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Haemorrhagic shock management

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https://www.readbyqxmd.com/read/29897100/controlled-hypotension-versus-normotensive-resuscitation-strategy-for-people-with-ruptured-abdominal-aortic-aneurysm
#1
REVIEW
Daniel H Moreno, Daniel G Cacione, Jose Cc Baptista-Silva
BACKGROUND: An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair...
June 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29894924/surgical-treatment-of-postoperative-laparostomy-and-pyloroduodenostomy-case-report
#2
António Bernardes, Catarina Melo, Sandra Ferraz
INTRODUCTION: Postoperative duodenal-cutaneous fistula represents a rare and very complex problem. In most cases operative management becomes necessary, but only after local and systemic stabilization and sepsis control. CASE PRESENTATION: A 39-year-old man was admitted for surgical management of laparostomy and pyloro-duodenostomy of the first (DI) and second (DII) duodenal segments with one year of evolution, as a complication of several surgical interventions...
June 4, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29793591/effect-of-early-use-of-noradrenaline-on-in-hospital-mortality-in-haemorrhagic-shock-after-major-trauma-a-propensity-score-analysis
#3
T Gauss, E Gayat, A Harrois, M Raux, A Follin, J-L Daban, F Cook, S Hamada
BACKGROUND: The role of vasopressors in trauma-related haemorrhagic shock (HS) remains a matter of debate. They are part of the most recent European recommendations on the management of HS and are regularly used in France. We assessed the effect of early administration of noradrenaline in 24 h mortality of trauma patients in HS, using a propensity-score analysis. METHODS: The study included patients from a multicentre prospective regional trauma registry. HS was defined as transfusion of ≥4 erythrocyte-concentrate units during the first 6 h...
June 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29717984/effect-of-tranexamic-acid-on-intra-and-postoperative-haemorrhage-in-dogs-with-surgically-treated-hemoperitoneum
#4
N Sigrist, L Olgiati, R S Jud Schefer
Tranexamic acid (TXA) is an antifibrinolytic drug that is used for uncontrolled bleeding of various origin. This retrospective study investigated the effect of tranexamic acid administration on bleeding tendency in dogs with surgically managed hemoperitoneum. Thirty dogs were treated with (TXA group) and 25 dogs without (CTR group) tranexamic acid prior to surgery. Various parameters (decrease in haematocrit, number of transfusions, shock index and changes in abdominal fluid accumulation) were used for characterization of bleeding tendency and compared between groups...
May 2018: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29664833/effect-of-pre-hospital-red-blood-cell-transfusion-on-mortality-and-time-of-death-in-civilian-trauma-patients
#5
Marius Rehn, Anne Weaver, Karim Brohi, Sarah Eshelby, Laura Green, Jo Røislien, David J Lockey
BACKGROUND: Current management principles of haemorrhagic shock after trauma emphasize earlier transfusion therapy to prevent dilution of clotting factors and correct coagulopathy. London's air ambulance (LAA) was the first UK civilian pre-hospital service to routinely offer pre-hospital red blood cell (RBC) transfusion (phRTx). We investigated the effect of phRTx on mortality. METHODS: Retrospective trauma database study comparing mortality before-implementation with after-implementation of phRTx in exsanguinating trauma patients...
