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"Shock index"

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https://www.readbyqxmd.com/read/29785693/massive-transfusion-the-revised-assessment-of-bleeding-and-transfusion-rabt-score
#1
Bellal Joseph, Muhammad Khan, Michael Truitt, Faisal Jehan, Narong Kulvatunyou, Asad Azim, Arpana Jain, Muhammad Zeeshan, Andrew Tang, Terence O'Keeffe
BACKGROUND: Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures. METHODS: We performed a 2-year (2014-2015) analysis of all high-level trauma activations and excluded patients dead on arrival...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#2
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29757064/factors-associated-with-the-effectiveness-of-intravenous-administration-of-chlorpromazine-for-delirium-in-patients-with-terminal-cancer
#3
Hideaki Hasuo, Kenji Kanbara, Ryohei Fujii, Kazuki Uchitani, Hiroko Sakuma, Mikihiko Fukunaga
BACKGROUND: Delirium in patients with terminal cancer is irreversible and increases treatment resistance, which leads to a deterioration in quality of life. OBJECTIVE: To investigate factors affecting the effectiveness and safety of intravenous chlorpromazine for irreversible delirium in patients with terminal cancer. DESIGN/MEASUREMENTS: Multiple regression analysis for factors affecting treatment effectiveness was carried out based on a retrospective comparison between responders and nonresponders to intravenous chlorpromazine...
May 14, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29728151/development-and-validation-of-a-pre-hospital-red-flag-alert-for-activation-of-intra-hospital-haemorrhage-control-response-in-blunt-trauma
#4
Sophie Rym Hamada, Anne Rosa, Tobias Gauss, Jean-Philippe Desclefs, Mathieu Raux, Anatole Harrois, Arnaud Follin, Fabrice Cook, Mathieu Boutonnet, Arie Attias, Sylvain Ausset, Mathieu Boutonnet, Gilles Dhonneur, Jacques Duranteau, Olivier Langeron, Catherine Paugam-Burtz, Romain Pirracchio, Guillaume de St Maurice, Bernard Vigué, Alexandra Rouquette, Jacques Duranteau
BACKGROUND: Haemorrhagic shock is the leading cause of early preventable death in severe trauma. Delayed treatment is a recognized prognostic factor that can be prevented by efficient organization of care. This study aimed to develop and validate Red Flag, a binary alert identifying blunt trauma patients with high risk of severe haemorrhage (SH), to be used by the pre-hospital trauma team in order to trigger an adequate intra-hospital standardized haemorrhage control response: massive transfusion protocol and/or immediate haemostatic procedures...
May 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29717984/effect-of-tranexamic-acid-on-intra-and-postoperative-haemorrhage-in-dogs-with-surgically-treated-hemoperitoneum
#5
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/29687672/volume-expansion-and-variation-in-hemodynamic-parameters
#6
Frank Daniel Martos-Benítez, Bertha Inés Guzmán-Breff
OBJECTIVES: To assess correlations among variations in hemodynamic parameters during fluid volume loading. MATERIAL AND METHODS: Prospective observational study in 2 intensive care units. Sixty patients requiring intravenous fluids underwent challenge tests with 300 mL of crystalloids over a 48-hour period. Percent change in hemodynamic parameters after infusion was measured. We used hierarchical cluster and principal component analyses to explore correlations among changes in hemodynamic responses...
June 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29667848/transarterial-embolization-for-postpartum-hemorrhage-lessons-learned
#7
Chen-Ju Fu, Wiwan Irama, Yon-Cheong Wong, Hsiao-Jung Tseng, Li-Jen Wang, Kee-Min Yeow, Cheng-Hsien Wu
Background Although transarterial embolization (TAE) can powerfully control postpartum hemorrhage (PPH), clinical failure of TAE is not uncommon. Purpose To discover whether any parameters could predict timely clinical failure of TAE, then whether a supplementary intervention could be promptly initiated. Material and Methods We retrospectively analyzed 118 TAE procedures in 113 patients with PPH performed at our institution between January 2012 and May 2015. The patients were divided into the following groups: clinically successful TAE and failed TAE...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29660298/postpartum-hemorrhage-new-insights-for-definition-and-diagnosis
#8
A Borovac-Pinheiro, R C Pacagnella, J G Cecatti, S Miller, A M El Ayadi, J P Souza, J Durocher, P D Blumenthal, B Winikoff
The current definition of postpartum hemorrhage (PPH) is inadequate for early recognition of this important cause of maternal mortality, responsible for more than 80,000 deaths worldwide in 2015. A stronger definition of PPH should include both blood loss and clinical signs of cardiovascular changes after delivery, which would help providers to more promptly and accurately identify PPH. Along with the amount of blood loss, clinical signs and specifically the Shock Index (heart rate divided by systolic blood pressure) appear to aid in more accurate diagnosis of PPH...
April 13, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29642920/reverse-shock-index-multiplied-by-glasgow-coma-scale-score-rsig-is-a-simple-measure-with-high-discriminant-ability-for-mortality-risk-in-trauma-patients-an-analysis-of-the-japan-trauma-data-bank
#9
Akio Kimura, Noriko Tanaka
BACKGROUND: The shock index (SI), defined as heart rate (HR) divided by systolic blood pressure (SBP), is reported to be a more sensitive marker of shock than traditional vital signs alone. In previous literature, use of the reverse shock index (rSI), taken as SBP divided by HR, is recommended instead of SI for hospital triage. Among traumatized patients aged > 55 years, SI multiplied by age (SIA) might provide better prediction of early post-injury mortality. Separately, the Glasgow Coma Scale (GCS) score has been shown to be a very strong predictor...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29621917/the-inferior-vena-cava-diameter-is-a-useful-ultrasound-finding-for-predicting-postpartum-blood-loss
#10
Tomohiro Oba, Maya Koyano, Junichi Hasegawa, Hiroko Takita, Tatsuya Arakaki, Masamitsu Nakamura, Akihiko Sekizawa
PURPOSE: To assess whether the ultrasonographic measurement of the inferior vena cava (IVC) diameter in postpartum women is a useful parameter in evaluating the actual blood loss during delivery due to massive postpartum hemorrhage. MATERIALS AND METHODS: In postpartum women with blood loss ≥ 500 g, abdominal ultrasonography was performed 1 hour after delivery. The IVC diameter was measured during inspiration (IVCi) and expiration (IVCe). The maternal heart rate, blood pressure, and shock index (heart rate/systolic blood pressure) were also measured...
