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Haemorrhagic shock management

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https://www.readbyqxmd.com/read/27864873/hereditary-haemorrhagic-telangiectasia-to-transplant-or-not-to-transplant-is-there-a-right-time-for-liver-transplantation
#1
Yannick D Muller, Roland Oppliger, Romain Breguet, Philippe Meyer, Laura Rubbia-Brandt, Pierre-Auguste Petignat, Thomas Harr, Eric Dayer, Jörg D Seebach
BACKGROUND & AIMS: Hereditary haemorrhagic telangiectasia is characterized by arterio-venous malformations (AVM). It frequently involves the liver without clinical symptoms, but may lead to biliary ischaemia, portal hypertension, or fatal high-output heart failure. The indication of liver transplantation is controversial. METHODS: Herein, we report the case of a 65-year-old female patient with a 'double Osler syndrome' consisting of hereditary haemorrhagic telangiectasia (HHT) and type I hereditary angioedema diagnosed at the age of 25 and 22 years respectively...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27833056/splenic-rupture-in-community-acquired-pneumonia-a-case-report
#2
Stephen Guy, Stefaan De Clercq
INTRODUCTION: Splenic rupture is a rare but potentially lethal complication of community acquired pneumonia. PRESENTATION OF CASE: We present an unusual case of haemorrhagic shock following splenic rupture requiring emergency splenectomy in a 49 year old female with community acquired pneumonia. DISCUSSION: The epidemiology, aetiology, pathogenesis, clinical features, investigation, management and outcomes of atraumatic splenic rupture are discussed...
October 26, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27797797/infrarenal-aortic-clamp-reviving-a-patient-from-acute-surgical-haemorrhagic-shock-a-novel-management-technique
#3
Ranjith Kumar, M V S Satya Prakash, Subhasree Das, Ramanitharan Manikandan
Surgical management of renal cell carcinoma extending into the inferior vena cava (IVC) is almost always accompanied by massive intraoperative blood loss and associated complications. It is a widely recognised problem, and its active management is essential in improving the perioperative morbidity and mortality. We share our experience with a similar case of open radical nephrectomy with massive blood loss of twice the circulating volume in a duration of <8 surgical hours. Although we emphasise the goals of securing haemostasis, restoration of circulating volume, and efficient management by replacing blood components, in the present case, despite the above-mentioned goals being fulfilled, we were unable to extricate the patient from haemorrhagic shock by conventional means and therefore resorted to desperate measures, namely the novel approach of infrarenal aortic clamping along with higher than recommended vasopressor support...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27793553/-thrombosis-during-thrombopoietin-receptor-agonist-treatment-for-immune-thrombocytopenia-a-french-multicentric-observational-study
#4
E Weber, G Moulis, M Mahévas, C Guy, B Lioger, I Durieu, M Hunault, M Ramanantsoa, B Royer, A Default, M-C Pérault-Pochat, L Moachon, N Bernard, G Bardy, A-P Jonville-Bera, H Geniaux, B Godeau, P Cathébras
INTRODUCTION: Thrombopoietin-receptor agonists (TPO-RA) are marketed for immune thrombocytopenia (ITP). They have been associated to thrombosis occurrence in randomized controlled trials. However, the characteristics of these thromboses in the real-life practice as well as their management are poorly known. The objectives of this study were to determine the risk factors, circumstances and management of thrombosis occurring during exposure to TPO-RA in ITP. METHODS: We carried out a multicentre retrospective study in France...
October 25, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27743399/dengue-related-osteonecrosis-of-the-maxillary-dento-alveolar-bone
#5
N M Al-Namnam, P Nambiar, P Shanmuhasuntharam, M Harris
Dengue is a mosquito transmitted flaviviral infection which can give rise to severe haemorrhage (dengue haemorrhagic fever/DHF) and with capillary leakage induces hypovolemic shock (dengue shock syndrome/DSS). Although dengue symptoms and complications have been known for many decades there has only been one documented case of osteonecrosis of the maxilla which was treated by excision of the necrotic bone. In this case of dengue infection, extensive maxillary osteonecrosis and minimal root resorption appeared to follow factitious injury with a toothpick but resolved with nonsurgical management...
