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Haemorrhagic shock

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https://www.readbyqxmd.com/read/28193297/pre-hospital-transfusion-of-packed-red-blood-cells-in-147-patients-from-a-uk-helicopter-emergency-medical-service
#1
Richard M Lyon, Eleanor de Sausmarez, Emily McWhirter, Gary Wareham, Magnus Nelson, Ashley Matthies, Anthony Hudson, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Early transfusion of packed red blood cells (PRBC) has been associated with improved survival in patients with haemorrhagic shock. This study aims to describe the characteristics of patients receiving pre-hospital blood transfusion and evaluate their subsequent need for in-hospital transfusion and surgery. METHODS: The decision to administer a pre-hospital PRBC transfusion was based on clinical judgment. All patients transfused pre-hospital PRBC between February 2013 and December 2014 were included...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28148540/acute-lower-gi-bleeding-in-the-uk-patient-characteristics-interventions-and-outcomes-in-the-first-nationwide-audit
#2
Kathryn Oakland, Richard Guy, Raman Uberoi, Rachel Hogg, Neil Mortensen, Michael F Murphy, Vipul Jairath
OBJECTIVE: Lower GI bleeding (LGIB) is a common reason for emergency hospital admission, although there is paucity of data on presentations, interventions and outcomes. In this nationwide UK audit, we describe patient characteristics, interventions including endoscopy, radiology and surgery as well as clinical outcomes. DESIGN: Multicentre audit of adults presenting with LGIB to UK hospitals over 2 months in 2015. Consecutive cases were prospectively enrolled by clinical teams and followed for 28 days...
February 1, 2017: Gut
https://www.readbyqxmd.com/read/28148427/nursing-procedures-in-dealing-with-haemorrhagic-shock
#3
Isabelle Clavagnier
Sophie assesses a patient whose condition is deteriorating. She manages the critical situation in conjunction with the doctor on duty.
October 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/28137905/wunderlich-s-syndrome-as-a-manifestation-of-polyarteritis-nodosa
#4
Pedro Beirão, Lídia Teixeira, Patrícia Pereira, Margarida Lopes Coelho
Wunderlich syndrome is a rare clinical entity characterised by spontaneous renal haemorrhage that can be life-threatening and requires emergency attention. The most frequent aetiologies are renal tumours and vascular diseases. The authors report a case of a patient admitted with hypovolaemic shock due to a retroperitoneal haematoma in the context of polyarteritis nodosa (PAN). Prognosis of untreated PAN is very poor with 13% 5-year survival rate. Therefore, early recognition of disease and proper treatment with immunosuppressors will prevent catastrophic complications and improves survival...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28130699/autopsy-after-transcatheter-aortic-valve-implantation
#5
F van Kesteren, E M A Wiegerinck, S Rizzo, J Baan, R N Planken, J H von der Thüsen, H W M Niessen, M F M van Oosterhout, A Pucci, G Thiene, C Basso, M N Sheppard, K Wassilew, A C van der Wal
Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of the autopsy findings in patients with TAVI in their medical history divided by the timing of death with specific interest in the added value of autopsy over a solely clinically determined cause of death. In 8 European centres, 72 cases with autopsy reports were available...
January 27, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28129766/severe-plasmodium-vivax-infection-in-korea
#6
Jae Hyoung Im, Hea Yoon Kwon, JiHyeon Baek, Seong Wook Park, Areum Durey, Kyung Hee Lee, Moon-Hyun Chung, Jin-Soo Lee
BACKGROUND: Although severe malaria by Plasmodium vivax has been increasingly reported, there are marked variations in the type and rate of the complications by geographic area. This is possibly because of the presence of concurrent falciparum malaria or bacteraemia, and of differences in underlying immune status among the infected subjects. Furthermore, published studies on P. vivax in temperate regions are limited. The present study investigated severe vivax malaria in Korea, where only vivax malaria occurs...
