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Survival after trauma

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https://www.readbyqxmd.com/read/28107308/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#1
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. Inhaled nitric oxide (iNO) lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28105985/impact-of-traumatic-brain-injury-on-dopaminergic-transmission
#2
Yuan-Hao Chen, Eagle Yi-Kung, Tung-Tai Kuo, Jonathan Miller, Yung-Hsiao Chiang, Barry J
Brain trauma is often associated with severe morbidity and is a major public health concern. Even when injury is mild and no obvious anatomic disruption is seen, many individuals suffer disabling neuropsychological impairments such as memory loss, mood dysfunction, substance abuse, and adjustment disorder. These changes may be related to subtle disruption of neural circuits as well as functional changes at the neurotransmitter level. In particular, there is considerable evidence that dopamine physiology in the nigrostriatal and mesocorticolimbic pathways might be impaired after TBI...
January 20, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28089060/evaluating-services-at-a-major-trauma-center-before-helipad-construction
#3
Danny Jon Nian Wong, James Robert Bedford, Simon Luck, Roger Bloomer
INTRODUCTION: Two of the 4 hospitals designated as major trauma centers in London, UK, currently operate on-site helicopter landing pads. King's College Hospital (KCH) is constructing a third. We evaluate current trauma services at King's College Hospital, before the helipad entering service, establishing baseline workload and mortality measures. METHODS: We retrospectively analyzed data from patients admitted January 1, 2014, to December 31, 2015, to KCH after major trauma with on-scene helicopter emergency medical services involvement (N = 427) using the Trauma Audit and Research Network database...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28088938/clinical-analysis-of-54-cases-of-large-area-soft-tissue-avulsion-in-the-lower-limb
#4
Yu Chen, Lei Liu
OBJECTIVE: To assess the clinical curative effect of different treatment methods for large area avulsion injury in the lower limb. METHODS: Between January 2010 and December 2013, 54 patients with large area avulsion injury in the lower limb were treated in the trauma center of our hospital, including 34 males and 20 females with a mean age of 35.7 years (range, 16-65 years). The injury mechanism was traffic accident in 44 cases, hitting by heavy objects in 8 cases, and fall from height in 2 cases, involving 31 thighs, 19 legs and 4 feet involved...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088436/injury-severity-sex-and-transfusion-volume-but-not-transfusion-ratio-predict-inflammatory-complications-after-traumatic-injury
#5
Allison R Jones, Heather M Bush, Susan K Frazier
BACKGROUND: Blood component (packed red blood cells [PRBC], fresh frozen plasma [FFP], platelets [PLT]) ratios transfused in a 1:1:1 fashion are associated with survival after trauma; the relationship among blood component ratios and inflammatory complications after trauma is not fully understood. OBJECTIVES: To evaluate the relationship among blood component ratios (1:1 vs other for PRBC:FFP and PRBC:PLT) and inflammatory complications (primary outcome) in patients with major trauma...
January 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28079652/long-term-survival-and-causes-of-late-death-in-children-treated-with-extracorporeal-membrane-oxygenation
#6
Viktor von Bahr, Jan Hultman, Staffan Eksborg, Roxana Gerleman, Øyvind Enstad, Björn Frenckner, Håkan Kalzén
OBJECTIVE: Extracorporeal membrane oxygenation has been used in patients with severe circulatory or respiratory failure since the 1970s, but the knowledge on long-term survival in this group is scarce. The aim of the present study was to investigate the 10-year survival rates and causes of late death in children treated with extracorporeal membrane oxygenation. DESIGN: Single-center, retrospective cohort study. SETTING: Tertiary referral center for extracorporeal life support...