April 16, 2018: Shock
https://www.readbyqxmd.com/read/29657718/endotracheal-tube-clamping-and-extracorporeal-membrane-oxygenation-to-resuscitate-massive-pulmonary-haemorrhage
#6
Chien-Feng Lee, Chun-Ta Huang, Sheng-Yuan Ruan
Massive pulmonary haemorrhage is a life-threatening and difficult-to-manage condition. In certain circumstances, traditional approaches for haemoptysis may not be effective. Here, we report a 64-year-old man presenting with dyspnoea and leg oedema. He was diagnosed with microscopic polyangiitis due to positive perinuclear anti-neutrophil cytoplasmic antibody and other supportive evidence. His hospital course was complicated with massive pulmonary haemorrhage, which led to hypoxic respiratory failure, shock, and pulseless electrical activity...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29587875/evaluation-of-a-novel-device-for-the-management-of-high-blood-pressure-and-shock-in-pregnancy-in-low-resource-settings-study-protocol-for-a-stepped-wedge-cluster-randomised-controlled-trial-cradle-3-trial
#7
Hannah L Nathan, Kate Duhig, Nicola Vousden, Elodie Lawley, Paul T Seed, Jane Sandall, Mrutyunjaya B Bellad, Adrian C Brown, Lucy C Chappell, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Andrew H Shennan
BACKGROUND: Obstetric haemorrhage, sepsis and pregnancy hypertension account for more than 50% of maternal deaths worldwide. Early detection and effective management of these conditions relies on vital signs. The Microlife® CRADLE Vital Sign Alert (VSA) is an easy-to-use, accurate device that measures blood pressure and pulse. It incorporates a traffic-light early warning system that alerts all levels of healthcare provider to the need for escalation of care in women with obstetric haemorrhage, sepsis or pregnancy hypertension, thereby aiding early recognition of haemodynamic instability and preventing maternal mortality and morbidity...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29566986/fractures-of-the-femur-and-blood-transfusions
#8
Adam Wertheimer, Alexander Olaussen, Shanaka Perera, Susan Liew, Biswadev Mitra
BACKGROUND: Blood loss estimation after trauma (i.e. physical injury) and early identification of potential sources of bleeding are important for planning of investigation and management of trauma. Long bone fractures have been reported to be associated with substantial volumes of blood loss requiring blood transfusion. The aim of this study was to assess rates and amounts of blood transfusion in the setting of isolated extra capsular femur fractures and to determine variables associated with the need for transfusion within the first 48 h of admission...
April 2018: Injury
https://www.readbyqxmd.com/read/29536060/laparoscopic-splenectomy-for-splenic-rupture-secondary-to-metastatic-choriocarcinoma
#9
Tan Ming Ngan Aloysius, Vishalkumar G Shelat
Gestational choriocarcinoma is a rare and aggressive type of gestational trophoblastic neoplasia, which is characterized by early vascular invasion and widespread metastases. Choriocarcinoma metastasizes hematogenously, and bleeding from metastases is common. Splenic rupture from a metastatic tumour is exceedingly rare, with only a few reports. We report a case of a 41-year-old female presenting with acute abdomen and haemorrhagic shock secondary to splenic rupture from metastatic choriocarcinoma, which was managed with emergency laparoscopic splenectomy...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/29476943/evolution-and-organisation-of-trauma-systems
#10
Jean Stéphane David, Pierre Bouzat, Mathieu Raux
Over the last 20 years, numerous studies have fairly consistently reported an improvement in the prognosis of patients with severe trauma after the establishment of a trauma network. These systems can be either exclusive, in which all patients are referred only to a small number of specifically designated centres that meet strict criteria, or inclusive, in which patients may be referred to any hospital of a particular area according to capacity, which is observed in France. Hospitals are classified (level 1 to level 3) according to their technical facilities and the number of patients admitted for severe trauma, knowing that studies have also shown an improvement of the outcome for the most severely injured patients (haemorrhagic shock, severe head trauma), in hospitals with the greatest technical facilities and the most important activity...
February 21, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29440469/air-drop-blood-supply-in-the-french-army
#11
Olivier Javaudin, A Baillon, N Varin, C Martinaud, T Pouget, C Civadier, B Clavier, A Sailliol
BACKGROUND: Haemorrhagic shock remains the leading cause of preventable death in overseas and austere settings. Transfusion of blood components is critical in the management of this kind of injury. For French naval and ground military units, this supply often takes too long considering the short shelf-life of red blood cell concentrates (RBCs) and the limited duration of transport in cooling containers (five to six days). Air-drop supply could be an alternative to overcome these difficulties on the condition that air-drop does not cause damage to blood units...
