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"Shock index"

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https://www.readbyqxmd.com/read/28522144/viscoelastic-tissue-plasminogen-activator-challenge-predicts-massive-transfusion-in-15-minutes
#1
Hunter B Moore, Ernest E Moore, Michael P Chapman, Benjamin R Huebner, Peter M Einersen, Solimon Oushy, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Coagulopathy is associated with massive transfusion in trauma, yet most clinical scores to predict this end point do not incorporate coagulation assays. Previous work has identified that shock increases circulating tissue plasminogen activator (tPA). When tPA levels saturate endogenous inhibitors, systemic hyperfibrinolysis can occur. Therefore, the addition of tPA to a patient's blood sample could stratify a patients underlying degree of shock and early coagulation changes to predict progression to massive transfusion...
April 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28499381/experience-in-the-use-of-non-pneumatic-anti-shock-garment-nasg-in-the-management-of-postpartum-haemorrhage-with-hypovolemic-shock-in-the-fundaci%C3%A3-n-valle-del-lili-cali-colombia
#2
María Fernanda Escobar, Carlos Eduardo Füchtner, Javier Andrés Carvajal, Albaro José Nieto, Adriana Messa, Sara Sofía Escobar, Angélica María Monroy, Angélica María Forero, José David Casallas, Marcela Granados, Suellen Miller
BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application...
May 12, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28490915/older-patients-have-increased-risk-of-poor-outcomes-after-low-velocity-pedestrian-motor-vehicle-collisions
#3
Gerard A Baltazar, Parker Bassett, Amy J Pate, Akella Chendrasekhar
BACKGROUND: Motor vehicle collisions (MVCs) are a leading cause of injury in the US. While the probability of collision with a pedestrian (PMVC) has declined in recent years, the probability of a pedestrian fatality has risen. Our objective was to determine whether older age impacts potential outcomes in patients involved in low-velocity PMVCs. MATERIALS AND METHODS: We performed a retrospective-cohort study of adult patients aged >14 years involved in low-velocity pedestrian-MVCs (<15 miles per hour [24...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28482628/red-blood-cell-and-platelet-parameters-are%C3%A2-sepsis-predictors-in-an-escherichia-coli%C3%A2-induced-lethal-porcine-model
#4
Judit Tóth, Ildikó Beke Debreceni, Mariann Berhés, Endre Hajdú, Ádám Deák, Katalin Pető, Judit Szabó, Norbert Németh, Béla Fülesdi, János Kappelmayer
OBJECTIVE: In a fulminant porcine sepsis model, we determined the kinetics of hypoxia induced changes in relation to sepsis parameters and markers of organ damage. METHODS: Female pigs were challenged by live Escherichia coli and samples were analysed up to 4 hours. Bone marrow reactions were determined by analysing immature forms of peripheral blood cells by a hematology analyser and light microscopy. Platelet mitochondrial membrane depolarisation was determined by flow cytometry...
May 5, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28481840/age-shock-index-is-superior-to-shock-index-and-modified-shock-index-for-predicting-long-term-prognosis-in-acute-myocardial-infarction
#5
Tongtong Yu, Chunyang Tian, Jia Song, Dongxu He, Zhijun Sun, Zhaoqing Sun
BACKGROUND: Shock index (SI) has been reported to help us predict adverse prognosis in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). However, the prognostic value of age SI and modified shock index (MSI) in AMI undergoing PCI is unknown. Moreover, the prognostic performance of admission age SI is not compared with SI, MSI and the Global Registry of Acute Coronary Events (GRACE) risk score. METHODS: 1,864 AMI patients undergoing PCI were analyzed in a retrospective cohort study...
May 5, 2017: Shock
https://www.readbyqxmd.com/read/28465003/the-modified-rapid-emergency-medicine-score-a-novel-trauma-triage-tool-to-predict-in-hospital-mortality
#6
Ross T Miller, Niaman Nazir, Tracy McDonald, Chad M Cannon
BACKGROUND: Trauma systems currently rely on imperfect and subjective tools to prioritize responses and resources, thus there is a critical need to develop a more accurate trauma severity score. Our objective was to modify the Rapid Emergency Medicine (REMS) Score for the trauma population and test its accuracy as a predictor of in-hospital mortality when compared to other currently used scores, including the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the "Mechanism, Glasgow Coma Scale, Age and Arterial Pressure" (MGAP) score, and the Shock Index (SI) score...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28464969/utilization-criteria-for-prehospital-ultrasound-in-a-canadian-critical-care-helicopter-emergency-medical-service-determining-who-might-benefit
#7
Domhnall O'Dochartaigh, Matthew Douma, Chris Alexiu, Shell Ryan, Mark MacKenzie
Introduction Prehospital ultrasound (PHUS) assessments by physicians and non-physicians are performed on medical and trauma patients with increasing frequency. Prehospital ultrasound has been shown to be of benefit by supporting interventions. Problem Which patients may benefit from PHUS has not been clearly identified. METHODS: A multi-variable logistic regression analysis was performed on a previously created retrospective dataset of five years of physician- and non-physician-performed ultrasound scans in a Canadian critical care Helicopter Emergency Medical Service (HEMS)...