January 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28077534/reduced-mortality-by-meeting-guideline-criteria-before-using-recombinant-activated-factor-vii-in-severe-trauma-patients-with-massive-bleeding
#7
J-F Payen, M Berthet, C Genty, P Declety, D Garrigue-Huet, N Morel, P Bouzat, B Riou, J-L Bosson
BACKGROUND: Management of trauma patients with severe bleeding has led to criteria before considering use of recombinant activated factor VII (rFVIIa), including haemoglobin >8 g dl(-1), serum fibrinogen ≥1.0 g l(-1), platelets >50,000 x 10(9) l(-1), arterial pH ≥ 7.20, and body temperature ≥34 °C. We hypothesized that meeting these criteria is associated with improved outcomes. METHODS: In this prospective cohort study of 26 French trauma centres, subjects were included if they received rFVIIa for persistent massive bleeding despite appropriate care after severe blunt and/or penetrating trauma...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28076371/meta-analysis-of-the-long-term-success-rate-of-different-interventions-in-benign-biliary-strictures
#8
Orsolya Huszár, Bálint Kokas, Péter Mátrai, Péter Hegyi, Erika Pétervári, Áron Vincze, Gabriella Pár, Patrícia Sarlós, Judit Bajor, József Czimmer, Dóra Mosztbacher, Katalin Márta, Csaba Zsiborás, Péter Varjú, Ákos Szücs
BACKGROUND: Benign biliary stricture is a rare condition and the majority of the cases are caused by operative trauma or chronic inflammation based on various etiology. Although the initial results of endoscopic, percutaneous and surgical treatment are impressive, no comparison about long term stricture resolution is available. AIMS: The goal of this study was to compare the long term disease free survival in benign biliary strictures with various etiology after surgery, percutaneous transhepatic-and endoscopic treatment...
2017: PloS One
https://www.readbyqxmd.com/read/28061863/prognostic-indicators-for-perioperative-survival-after-diaphragmatic-herniorrhaphy-in-cats-and-dogs-96-cases-2001-2013
#9
Claire Legallet, Kelley Thieman Mankin, Laura E Selmic
BACKGROUND: To determine associations between perioperative mortality after surgery for traumatic diaphragmatic hernia, medical records of 17 cats and 79 dogs that underwent diaphragmatic herniorrhaphy were reviewed. RESULTS: The combined perioperative survival rate was 81.3% (88.2% in cats and 79.8% in dogs). Data from acute and chronic cases was assessed separately. Of the acute cases (12 cats and 48 dogs), 10 cats (83.3%) and 38 dogs (79.2%) survived to discharge...
January 7, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28052919/traumatic-brain-injuries-in-older-adults-6-years-of-data-for-one-uk-trauma-centre-retrospective-analysis-of-prospectively-collected-data
#10
Carol Hawley, Magdy Sakr, Sarah Scapinello, Jesse Salvo, Paul Wrenn
OBJECTIVES: Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. METHODS: Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma...
January 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28045980/long-term-effects-of-acute-stress-on-the-prefrontal-limbic-system-in-the-healthy-adult
#11
Yu Li, Xin Hou, Dongtao Wei, Xue Du, Qinglin Zhang, Guangyuan Liu, Jiang Qiu
Most people are exposed to at least one traumatic event during the course of their lives, but large numbers of people do not develop posttraumatic stress disorders. Although previous studies have shown that repeated and chronic stress change the brain's structure and function, few studies have focused on the long-term effects of acute stressful exposure in a nonclinical sample, especially the morphology and functional connectivity changes in brain regions implicated in emotional reactivity and emotion regulation...
2017: PloS One
https://www.readbyqxmd.com/read/28045743/role-of-survival-time-and-injury-severity-in-fatal-pulmonary-fat-embolism
#12
Juliane Jarmer, Garyfalia Ampanozi, Michael J Thali, Stephan A Bolliger
Pulmonary fat embolism (PFE) is frequent in blunt trauma and may occasionally lead to death. A correlation between fracture grade and severity and PFE grade has been described before, but no correlation between PFE and survival time, fat crushing extent, fat crush grade, or number of body regions with fractures could be noted in this small study. To further examine this, we decided to examine the aforementioned points in a far larger study group.Autopsy protocols of 188 nonresuscitated fatalities with blunt trauma and without right heart injury, which underwent whole body dissection, were retrospectively reviewed concerning the presence and the severity of PFE, injuries, survival time, age, sex, and the body mass index...
