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Acute traumatic coagulopathy

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https://www.readbyqxmd.com/read/29123853/high-grade-traumatic-torso-visceral-injury-with-hemodynamic-instability-effectiveness-of-transarterial-embolization-using-n-butyl-cyanoacrylate
#1
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/29110832/thromboelastometric-profile-and-acute-coagulopathy-of-the-polytraumatized-patient-clinical-and-prognostic-implications
#2
Antònia Bonet, Zoilo Madrazo, Maylin Koo, Israel Otero, Montserrat Mallol, Irene Macia, Luciano Ramirez, Antoni Sabaté
INTRODUCTION: About 25-35% of polytraumatized patients have a profound alteration of hemostasis on arrival at the hospital (acute traumatic coagulopathy [CAT]). Viscoelastic tests (ROTEM(®)) measure the hemostatic capacity and provide an early detection of CAT. The objectives of this study are to describe the initial thromboelastogram of these patients and to determine the prevalence of CAT according to predefined thromboelastographic profiles. METHODS: Single-center, observational, prospective study in polytraumatic patients...
October 27, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29095714/current-trends-in-the-management-of-hemodynamically-unstable-pelvic-ring-injuries
#3
Philip F Stahel, Clay C Burlew, Ernest E Moore
PURPOSE OF REVIEW: Complex traumatic pelvic ring disruptions are associated with a high mortality rate due to associated retroperitoneal hemorrhage, traumatic-hemorrhagic shock, and postinjury coagulopathy. The present review provides an update on current management strategies to improve survival rates form hemodynamically unstable pelvic ring injuries. RECENT FINDINGS: Recently published international consensus guidelines have attempted to standardize the classification of hemodynamically unstable pelvic ring injuries and provided classification-based management algorithms for acute resuscitation and pelvic ring stabilization...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29078927/acquired-bleeding-disorders
#4
REVIEW
Alisheba Hurwitz, Richard Massone, Bernard L Lopez
Emergency medicine practitioners treat bleeding patients on a regular basis. Disorders of hemostasis are an additional challenge in these patients but can be assessed and managed in a systematic fashion. Of particular importance to the emergency clinician are the iatrogenic causes of abnormal hemostasis. Other acquired causes of abnormal hemostasis include renal disease, immune thrombocytopenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, acquired coagulation factor inhibitors, acute traumatic coagulopathy, liver disease, and disseminated intravascular coagulopathy...
December 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29078871/shedding-new-light-on-rapidly-resolving-traumatic-acute-subdural-hematomas
#5
Magdalene Brooke, Atul Patel, Federico Castro-Moure, Gregory P Victorino
BACKGROUND: Rapidly resolving acute subdural hematomas (RRASDHs) have been described in case reports and case series but are still poorly understood. We hypothesized that a cohort analysis would confirm previously reported predictors of RRASDH including coagulopathy, additional intracranial hemorrhage, and low-density band on imaging. We also hypothesized that rapid resolution would be associated with improved trauma outcomes. METHODS: We reviewed all nonoperative acute subdural hematomas (ASDHs) treated at our center from 2011 to 2015...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29059118/early-haemorrhage-control-and-management-of-trauma-induced-coagulopathy-the-importance-of-goal-directed-therapy
#6
Jakob Stensballe, Hanne H Henriksen, Pär I Johansson
PURPOSE OF REVIEW: The aim of this study was to discuss the recent developments in trauma-induced coagulopathy and the evolvement of goal-directed therapy. RECENT FINDINGS: Mortality from major trauma continues to be a worldwide problem, and massive haemorrhage remains a major cause in 40% of potentially preventable trauma deaths. Development of trauma-induced coagulopathy challenges 25-35% of the patients further increasing trauma mortality. The pathophysiology of coagulopathy in trauma reflects at least two distinct mechanisms: Acute traumatic coagulopathy, consisting of endogenous heparinization, activation of the protein C pathway, hyperfibrinolysis and platelet dysfunction, and resuscitation associated coagulopathy...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29042693/occult-sources-of-bleeding-in-blunt-trauma-a-narrative-review
#7
REVIEW
Tetsuya Yumoto, Yoshinori Kosaki, Yasuaki Yamakawa, Atsuyoshi Iida, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Hiromichi Naito, Takaaki Osako, Atsunori Nakao
Worldwide, hemorrhagic shock in major trauma remains a major potentially preventable cause of death. Controlling bleeding and subsequent coagulopathy is a big challenge. Immediate assessment of unidentified bleeding sources is essential in blunt trauma patients with hemorrhagic shock. Chest/pelvic X-ray in conjunction with ultrasonography have been established classically as initial diagnostic imaging modalities to identify the major sources of internal bleeding including intra-thoracic, intra-abdominal, or retroperitoneal hemorrhage related to pelvic fracture...