May 3, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28452878/inefficacy-of-standard-vital-signs-for-predicting-mortality-and-the-need-for-prehospital-life-saving-interventions-in-blunt-trauma-patients-transported-via-helicopter-a-repeated-call-for-new-measures
#8
Nehemiah T Liu, John B Holcomb, Charles E Wade, Jose Salinas
OBJECTIVE: The aim of this study was to investigate the efficacy of traditional vital signs for predicting mortality and the need for prehospital life-saving interventions (LSIs) in blunt trauma patients requiring helicopter transport to a Level I trauma center. Our hypothesis was that standard vital signs are not sufficient for identifying or determining treatment for those patients most at risk. METHODS: This study involved prehospital trauma patients suffering from blunt trauma (motor vehicle/cycle collision) and transported from the point of injury via helicopter...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28421780/intestinal-dysfunction-in-the-critical-trauma-patients-an-early-and-frequent-event
#9
Beatriz Pinto Costa, Paulo Martins, Carla Verissimo, Marta Simões, Marisa Tomé, Manuela Grazina, Jorge Pimentel, Francisco Castro-Sousa
BACKGROUND: Small-bowel dysfunction exerts a relevant prognostic impact in the critically ill patients. Citrullinemia has been used in the evaluation of the intestinal function and it is considered an objective parameter of the functional enterocyte mass. Present study proposes to determine the intestinal dysfunction prevalence and the citrullinemia kinetic profile in severe trauma patients and to investigate its correlation with severity indicators and clinical outcome. METHODS: A prospective study including 23 critical trauma patients was performed...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28396047/prediction-of-massive-bleeding-shock-index-and-modified-shock-index
#10
L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto-Del Portillo, C Mudarra-Reche, I Sáez-de la Fuente, M Chico-Fernández
OBJECTIVE: To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. DESIGN: Retrospective cohort. SETTING: Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. SUBJECTS: Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015...
April 8, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28392701/evaluation-of-the-clinical-effect-of-small-volume-resuscitation-on-uncontrolled-hemorrhagic-shock-in-emergency
#11
Gang Zhao, Wei Wu, Qi-Ming Feng, Jian Sun
OBJECTIVE: The objective of the present study was to explore the resuscitative effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency. METHODS: In this study, the resuscitative effects in 200 trauma patients with uncontrolled hemorrhagic shock in emergency were studied. Half of these patients were infused with hypertonic/hyperoncotic fluid (small-volume resuscitation group, n=100), whereas the rest were infused with Hespan and lactated Ringer's solution (conventional fluid resuscitation group, n=100)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28365104/can-we-safely-decrease-intensive-care-unit-admissions-for-children-with-high-grade-isolated-solid-organ-injuries-using-the-shock-index-pediatric-age-adjusted-and-hematocrit-to-modify-apsa-admission-guidelines
#12
Mary Arbuthnot, Lindsey Bendure Armstrong, David P Mooney
BACKGROUND: In 2000, the American Pediatric Surgical Association (APSA) disseminated consensus practice guidelines for the management of blunt liver and splenic injury which included intensive care unit (ICU) admission for children with grade IV injuries. We sought to determine if we could better predict which children with isolated solid organ injuries (SOI) underwent an ICU-level intervention, thus necessitating ICU admission. METHODS: Children with isolated liver, spleen, or kidney injuries admitted to the ICU from November 2003 to August 2015 were identified in our trauma registry, and data were extracted from the medical record...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28357139/effect-of-focused-bedside-ultrasonography-in-hypotensive-patients-on-the-clinical-decision-of-emergency-physicians
#13
M Ikbal Sasmaz, Faruk Gungor, Ramazan Guven, K Can Akyol, Nalan Kozaci, Mustafa Kesapli
We assessed the effect of focused point of care ultrasound (POCUS) used for critical nontraumatic hypotensive patients presenting to the emergency department of our hospital on the clinical decisions of the physicians and whether it led to the modification of the treatment modality. This prospective clinical study was conducted at the Emergency Department of Antalya Training and Research Hospital. Nontraumatic patients aged 18 and older who presented to our emergency department and whose systolic blood pressure was <100 mmHg or shock index (heart rate/systolic blood pressure) was >1 were included in the study...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28348753/delayed-recognition-of-fatal-invasive-meningococcal-disease-in-adults
#14
Frederick W Nagel, Ifeoma Ezeoke, Mike Antwi, Paula E Del Rosso, Marie Dorsinville, Beth M Isaac, Althea Hayden, Robert S Hoffman, Scott D Weingart, Don Weiss
INTRODUCTION: Invasive meningococcal disease can be difficult to detect early in its course when patients may appear well and the severity of their illness is obscured by non-specific complaints. CASE PRESENTATION: We report five cases of meningococcal sepsis in adult patients who presented to an emergency department early in the course of their disease, but whose severity of illness was not recognized. CONCLUSION: Suspicion of meningococcal sepsis should be heightened in the setting of hypotension, tachycardia, elevated shock index, leukopaenia with left shift, thrombocytopaenia and hypokalaemia, prompting early sepsis care...