December 29, 2016: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28041753/modified-reversed-superficial-peroneal-artery-flap-in-the-reconstruction-of-ankle-and-foot-defects-following-severe-burns-or-trauma
#13
Shi-Ji Li, Hao Cheng, Xu Fang, Jian-Yang Xu, Fei Wang, Sheng Liu, Xu-Lin Chen, Xiong-Wen Lv
OBJECTIVE: Challenges persist in the reconstruction of the ankle and the foot with exposed tendons, joints, and bones as a result of severe burns and trauma. In flap elevation involving the sensitive superficial nerve, the local nerve was always sacrificed to obtain an anesthetic donor site; however, such a procedure introduced the possibility of painful neuromas. In this study, we present a desired clinical application of a modified reversed superficial peroneal artery flap, in which the superficial peroneal nerve is preserved...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28032120/inhibition-of-poly-adp-ribosylation-fails-to-increase-axonal-regeneration-or-improve-functional-recovery-after-adult-mammalian-cns-injury
#14
Xingxing Wang, Yuichi Sekine, Alexandra B Byrne, William B J Cafferty, Marc Hammarlund, Stephen M Strittmatter
After traumatic damage of the brain or spinal cord, many surviving neurons are disconnected, and recovery of function is limited by poor axon regeneration. Recent data have suggested that poly ADP-ribosylation plays a role in limiting axonal regrowth such that inhibition of poly (ADP-ribose) polymerase (PARP) may have therapeutic efficacy for neurological recovery after trauma. Here, we tested systemic administration of the PARP inhibitor, veliparib, and showed effective suppression of PARylation in the mouse CNS...
November 2016: ENeuro
https://www.readbyqxmd.com/read/28030710/association-of-radiologic-indicators-of-frailty-with-1-year-mortality-in-older-trauma-patients-opportunistic-screening-for-sarcopenia-and-osteopenia
#15
Stephen J Kaplan, Tam N Pham, Saman Arbabi, Joel A Gross, Mamatha Damodarasamy, Itay Bentov, Lisa A Taitsman, Steven H Mitchell, May J Reed
Importance: Assessment of physical frailty in older trauma patients admitted to the intensive care unit is often not feasible using traditional frailty assessment instruments. The use of opportunistic computed tomography (CT) scans to assess sarcopenia and osteopenia as indicators of underlying frailty may provide complementary prognostic information on long-term outcomes. Objective: To determine whether sarcopenia and/or osteopenia are associated with 1-year mortality in an older trauma patient population...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28030638/effects-of-intracranial-pressure-monitoring-on-mortality-in-patients-with-severe-traumatic-brain-injury-a-meta-analysis
#16
Liang Shen, Zhuo Wang, Zhongzhou Su, Sheng Qiu, Jie Xu, Yue Zhou, Ai Yan, Rui Yin, Bin Lu, Xiaohu Nie, Shufa Zhao, Renfu Yan
BACKGROUND: The Brain Trauma Foundation (BTF) guidelines published in 2007 suggest some indications for intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI). However, some studies had not shown clinical benefit in patients with severe TBI; several studies had even reported that ICP monitoring was associated with an increased mortality rate. The effect of ICP monitoring has remained controversial, regardless of the ICP monitoring guidelines. Here we performed a meta-analysis of published studies to assess the effects of ICP monitoring in patients with severe TBI...
2016: PloS One
https://www.readbyqxmd.com/read/28030496/temporary-arterial-shunts-in-damage-control-experience-and-outcomes
#17
Sarah Matthew, Brian P Smith, Jeremy W Cannon, Patrick M Reilly, C William Schwab, Mark J Seamon
BACKGROUND: Arterial shunting is a well-described method to control hemorrhage and rapidly re-establish flow, but optimal shunt dwell times remain controversial. We hypothesized that prolonged shunt dwell times of >6 hours are related to adverse outcomes after major arterial injury. METHODS: A review (2005-2013) of all patients with arterial shunts placed after traumatic injury at our urban Level-I trauma center was undertaken. Patients who expired prior to shunt removal (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030495/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-in-youth
#18
Tatsuya Norii, Shin Miyata, Yusuke Terasaka, Sundeep Guliani, Stephen W Lu, Cameron Crandall
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown. OBJECTIVES: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤ 18 years with severe traumatic injury who received REBOA. METHODS: We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#19
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027262/evidence-based-medicine-management-of-acute-lower-extremity-trauma
#20
Roberto D Lachica
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Select and design flaps for the acutely injured lower limb based on wound location, size, and complexity. 2. Select and design tissue-specific flaps based on the functional demand of the zone of injury. 3. Understand the indications for using a flap with a skin component versus a muscle-only flap. 4. Understand the preoperative vascular assessment for lower extremity flap reconstruction. 5. Recognize and manage risk factors to decrease complications and improve flap survival...
January 2017: Plastic and Reconstructive Surgery
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