October 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28981587/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#8
(no author information available yet)
No abstract text is available yet for this article.
August 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28966820/age-related-differences-in-fibrinolytic-parameters-in-patients-with-acute-traumatic-brain-injury
#9
Ryuta Nakae, Shoji Yokobori, Yasuhiro Takayama, Kentaro Kuwamoto, Yasutaka Naoe, Hiroyuki Yokota
BACKGROUND: Coagulopathy and old age have been associated with poor outcomes in traumatic brain injury (TBI) patients; however, the relationships of coagulopathy and age with the acute phase of TBI remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more severe in older patients in the acute phase of TBI and may explain, in part, their poor outcome. METHODS: We analyzed the relationship between coagulation/fibrinolytic parameters and age in the acute phase of TBI by retrospectively evaluating 274 patients with initial blood samples obtained no more than 1 hour after injury...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28948335/damage-control-surgery-for-non-traumatic-abdominal-emergencies
#10
Edouard Girard, Julio Abba, Bastien Boussat, Bertrand Trilling, Adrian Mancini, Pierre Bouzat, Christian Létoublon, Mircea Chirica, Catherine Arvieux
BACKGROUND: Damage control surgery (DCS) was a major paradigm change in the management of critically ill trauma patients and has gradually expanded in the general surgery arena, but data in this setting are still scarce. The study aim was to evaluate outcomes of DCS in patients with general surgery emergencies. METHODS: Between 2005 and 2015, 164 patients (104 men, age 66) underwent DCS for non-traumatic abdominal emergencies. The decision to perform DCS was triggered by the presence of at least one trauma DCS criterion: hypotension (<70 mmHg), hypothermia (<35 °C), acidosis (pH < 7...
September 25, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28920070/prevalence-and-associated-factors-of-acute-traumatic-coagulopathy-a-cross-sectional-study
#11
Hojjat Derakhshanfar, Ali Vafaei, Ali Tabatabaey, Shamila Noori
INTRODUCTION: Acute traumatic coagulopathy (ATC) is defined as having evidence of coagulopathy in patients with severe trauma. The aim of this preliminary study was to assess the prevalence and associated factors of ATC in severely traumatic patients presenting to emergency department (ED). METHODS: In this retrospective cross sectional study, all patients with severe traumatic injury and available coagulation profile, presenting to the EDs of two major trauma centers in Tehran, Iran, during one year, were studied...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28826407/disseminated-intravascular-coagulation-with-increased-fibrinolysis-during-the-early-phase-of-isolated-traumatic-brain-injury
#12
Takeshi Wada, Satoshi Gando, Kunihiko Maekaw, Kenichi Katabami, Hisako Sageshima, Mineji Hayakawa, Atsushi Sawamura
BACKGROUND: There is evidence to demonstrate that the coagulopathy which occurs in patients with traumatic brain injury coincides with disseminated intravascular coagulation (DIC). We hypothesized that DIC with increased fibrinolysis during the early stage of isolated traumatic brain injury (iTBI) affects the outcome of the patients and that hypoperfusion contributes to hyperfibrinolysis in the DIC. METHODS: This retrospective study included 92 patients with iTBI who were divided into DIC and non-DIC groups according to the Japanese Association Acute Medicine DIC scoring system...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28816786/acute-traumatic-coagulopathy-thrombin-is-the-driver
#13
Kenichi A Tanaka, Michael A Mazzeffi, Brittney Williams
No abstract text is available yet for this article.