January 28, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28124417/interleukin-8-interleukin-1%C3%AE-and-tumour-necrosis-factor-%C3%AE-in-sequential-units-of-packed-red-blood-cells-collected-from-retired-racing-greyhounds
#7
S L Purcell, M Claus, G Hosgood, L Smart
BACKGROUND: We hypothesised that concentrations of interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) would increase during storage in the third sequential unit (U3) of canine packed red blood cells (PRBC) collected from terminal donors in haemorrhagic shock. We further hypothesised that leucoreduction would prevent cytokine accumulation in U3 and that cytokine concentrations in U3 would be higher than in the first units (U1) collected from the same dogs...
January 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28087117/erythropoietin-attenuates-experimental-haemorrhagic-shock-induced-renal-damage-through-an-inos-dependent-mechanism-in-male-wistar-rats
#8
M Ranjbaran, M Kadkhodaee, B Seifi, M Adelipour, B Azarian
AIM: Erythropoietin (EPO) is shown to exert protective effects on different tissues in haemorrhagic shock (HS) states. Nitric oxide (NO), as a multifunctional signaling molecule, is implicated in diverse physiologic and pathologic processes. In order to understand the exact mechanism of EPO protection, in this study we evaluated the role of different NOS enzymes in the EPO signaling pathway in male rats. METHODS: Rats were randomized to five groups: 1) Sham, 2) HS 3) EPO 4) L-NAME, a non-specific NOS inhibitor 5) 1400W, a specific iNOS inhibitor...
February 2017: Injury
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#9
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28070330/the-approximated-cardiovascular-reserve-index-complies-with-haemorrhage-related-hemodynamic-deterioration-pattern-a-swine-exsanguination-model
#10
Roy Nadler, Elon Glassberg, Itay E Gabbay, Linn Wagnert-Avraham, Gal Yaniv, David Kushnir, Arik Eisenkraft, Ben-Zion Bobrovsky, Uri Gabbay
BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHODS: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28062078/-coexistence-of-acute-appendicitis-and-dengue-fever-a-case-report
#11
Juan Fidel Osuna-Ramos, Carlos Silva-Gracia, Gerardo Joel Maya-Vacio, Alejandra Romero-Utrilla, Efrén Rafael Ríos-Burgueño, Jesús Salvador Velarde-Félix
BACKGROUND: Dengue is the most important human viral disease transmitted by mosquitoes. It can be asymptomatic or it can present in any of its 3clinical forms: Dengue fever, dengue haemorrhagic fever and dengue shock syndrome. However, some atypical manifestations have been reported in surgical emergencies caused by acute appendicitis in patients with dengue fever. CLINICAL CASE: We report the case of an 18-year-old Mexican male who presented to the emergency department of the General Hospital of Culiacan, Sinaloa, with symptoms of dengue fever, accompanied by crampy abdominal pain with positive Rovsing and Dunphy signs...
January 3, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28050452/primary-abdominal-pregnancy-a-case-report
#12
Sunita Dubey, Mohit Satodiya, Priyanka Garg, Mamta Rani
Abdominal pregnancy is a potentially life threatening form of ectopic gestation with an incidence of 1% of all the ectopic pregnancies. Rarely, it may reach at advanced gestation and a viable fetal outcome is indeed a rare event. Most of them are terminated earlier due to poor fetal prognosis and higher chances of maternal mortality secondary to haemorrhagic shock following spontanous placental separation. A high index of suspicion is important for making a diagnosis of abdominal pregnancy and its timely management after correct diagnosis...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28009388/acute-gastrointestinal-haemorrhage-on-board-a-cruise-ship-in-the-antarctic-peninsula
#13
Mathieu Carron, Peter Globokar, Bruno A Sicard
Antarctic tourism on board cruise ships has expanded since the 1990s, essentially in the Antarctic Peninsula. Due to remoteness, medical cases may evolve into life threatening conditions as emergency medical evacuations are challenging. We discuss the case of a young crew member who suddenly fainted with an epigastric pain and abundant rectal bleeding while on board a cruise ship heading to the Deception Island (62°57.6 South, 60°29.5 West), 44 h away from Ushuaia by sea. A medical evacuation was necessary to save the patient whose haemoglobin level rapidly decreased from 11 g/dL to 8...
