pneumonia prevention in critically ill patients with abdominal sepsis: a multicenter before-and-after controlled study.
A nurse-led respiratory care bundle in abdominal sepsis was associated with roughly halved pneumonia incidence (25.6% vs 42.2%; adjusted OR 0.39), shorter length of stay, and lower 28-day mortality (18.3% vs 22.8%), consistent across five sensitivity analyses — supporting structured pulmonary nursing bundles in this population.
Operative versus nonoperative management of pelvic ring fractures in older adults: A propensity-matched analysis of mortality and complications.
In matched adults ≥55 with pelvic ring fractures, operative management was associated with lower 2-year mortality (robust across analyses) and a non-robust 1-year signal, but neither benefit persisted after multivariable adjustment, while surgery carried consistently higher VTE and pneumonia. The operate-or-not decision should balance improved mobility against perioperative risk; prospective trials are needed.
Reverse-engineering the diagnostic process: An indirect finding-driven deep learning model for pelvic active bleeding detection on CT.
A curriculum-based deep-learning pipeline detected active pelvic bleeding on contrast-enhanced CT in ~2 seconds with a test AUC of 0.90, outperforming residents and matching board-certified specialists. A plausible triage aid to speed hemorrhage detection in blunt pelvic trauma, pending prospective clinical validation.
State-level retrospective analysis of the burden of emergency and operative conditions in India from 1980 to 2023.
In 2023, emergency, operative, and emergency-operative conditions accounted for roughly 50%, 23%, and 10% of all-cause mortality (and ~41%, 22%, 11% of DALYs) across India; burdens fell substantially since 1980 but remain persistently high in states like Telangana, Chhattisgarh, and Uttarakhand — arguing surgical and emergency care should be a national and state-level policy priority.
Medical Management of Aortic Emergencies in Critical Care Transport.
In aortic dissection/aneurysm transports, esmolol, labetalol, or nicardipine as single agents achieved similar odds of hitting HR/SBP targets versus combinations; labetalol alone had the least hypotension and esmolol the most — suggesting single-agent therapy is a reasonable option when combination beta+CCB isn't feasible en route.
Practice Patterns and Performance of Pediatric Air Medical Tracheal Intubation: A National Multisite Cohort Study.
Across 1,040 pediatric air-medical intubations at 39 sites (57.7% trauma/burn), first-pass success was 86.5% overall but fell to 69.1% in infants under 1 year, who also had more post-attempt physiologic instability and less ETCO2 confirmation — flagging infants as the key training and benchmarking target.
Stress displacement and surgical benefit in Beckmann 7-9 pelvic ring injuries: A retrospective multicenter analysis.
In stability-indeterminate LC1 pelvic ring injuries with 12-16 mm stress displacement, surgical fixation was associated with fewer early composite adverse events (NNT ~2.5) than nonoperative care; the authors stress the finding is statistically fragile and hypothesis-generating, requiring prospective validation.
Clinical Pearl7 papers
Quantifying the impact of prehospital arterial line insertion on scene time.
Across four studies, prehospital arterial-line insertion was consistently associated with longer scene time (4-34.4 min), but the evidence is weak and the clinical significance context-specific — a caution to weigh invasive prehospital BP monitoring against transport delay rather than a directive against it.
Individualising blood glucose control in ICU patients: evidence and practical implementations.
Both severe/iatrogenic hyperglycaemia and hypoglycaemia should be avoided; tight glucose control helps only with a validated protocol that prevents severe hypoglycaemia (e.g. early parenteral nutrition), otherwise intermediate targets are the safer default — glucose targets should be tailored to clinical context.
Hip fracture surgery within 24 hours: no association between time to surgery and mortality in a real-world cohort.
Among hip-fracture patients all operated within 24h, further acceleration (<6h vs 6-12h vs 12-24h) showed no mortality difference; perioperative medical complications (pneumonia, renal failure, cardiac events) were the dominant mortality drivers — supporting current 24h targets while shifting emphasis to orthogeriatric/perioperative optimization.
Modern Management of Inferior Vena Caval Injuries: What You Need to Know.
Physiology-first, segment-specific playbook for traumatic IVC injury — prioritize hemodynamics over imaging, use damage-control resuscitation and primary venorrhaphy when feasible, and reserve endovascular/hybrid or nonoperative approaches for stable patients with contained bleeding and immediate open-conversion capability.
Age-specific TBSA thresholds for pediatric burn complications: A 13-year single-center inpatient retrospective cohort.
Across 942 admitted pediatric burns, age-adjusted TBSA cut-points supported earlier ICU consideration at ~8-10% TBSA in toddlers and ~15% in school-age children/adolescents. ICU transfer and surgery rarely occurred without fever, and hands/joints/perineum/buttocks or persistent fever/delayed presentation warranted heightened surgical review.
Do ECG abnormalities, degree of sternal displacement or troponin level influence outcomes following sternal fracture?
In 245 sternal-fracture patients (9% mortality), moderate/complete displacement (36% vs 8%), high-sensitivity troponin T >17.5 ng/L (20% vs 2%), and ECG conduction abnormalities (33% vs 1%) were each associated with markedly higher mortality on univariate analysis — practical red flags for triage, though unadjusted and hypothesis-generating.
Persistent postoperative hypercoagulability and venous thromboembolism risk following pelvic and acetabular fractures: A prospective pilot study.
Despite standard 28-day LMWH prophylaxis, pelvic/acetabular fracture patients stayed hypercoagulable on serial TEG (75% at 4 weeks, 29% at 3 months) and 23% developed VTE (mostly PE), with acetabular fractures highest — signaling current prophylaxis duration may be too short and supporting study of extended/individualized regimens.