June 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28345066/correlation-of-central-venous-pressure-with-venous-blood-gas-analysis-parameters-a-diagnostic-study
#15
Sima Rahim-Taleghani, Alireza Fatemi, Mostafa Alavi Moghaddam, Majid Shojaee, Abdelrahman Ibrahim Abushouk, Mohammad Mehdi Forouzanfar, Alireza Baratloo
OBJECTIVE: This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. MATERIAL AND METHODS: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28303647/ratio-of-systolic-blood-pressure-to-left-ventricular-end-diastolic-pressure-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-in-hospital-mortality-in-patients-with-st-elevation-myocardial-infarction
#16
Michael Sola, Kiran Venkatesh, Melissa Caughey, Robert Rayson, Xuming Dai, George A Stouffer, Michael Yeung
OBJECTIVE: To determine the ability of simple hemodynamic parameters obtained at the time of cardiac catheterization to predict in-hospital mortality following ST-elevation myocardial infarction (STEMI). BACKGROUND: Hemodynamic parameters measured at the time of primary percutaneous coronary intervention (PPCI) could potentially identify high-risk patients who would benefit from aggressive hemodynamic support in the Cardiac Catheterization laboratory. METHODS: This is a retrospective single-center study of 219 consecutive patients with STEMI...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#17
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28268811/occurrence-of-elevated-shock-index-in-acute-patients-and-development-of-a-proportional-shock-index-metric
#18
Thomas Schmidt, Annmarie Lassen, Uffe Kock Wiil
Although shock index, as the ratio between heart rate and systolic blood pressure, is a well-recognized predictor for adverse outcomes, it is seldom integrated into clinical evaluation procedures as it requires on-the-fly evaluation of multiple terms. In this paper, we investigate the prevalence of elevated shock index in emergency department patients through an analysis of automatic heart rate and blood pressure readings from 809 admissions to an acute bedside ward at a large Danish hospital. The analysis is conducted by evaluating differences in terms of 30 day mortality...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227006/occurrence-of-elevated-shock-index-in-acute-patients-and-development-of-a-proportional-shock-index-metric
#19
Thomas Schmidt, Annmarie Lassen, Uffe Kock Wiil, Thomas Schmidt, Annmarie Lassen, Uffe Kock Wiil, Uffe Kock Wiil, Thomas Schmidt, Annmarie Lassen
Although shock index, as the ratio between heart rate and systolic blood pressure, is a well-recognized predictor for adverse outcomes, it is seldom integrated into clinical evaluation procedures as it requires on-the-fly evaluation of multiple terms. In this paper, we investigate the prevalence of elevated shock index in emergency department patients through an analysis of automatic heart rate and blood pressure readings from 809 admissions to an acute bedside ward at a large Danish hospital. The analysis is conducted by evaluating differences in terms of 30 day mortality...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28210362/serum-lactate-predicts-adverse-outcomes-in-emergency-department-patients-with-and-without-infection
#20
Kimie Oedorf, Danielle E Day, Yotam Lior, Victor Novack, Leon D Sanchez, Richard E Wolfe, Hans Kirkegaard, Nathan I Shapiro, Daniel J Henning
INTRODUCTION: Lactate levels are increasingly used to risk stratify emergency department (ED) patients with and without infection. Whether a serum lactate provides similar prognostic value across diseases is not fully elucidated. This study assesses the prognostic value of serum lactate in ED patients with and without infection to both report and compare relative predictive value across etiologies. METHODS: We conducted a prospective, observational study of ED patients displaying abnormal vital signs (AVS) (heart rate ≥130 bpm, respiratory rate ≥24 bpm, shock index ≥1, and/or systolic blood pressure <90 mmHg)...
February 2017: Western Journal of Emergency Medicine
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