2016: International Maritime Health
https://www.readbyqxmd.com/read/28003301/safety-and-feasibility-of-sublingual-microcirculation-assessment-in-the-emergency-department-for-civilian-and-military-patients-with-traumatic-haemorrhagic-shock-a-prospective-cohort-study
#14
David N Naumann, Clare Mellis, Iain M Smith, Jasna Mamuza, Imogen Skene, Tim Harris, Mark J Midwinter, Sam D Hutchings
OBJECTIVES: Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#15
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27931646/haemodynamic-coherence-in-haemorrhagic-shock
#16
REVIEW
Nicolas Libert, Anatole Harrois, Jacques Duranteau
In case of haemorrhage, a combination of low volume fluid resuscitation and permissive hypotension is used to avoid the adverse effects of early aggressive fluid resuscitation. During this phase, occult microvascular hypoperfusion can possibly develop over time. After controlling the bleeding, it is expected that optimization of macrocirculation will result in an improvement in microcirculation. However, this is the case only without alterations in microcirculation regulation. Haemodynamic coherence must be maintained to expect the restoration of microcirculation through systemic haemodynamic-driven resuscitation...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931645/haemodynamic-coherence%C3%A2-%C3%A2-the-relevance-of-fluid-therapy
#17
REVIEW
Philip Arnemann, Laura Seidel, Christian Ertmer
The ultimate goal of fluid therapy is to improve the oxygenation of cells by improving the cardiac output, thus improving microcirculation by optimizing macrocirculation. This haemodynamic coherence is often altered in patients with haemorrhagic shock and sepsis. The loss of haemodynamic coherence is associated with adverse outcomes. It may be influenced by the mechanisms of the underlying disease and properties of different fluids used for resuscitation in these critically ill patients. Monitoring microcirculation and haemodynamic coherence may be an additional tool to predict the response to fluid administration...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27921447/haemorrhagic-shock-due-to-spontaneous-splenic-rupture-in-a-patient-subsequently-diagnosed-with-advanced-ovarian-cancer
#18
Mariaclelia La Russa, Fani Kokka, Michelle Lockley, Elly Brockbank
No abstract text is available yet for this article.
December 6, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27920694/pancreatic-and-hepatic-metastasis-of-an-undiagnosed-choriocarcinoma-an-exceptional-cause-of-haemoperitoneum-in-young-women-report-of-a-rare-case
#19
Nishat Fatema, Neeru Vinod Arora, Fatma Majid Al Abri, Yaseer Muhammad Tareq Khan
Haemoperitoneum in women of reproductive age usually suggests either ruptured ectopic pregnancy or ruptured ovarian cysts. Metastatic choriocarcinoma is considered the least common cause of haemoperitoneum in women of childbearing age. We report a rare case of pancreatic and hepatic metastasis of choriocarcinoma in a young, 30-year-old female who had delivered 10 months prior at term gestation with no previous history of gestational trophoblastic disease or molar pregnancy. She had a short history of fever and pain in the right hypochondrium, with findings of hypovolaemic shock due to intraperitoneal haemorrhage...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27882764/-acute-pancreatitis-in-pregnancy-complicated-by-rupture-of%C3%A2-aneurysm-of-artery-lienalis
#20
E Hostinská, K Huml, R Pilka
OBJECTIVE: We present a case of pregnant woman with acute pacreatitis in 38th week comlicated by acute rupture of aneurysm of artery lienalis. DESIGN: Case report. SETTING: Department of Gynaecology and Obstetrics, Faculty Hospital and Palacky University, Olomouc. CASE REPORT: 28-years-old primipara in 38th week of gestation was admitted to our department for acute pancreatitis caused by gallstones. Subsequent conservative treatment was complicated by rupture of aneurysm of lienal artery and haemorrhagic shock...
2016: Ceská Gynekologie
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