September 2017: Anesthesiology
https://www.readbyqxmd.com/read/28765479/early-intracardiac-thrombus-and-pulmonary-embolus-after-trauma
#14
Neel Desai, Julia Heid, Andrew Leitch
Here, we present the case of a patient with the findings of an early intracardiac thrombus and a pulmonary embolus after major trauma. A large clot was identified extending from the inferior vena cava into the right atrium and ventricle in the setting of preserved right ventricular function. Post-traumatic intracardiac thrombus is extremely rare and no comparable cases have previously been described in the absence of a congenital heart defect and obvious myocardial injury. Best practice afterpost-traumatic intracardiac thrombus is not well established but we found that early inferior vena cava filter placement and treatment with therapeutic coagulation resulted in clinical improvement, resolution of the thrombus and no further emboli...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28637514/performance-of-point-of-care-international-normalized-ratio-measurement-to-diagnose-trauma-induced-coagulopathy
#15
Thomas Mistral, Yvonnick Boué, Jean-Luc Bosson, Pauline Manhes, Jules Greze, Julien Brun, Pierre Albaladejo, Jean-François Payen, Pierre Bouzat
BACKGROUND: Trauma-induced coagulopathy (TIC) is a common feature after severe trauma. Detection of TIC is based upon classic coagulation tests including international normalized ratio (INR) value. Point-of-care (POC) devices have been developed to rapidly measure INR at the bedside on whole blood. The aim of the study was to test the precision of the Coagucheck® XS Pro device for INR measurement at hospital admission after severe trauma. METHODS: We conducted a prospective observational study in a French level I trauma center...
June 21, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#16
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28480110/point-of-care-testing-in-the-acute-management-of-traumatic-brain-injury-identifying-the-coagulopathic-patient
#17
Yair M Gozal, Christopher P Carroll, Bryan M Krueger, Jane Khoury, Norberto O Andaluz
BACKGROUND: The use of anticoagulants or antiplatelet medications has become increasingly common and is a well-established risk factor for worsening of hemorrhages in trauma patients. The current study addresses the need to investigate the efficacy of point-of-care tests (POC) as an adjunct to conventional coagulation testing in traumatic brain injury (TBI) patients. METHODS: A retrospective review of 190 TBI patients >18 years of age who underwent both conventional and POC testing as part of their admission coagulopathy workup was conducted...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28477287/the-current-understanding-of-trauma-induced-coagulopathy-tic-a-focused-review-on-pathophysiology
#18
REVIEW
Stefano Giordano, Luca Spiezia, Elena Campello, Paolo Simioni
The emergency management of acute severe bleeding in trauma patients has changed significantly in recent years. In particular, greater attention is now being devoted to a prompt assessment of coagulation alterations, which allows for immediate haemostatic resuscitation procedures when necessary. The importance of an early trauma-induced coagulopathy (TIC) diagnosis has led physicians to increase the efforts to better understand the pathophysiological alterations observed in the haemostatic system after traumatic injuries...
May 5, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28465266/increased-transfusion-of-fresh-frozen-plasma-is-associated-with-mortality-or-worse-functional-outcomes-after-severe-traumatic-brain-injury-a-retrospective-study
#19
MULTICENTER STUDY
Li-Min Zhang, Rui Li, Xiao-Chun Zhao, Qian Zhang, Xing-Liao Luo
BACKGROUND: The fresh frozen plasma (FFP) transfusion threshold and timing for traumatic brain injury (TBI)-associated coagulopathy are controversial. Thus, a multicenter retrospective study was conducted to determine whether or not FFP transfusion is associated with poor outcomes after severe TBI. METHODS: Data from decompressive craniotomy after blunt force trauma that took place between December 2013 and June 2016 were collected in a multicenter chart. The primary outcomes were mortality and survival, as well as worse outcomes (defined as a Glasgow Outcome Scale [GOS] score ≤3) and better outcomes (GOS score ≥4)...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28366792/serum-macrophage-migration-inhibitory-factor-concentrations-correlate-with-prognosis-of-traumatic-brain-injury
#20
Ding-Bo Yang, Wen-Hua Yu, Xiao-Qiao Dong, Zu-Yong Zhang, Quan Du, Qiang Zhu, Zhi-Hao Che, Hao Wang, Yong-Feng Shen, Li Jiang
BACKGROUND: Macrophage migration inhibitory factor (MIF) is a well-known pro-inflammatory cytokine. Serum MIF concentrations are associated with the severity and prognosis of ischemic stroke. METHODS: In this prospective, observational study, white blood cell (WBC) count and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and MIF among 108 severe traumatic brain injury (TBI) patients and 108 controls were measured...
March 30, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
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