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hemostatic resuscitation

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https://www.readbyqxmd.com/read/29664514/-damage-control-resuscitation-in-pediatric-severe-trauma
#1
Adriana Wegner Araya
INTRODUCTION: Trauma is an important cause of morbidity and mortality in the pediatric population. It has the first place in mortality in our country without considering perinatal pathologies and congenital malformations. An important percentage of early and late deaths secondary to this cau se, as well as its sequelae, could be prevented with optimal and timely resuscitation. OBJECTIVE: To review the applicability of damage control resuscitation (DCR) in severe pediatric trauma, with emphasis on medical management...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29661286/comparison-of-zone-3-resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-abdominal-aortic-and-junctional-tourniquet-in-a-model-of-junctional-hemorrhage-in-swine
#2
Jason M Rall, Theodore T Redman, Elliot M Ross, Jonathan J Morrison, Joseph K Maddry
BACKGROUND: Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field; however, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and the Abdominal Aortic and Junctional Tourniquet (AAJT) constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. METHODS: Yorkshire swine (n = 10, 70-90 kg) underwent general anesthesia, instrumentation, and surgical isolation of the femoral artery...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29622331/postoperative-tonsillectomy-hemorrhage
#3
REVIEW
Jessica J Wall, Khoon-Yen Tay
Post-tonsillectomy hemorrhage represents a potentially life-threatening condition that occurs in up to 5% of pediatric patients. Minor bleeding often precedes severe hemorrhage. Patients with minor or self-resolving bleeding should be observed in the emergency department or admitted for monitoring. Patients with severe bleeding should be immediately assessed for airway and hemodynamic stability. Management of severe bleeding includes immediate surgical consultation or initiation of the transfer process to a center with surgical capabilities, direct pressure to the site of hemorrhage with or without the additional of a hemostatic agent, possible rapid sequence intubation, and management of hemodynamic instability with volume resuscitation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29554046/the-evolution-of-pediatric-transfusion-practice-during-combat-operations-2001-2013
#4
Jeremy W Cannon, Lucas P Neff, Heather F Pidcoke, James K Aden, Philip C Spinella, Michael A Johnson, Andrew P Cap, Matthew A Borgman
BACKGROUND: Hemostatic resuscitation principles have significantly changed adult trauma resuscitation over the past decade. Practice patterns in pediatric resuscitation likely have changed as well; however, this evolution has not been quantified. We evaluated pediatric resuscitation practices over time within a combat trauma system. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2013 for pediatric patients (<18 years). Patients with burns, drowning, and missing injury severity score were excluded...
June 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29538234/intravenous-administration-of-synthetic-platelets-synthoplatetm-in-a-mouse-liver-injury-model-of-uncontrolled-hemorrhage-improves-hemostasis
#5
Mitchell R Dyer, DaShawn Hickman, Norman Luc, Shannon Haldeman, Patricia Loughran, Christa Pawlwoski, Anirban Sen Gupta, Matthew D Neal
BACKGROUND: Clinical resuscitative treatment of traumatic hemorrhage involves transfusion of RBC, platelets and plasma in controlled ratios. However, use of such blood components, especially platelets, present many challenges including availability, portability, contamination risks, and short shelf-life, which limit the use of platelet transfusions outside of large trauma centers such as remote civilian hospitals and austere pre-hospital settings. This has prompted significant research in platelet substitutes that may resolve the above issues while providing platelet-mimetic hemostatic action...
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29510717/restrictive-versus-massive-fluid-resuscitation-strategy-refill-study-influence-on-blood-loss-and-hemostatic-parameters-in-obstetric-hemorrhage-study-protocol-for-a-randomized-controlled-trial
#6
Natascha de Lange, Pim Schol, Marcus Lancé, Mallory Woiski, Josje Langenveld, Robbert Rijnders, Luc Smits, Martine Wassen, Yvonne Henskens, Hubertina Scheepers
BACKGROUND: Postpartum hemorrhage (PPH) is associated with maternal morbidity and mortality and has an increasing incidence in high-resource countries, despite dissemination of guidelines, introduction of skills training, and correction for risk factors. Current guidelines advise the administration, as fluid resuscitation, of almost twice the amount of blood lost. This advice is not evidence-based and could potentially harm patients. METHODS: All women attending the outpatient clinic who are eligible will be informed of the study; oral and written informed consent will be obtained...
March 6, 2018: Trials
https://www.readbyqxmd.com/read/29474273/damage-control-resuscitation-in-pediatric-trauma
#7
Meghan Gilley, Suzanne Beno
PURPOSE OF REVIEW: Damage control resuscitation is an overall management strategy used in trauma patients to rapidly restore physiologic stability, while mitigating hypothermia, coagulopathy and acidosis. We review the evidence and current practice of damage control resuscitation in pediatric trauma patients with a specific focus on fluid management. RECENT FINDINGS: There have been a number of studies over the last several years examining crystalloid fluid resuscitation, balanced blood product transfusion practice and hemostatic agents in pediatric trauma...
June 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29470190/blood-transfusion-management-in-the-severely-bleeding-military-patient
#8
Jennifer M Gurney, Philip C Spinella
PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29443862/red-tides-mass-casualty-and-whole-blood-at-sea-red-tides
#9
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29430670/the-effect-of-3-resuscitative-fluid-therapies-on-hemostasis-as-measured-by-rotational-thromboelastometry-in-dogs
#10
Sunita Seshia, M Casey Gaunt, Beverly A Kidney, Marion L Jackson
BACKGROUND: Evidence suggests that administration of intravenous fluids impairs hemostasis. Thromboelastometry (TEM) may provide a more sensitive measure of the fluid effects on hemostasis than traditional coagulation tests. OBJECTIVE: The study aim was to determine if resuscitative fluid therapy affects hemostasis, as measured by TEM. MATERIALS AND METHODS: Using a randomized crossover design, 6 healthy dogs were administered intravenous colloid, crystalloid, and hypertonic saline at therapeutic doses...