February 12, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29440235/do-patients-with-blunt-thoracic-aortic-injury-present-to-hospital-with-unstable-vital-signs-a-systematic-review-and-meta-analysis
#12
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
April 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29389837/airway-and-ventilation-management-strategies-for-haemorrhagic-shock-to-tube-or-not-to-tube-that-is-the-question
#13
Anthony J Hudson, Geir Strandenes, Christopher K Bjerkvig, Marius Svanevik, Elon Glassberg
Many standard trauma management guidelines advocate the early use of endotracheal intubation and positive pressure ventilation as key treatment interventions in haemorrhagic shock. The evidence for using these airway and ventilation strategies to manage a circulation problem is unclear. The potentially harmful effects of drug assisted intubation and positive pressure ventilation include reduced cardiac output, apnoea, hypoxia, hypocapnoea (due to inadvertent hyperventilation) and unnecessarily prolonged on-scene times...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29297368/the-bloody-mess-of-red-blood-cell-transfusion
#14
REVIEW
Susilo Chandra, Hrishikesh Kulkarni, Martin Westphal
Red blood cell (RBC) transfusion might be life-saving in settings with acute blood loss, especially uncontrolled haemorrhagic shock. However, there appears to be a catch-22 situation reflected by the facts that preoperative anaemia represents an independent risk factor for postoperative morbidity and mortality, and that RBC transfusion might also contribute to adverse clinical outcomes. This dilemma is further complicated by the difficulty to define the "best" transfusion trigger and strategy. Since one size does obviously not fit all, a personalised approach is merited...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29079917/permissive-hypotensive-resuscitation-in-adult-patients-with-traumatic-haemorrhagic-shock-a-systematic-review
#15
REVIEW
Mohammed Albreiki, David Voegeli
BACKGROUND: Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation whilst treating severely injured patients, and its effectiveness on the survival rate remains unexplored. This detailed systematic review aims to critically evaluate the available literature that investigates the effects of PHR on survival rate. METHODS: A systematic review design searched for comparative and non-comparative studies using EMBASE, MEDLINE, PubMed, Web-of-Science and CENTRAL...
April 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#16
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29029632/fatal-haemorrhage-and-neoplastic-thrombosis-in-a-captive-african-lion-panthera-leo-with-metastatic-testicular-sex-cord-stromal-tumour
#17
Omar Antonio Gonzales-Viera, Angélica María Sánchez-Sarmiento, Natália Coelho Couto de Azevedo Fernandes, Juliana Mariotti Guerra, Rodrigo Albergaria Ressio, José Luiz Catão-Dias
BACKGROUND: The study of neoplasia in wildlife species contributes to the understanding of cancer biology, management practices, and comparative pathology. Higher frequencies of neoplasms among captive non-domestic felids have been reported most commonly in aging individuals. However, testicular tumours have rarely been reported. This report describes a metastatic testicular sex cord-stromal tumour leading to fatal haemorrhage and thrombosis in a captive African lion (Panthera leo). CASE PRESENTATION: During necropsy of a 16-year-old male African lion, the left testicle and spermatic cord were found to be intra-abdominal (cryptorchid), semi-hard and grossly enlarged with multiple pale-yellow masses...
October 13, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28977019/effectiveness-of-a-fluid-chart-in-outpatient-management-of-suspected-dengue-fever-a-pilot-study
#18
RANDOMIZED CONTROLLED TRIAL
Nazrila Hairin Nasir, Mohazmi Mohamad, Lucy Chai See Lum, Chirk Jenn Ng
INTRODUCTION: Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever...
2017: PloS One
https://www.readbyqxmd.com/read/28931184/-modern-interdisciplinary-management-of-a-uretero-iliac-artery-fistula-case-report
#19
D Benedix, F Meyer, F Fischbach, A Janitzky, Z Halloul
Introduction Abnormal links between the arterial system and other luminal systems are a challenge to those in charge of their adequate diagnostic and therapeutic management. Objective Scientific case report on an individual who underwent successful treatment combining vascular-surgical and interventional radiology techniques for a rare right uretero-iliac artery fistula based on personal clinical experience, a selective literature research and a detailed discussion of current recommendations for diagnostic workup and subsequent treatment...
September 20, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28904675/von-willebrand-s-disease-case-report-and-review-of-literature
#20
REVIEW
Hanae Echahdi, Brahim El Hasbaoui, Mohamed El Khorassani, Aomar Agadr, Mohamed Khattab
Von Willebrand Disease (VWD) is the most common human inherited bleeding disorder due to a defect of Von Willebrand Factor (VWF), which a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels < 50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50IU/dL)...
2017: Pan African Medical Journal
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