October 15, 2016: Australian Dental Journal
https://www.readbyqxmd.com/read/27719798/nursing-procedures-in-dealing-with-haemorrhagic-shock
#6
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/27662216/acute-appendiceal-abscess-and-atraumatic-splenic-rupture-a-case-of-dual-pathology
#7
Piriyankan Ananthavarathan, Kamlesh Patel, Catherine Doran, Nigel Suggett
INTRODUCTION: Atraumatic splenic rupture is a rare surgical emergency that is often attributed to neoplastic or infectious causes. Rarely, it has been identified to also occur in the setting of an acute severe sepsis and in cases of pelvic or splenic abscess formation post-appendicectomy. However, to our knowledge, the co-presentation of acute appendiceal abscess and splenic rupture has not been previously described. PRESENTATION OF CASE: We present the case of a 67-year old male with decompensating haemorrhagic shock secondary to atraumatic splenic rupture on a background of an inadequately treated complicated appendicitis originally managed as diverticulitis with antibiotics in the community...
April 13, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27574675/new-perspectives-of-volemic-resuscitation-in-polytrauma-patients-a-review
#8
REVIEW
Ovidiu Horea Bedreag, Marius Papurica, Alexandru Florin Rogobete, Mirela Sarandan, Carmen Alina Cradigati, Corina Vernic, Corina Maria Dumbuleu, Radu Nartita, Dorel Sandesc
Nowadays, fluid resuscitation of multiple trauma patients is still a challenging therapy. Existing therapies for volume replacement in severe haemorrhagic shock can lead to adverse reactions that may be fatal for the patient. Patients presenting with multiple trauma often develop hemorrhagic shock, which triggers a series of metabolic, physiological and cellular dysfunction. These disorders combined, lead to complications that significantly decrease survival rate in this subset of patients. Volume and electrolyte resuscitation is challenging due to many factors that overlap...
2016: Burns and trauma
https://www.readbyqxmd.com/read/27531659/tactical-damage-control-resuscitation-in-austere-military-environments
#9
REVIEW
Yann Daniel, S Habas, L Malan, J Escarment, J-S David, S Peyrefitte
BACKGROUND: Despite the early uses of tourniquets and haemostatic dressings, blood loss still accounts for the vast majority of preventable deaths on the battlefield. Over the last few years, progress has been made in the management of such injuries, especially with the use of damage control resuscitation concepts. The early application of these procedures, on the field, may constitute the best opportunity to improve survival from combat injury during remote operations. DATA SOURCES: Currently available literature relating to trauma-induced coagulopathy treatment and far-forward transfusion was identified by searches of electronic databases...
December 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27503306/-preclinical-fibrinolysis-in-patients-with-st-segment-elevation-myocardial-infarction-in-a-rural-region
#10
T Viergutz, J Grüttner, T Walter, C Weiss, B Haaff, G Pollach, C Madler, T Luiz
BACKGROUND: In the current guidelines for the treatment of patients with ST-segment elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) recommends preclinical fibrinolysis as a reperfusion therapy if, due to long transportation times, no cardiac catheterisation is available within 90-120 min. However, there is little remaining in-depth expertise in this method because fibrinolysis is presently only rarely indicated. METHODS: In a rural area in southwestern Germany, where an emergency primary percutaneous coronary intervention was not routinely available within 90-120 min, 156 STEMI patients underwent fibrinolysis with the plasminogen activator reteplase, performed by trained emergency physicians...
September 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27456289/advances-in-the-diagnosis-of-shock-its-assessment-and-resuscitation-during-the-great-war
#11
A G P Bullingham
The Great War of 1914-1918 ushered in a new era of technology on the battlefield resulting in casualties on an unprecedented scale. There had been progress in many related areas of medicine before the outbreak of hostilities but these had not been applied or fully developed in clinical practice. This is particularly true for the management of haemorrhagic shock and resuscitation. This article discusses the history and development of medical treatment of shock and trauma patients during the conflict.
July 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27450867/preventing-deaths-due-to-haemorrhage
#12
G Justus Hofmeyr, Zahida Qureshi
Prevention of deaths from obstetric haemorrhage requires effective health systems including family planning, commodities, personnel, infrastructure and ultimately universal access to comprehensive obstetric care for women giving birth. The main causes of death associated with antepartum haemorrhage are placental abruption, placenta praevia and uterine rupture. Preventive measures include preconceptual folate supplementation, management of hypertensive disorders, early diagnosis of placenta praevia and use of uterine stimulants cautiously, particularly misoprostol...