March 2018: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/29389838/too-little-too-late-hypotension-and-blood-transfusion-in-the-trauma-bay-are-independent-predictors-of-death-in-injured-children
#11
Christine M Leeper, Christine McKenna, Barbara A Gaines
BACKGROUND: Hypotension is a late finding in pediatric shock despite significant blood loss; consequently, recognition of hemodynamic compromise can be delayed. We sought to describe the impact of late stage shock in children, indicated by hypotension or trauma bay blood transfusion, and quantify the association with poor outcome. METHODS: Children age<18 from the Pennsylvania Trauma Outcome Study registry (2000-2013) were included. Primary outcome was mortality...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29389749/trauma-and-transfusion-in-the-geriatric-patient
#12
Corey S Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29334568/goal-directed-hemostatic-resuscitation-for-trauma-induced-coagulopathy-maintaining-homeostasis
#13
Ernest E Moore, Hunter B Moore, Michael P Chapman, Eduardo Gonzalez, Angela Sauaia
No abstract text is available yet for this article.
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29332316/how-do-i-implement-a-whole-blood-program-for-massively-bleeding-patients
#14
Mark H Yazer, Andrew P Cap, Philip C Spinella, Louis Alarcon, Darrell J Triulzi
Building on the successful military experience, interest has been rekindled in transfusing whole blood (WB) early in the resuscitation of traumatically injured civilians, often before their ABO group is known. WB efficiently provides treatment for shock and coagulopathy, as well as platelet hemostatic function, to patients losing large volumes of blood. Unlike group O uncrossmatched red blood cells (RBCs), group O WB contains a substantial amount of plasma, which is incompatible with the RBCs of all non-group O recipients...
March 2018: Transfusion
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#15
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a noninvasive clamp of the aorta after diverse posttraumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop ongoing bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29286568/utilization-of-frozen-plasma-cryoprecipitate-and-recombinant-factor-viia-for-children-with-hemostatic-impairments-an-audit-of-transfusion-appropriateness
#16
Lani Lieberman, Yulia Lin, Christine Cserti-Gazdewich, Qi Long Yi, Jacob Pendergrast, Wendy Lau, Jeannie Callum
BACKGROUND: Blood transfusions and fractionated products are not without risk and may lead to acute and long-term adverse events. The objective of this study was to evaluate the appropriateness of usage of frozen plasma (FP), cryoprecipitate (CRYO), and recombinant factor VIIa (rVIIa) in a pediatric setting. METHODS: All orders for FP, CRYO, and rVIIa were prospectively audited over 6 weeks. Data collected included demographics, laboratory values, indication, and adverse reactions...
April 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29251714/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-and-meta-analysis
#17
Alexandre Tran, Maher Matar, Jacinthe Lampron, Ewout Steyerberg, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Delays in appropriate triage of bleeding trauma patients result in poor outcomes. Clinical gestalt is fallible and objective measures of risk stratification are needed. The objective of this review is to identify and assess prediction models and predictors for the early identification of traumatic hemorrhage patients requiring massive transfusion, surgery, or embolization. METHODS: We searched electronic databases through to September 31, 2016, for studies describing clinical, laboratory, and imaging predictors available within the first hour of resuscitation for identifying patients requiring major intervention for hemorrhage within the first 24 hours...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#18
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29123853/high-grade-traumatic-torso-visceral-injury-with-hemodynamic-instability-effectiveness-of-transarterial-embolization-using-n-butyl-cyanoacrylate
#19
REVIEW
Junya Tsurukiri, Shoichi Ohta, Akira Hoshiai, Hidefumi Sano, Eitaro Okumura, Nobuhiko Tsubouchi, Hiroyuki Konishi, Tetsuo Yukioka
Trauma patients with uncontrolled hemorrhage encountering coagulopathy are often associated with poor outcome. Recently, the concept of damage control interventional radiology, which focuses on "speedy stoppage of bleeding" by interventional radiology among trauma patients with hemodynamic instability and acute traumatic coagulopathy, was proposed as an alternative to damage control surgery. N-butyl cyanoacrylate (NBCA) has been used as a liquid embolic agent in various non-traumatic situations, where it has been shown to have a high technical success rate and low recurrent bleeding rate, especially in patients with coagulopathy...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29112094/thrombelastography-early-amplitudes-in-bleeding-and-coagulopathic-trauma-patients-results-from-a-multicenter-study
#20
Thomas H Laursen, Martin A S Meyer, Anna Sina P Meyer, Tina Gaarder, Paal A Naess, Jakob Stensballe, Sisse R Ostrowski, Pär I Johansson
BACKGROUND: Early amplitudes in the viscoelastic hemostatic assays, thrombelastography (TEG) and rotation thromboelastometry (ROTEM), provide fast results, which is critical in the resuscitation of bleeding patients. This study investigated associations between TEG early amplitudes and standard TEG variables in a large multicenter cohort of moderately to severely injured trauma patients admitted at three North European Level I Trauma Centers. METHODS: Prospective observational study of 404 trauma patients with clinical suspicion of severe injury from London, UK, Copenhagen, Denmark and Oslo, Norway...
February 2018: Journal of Trauma and Acute Care Surgery
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