id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-266750-41gth6o0	Puzzitiello, Richard N.	Inflammatory and Coagulative Considerations for the Management of Orthopaedic Trauma Patients With COVID-19: A Review of the Current Evidence and Our Surgical Experience	2020-05-14		.txt	text/plain	3742	221	39	A better understanding of this relationship can inform the development of evidencebased management strategies in these patients and limit admissions to overcrowded ICUs. To demonstrate and further define these developing theories on the coagulative and inflammatory risks associated with the surgical treatment of trauma patients with COVID-19, we will present an unexpected outcome on such a patient at our institution. In addition, the hypercoagulable state secondary to COVID-19 and the inflammatory load of intramedullary reaming, fat emboli, and pulmonary embolism resulted in a "second hit" that may have cumulatively pushed our patient past a "tipping point" and into respiratory failure (Fig. 4) . The level of cytokine response, hypercoagulability, and pulmonary dysfunction associated with the COVID-19 virus may predispose to a catastrophic "second hit" after even low-energy trauma. Careful consideration and risk/benefit analysis, including preoperative evaluation of systemic inflammation and respiratory status, is paramount in patients with COVID-19 presenting with orthopaedic trauma injuries.	./cache/cord-266750-41gth6o0.txt	./txt/cord-266750-41gth6o0.txt