June 23, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27427351/ruptured-left-gastric-artery-aneurysms-three-cases-managed-successfully-with-open-surgical-repair
#13
Anna Sandstrom, Pankhaj Jha
INTRODUCTION: Visceral artery aneurysms (VAA) are an uncommon vascular pathology with an incidence estimated at 0.01% to 2%. The likely aetiology of visceral artery aneurysms is uncertain includes atherosclerosis, trauma and inflammation. VAAs are often asymptomatic until rupture which causes life threatening haemorrhage and is associated with a high mortality. Gastric artery aneurysms (GAA) form a very small proportion of VAAs (<4%). CASE DESCRIPTION: This is a case series of three patients who presented to Nambour Hospital with a ruptured left gastric aneurysm...
July 14, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27399167/the-emerging-trend-of-self-circumcision-and-the-need-to-define-cause-case-report-of-a-21-year-old-male
#14
Ronald Kintu-Luwaga
INTRODUCTION: Male circumcision is traditionally carried out by ascribed practitioners, so self-circumcision is very rare. It is intriguing why the victims should not seek available modern health care. This article highlights another case of self-circumcision, the related causes, complications and their management. The gradual increase in numbers is contributing to the surgical disease burden. CASE PRESENTATION: A 21year old male circumcised himself using a razor-blade 13days prior to presentation at the hospital...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27283388/a-local-network-for-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock
#15
Carlotta Sorini Dini, Chiara Lazzeri, Marco Chiostri, Gian Franco Gensini, Serafina Valente
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA ECMO) represents a therapeutic option in patients with refractory cardiogenic shock (RCS). This strategy is limited to a restricted number of centres with capabilities for implanting VA ECMO and management patients on this support. We report on the initial experience of our ECMO referral centre for patients with RCS. METHODS: We retrospectively analysed our ECMO data registry for RCS of 14 patients treated with VA ECMO, consecutively admitted to our intensive cardiac care unit (ICCU), which is an ECMO referral centre...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/27176127/controlled-hypotension-versus-normotensive-resuscitation-strategy-for-people-with-ruptured-abdominal-aortic-aneurysm
#16
REVIEW
Daniel H Moreno, Daniel G Cacione, Jose C C 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...
May 13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27147768/training-of-midwives-in-advanced-obstetrics-in-liberia
#17
Obed Dolo, Alice Clack, Hannah Gibson, Naomi Lewis, David P Southall
PROBLEM: The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. APPROACH: In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. LOCAL SETTING: The training took place in CB Dunbar Maternity Hospital...
May 1, 2016: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/27138661/haemotoxic-snakebite-in-rural-kwazulu-natal-south-africa-a-case-presenting-with-haematemesis
#18
Mark Wagener
A 36-year-old man who had been bitten on his left index finger by a snake identified as a boomslang (Dispholidus typus) presented with haematemesis and hypovolaemic shock. Coagolopathy was presumed, and the platelet count was 2 × 10⁹/L. Findings on upper endoscopy included oesophageal petechial haemorrhages, severe haemorrhagic gastritis and an antral ulcer. The patient was successfully managed using freeze-dried plasma, packed red blood cells, isotonic crystalloids and polyvalent antivenom.
May 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27135863/-ruptured-abdominal-aortic-aneurysm-results-and-prognostic-factors-at-a-certified-centre-of-vascular-surgery
#19
A Koscielny, M Kühnel, F Verrel, J C Kalff
Introduction: Although the perioperative management has been optimised over the past few decades, there has not been a remarkable improvement in the mortality rates of patients with a ruptured abdominal aortic aneurysm (rAAA). The aim of this retrospective trial was to define pre-, intra- and postoperative parameters which influence the perioperative and long-term outcome of patients and which can be modified by the operating team. Methods: A retrospective database analysis was performed in 49 patients who had undergone an operation of rAAA in our certified centre of vascular surgery between the beginning of 2006 and the end of 2012...
October 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27069349/spectrum-of-maternofetal-outcomes-during-dengue-infection-in-pregnancy-an-insight
#20
Swati Sharma, Sandhya Jain, Shalini Rajaram
Dengue is a vector transmitted viral infection; tropical and subtropical countries see outbreaks of dengue each year. There is a paucity of literature on effects of dengue infection on pregnancy outcome and this prompted us to undertake a study for better understanding of pregnancy implications with dengue infection. Pregnant women admitted during the seasonal outbreak of dengue between September 2015 and October 2015 were studied and maternal and fetal outcomes in sixteen NS1Ag positive women were analysed...
2016: Infectious Diseases in Obstetrics and Gynecology
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