April 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29560047/prehospital-lactate-predicts-need-for-resuscitative-care-in-non-hypotensive-trauma-patients
#11
Alexander E St John, Andrew M McCoy, Allison G Moyes, Francis X Guyette, Eileen M Bulger, Michael R Sayre
Introduction: The prehospital decision of whether to triage a patient to a trauma center can be difficult. Traditional decision rules are based heavily on vital sign abnormalities, which are insensitive in predicting severe injury. Prehospital lactate (PLac) measurement could better inform the triage decision. PLac's predictive value has previously been demonstrated in hypotensive trauma patients but not in a broader population of normotensive trauma patients transported by an advanced life support (ALS) unit...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29538238/multicenter-study-of-crystalloid-boluses-and-transfusion-in-pediatric-trauma-when-to-go-to-blood
#12
Stephanie F Polites, Rachel M Nygaard, Pooja N Reddy, Martin D Zielinski, Chad J Richardson, Terri A Elsbernd, Branden M Petrun, Sean L Weinberg, Sherrie Murphy, Donald D Potter, Denise B Klinkner, Christopher R Moir
BACKGROUND: The 9th edition of ATLS recommends up to three crystalloid boluses in pediatric trauma patients with consideration of transfusion after the second bolus however this approach is debated. We aimed to determine if requirement of more than one fluid bolus predicts the need for transfusion. METHODS: 2010-2016 highest tier activation patients <15 years of age from two ACS Level I pediatric trauma centers were identified from prospectively maintained trauma databases...
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29521799/shock-volume-patient-specific-cumulative-hypoperfusion-predicts-organ-dysfunction-in-a-prospective-cohort-of-multiply-injured-patients
#13
Todd O McKinley, Tyler McCarroll, Cameron Metzger, Ben L Zarzaur, Stephanie A Savage, Teresa M Bell, Greg E Gaski
BACKGROUND: Multiply injured patients are at risk of developing hemorrhagic shock and organ dysfunction. We determined how cumulative hypoperfusion predicted organ dysfunction by integrating serial shock index measurements. METHODS: In this study, we calculated Shock Volume (SHVL) which is a patient-specific index that quantifies cumulative hypoperfusion by integrating abnormally elevated shock index (heart rate/systolic blood pressure ≥ 0.9) values acutely after injury...
March 8, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29504991/delayed-retroperitoneal-arterial-hemorrhage-after-inferior-vena-cava-filter-deployment-a-case-report
#14
Yongzheng Wang, Haiyang Chang, Wujie Wang, Wei Wang, Bin Liu, Zheng Li, Yuliang Li
RATIONALE: Pulmonary embolization is a life-threatening condition. The deployment of inferior vena cava (IVC) filter is the first choice for preventing embolus from the lower extremity. However, IVC filter complications are rare but not to be neglected. Penetration of the arterial wall may result in catastrophic damages. This case report describes a woman who suffered from retroperitoneal hemorrhage after placement of an IVC filter due to a pulmonary embolization. Her filter was found to have penetrated the right lumbar artery and caused the massive bleeding...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29504087/the-diagnostic-utility-of-d-dimer-and-other-clinical-variables-in-pregnant-and-post-partum-patients-with-suspected-acute-pulmonary-embolism
#15
Hyun Choi, Dinesh Krishnamoorthy
BACKGROUND: Pulmonary embolism (PE) during pregnancy remains one of the leading causes of maternal morbidity and mortality in the developed world. However, there is a paucity of high-quality evidence resulting in a lack of consensus in managing this group of patients. The aims of the study were to address the diagnostic utility of D-dimer for suspected PE in pregnant and post-partum patients and to identify any clinical presentation variables that are predictors of PE in this group of patients...
March 5, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29489667/predictors-of-mortality-in-st-elevation-mi-patients-a-prospective-study
#16
Onur Zorbozan, Arif A Cevik, Nurdan Acar, Engin Ozakin, Hamit Ozcelik, Alparslan Birdane, Fikri M Abu-Zidan
We aimed to define factors predicting mortality in patients having ST elevation myocardial infarction (STEMI) who had Primary Percutaneous Coronary Intervention (PCI) in our setting.This is a prospective study on patients presenting to the emergency department with STEMI who underwent PCI during a 12-month period. Physiological parameters were calculated using the vital signs and age of patients. Time-based factors in the institutional protocol were collected. Univariate analysis was performed to define significant factors that affected mortality...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29466514/basic-ultrasound-training-assessment-in-the-initial-abdominal-trauma-screening
#17
Luan Geraldo Ocaña Oliveira, Debora Tagliari, Mariana Juliato Becker, Thiago Adame, José Cruvinel Neto, Fernando Antônio Campelo Spencer Netto
OBJECTIVE: to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma) for emergency physicians in the primary evaluation of abdominal trauma. METHODS: a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT). FAST results started to be collected two months after the course...
February 19, 2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29457430/-clinical-effect-of-superselective-arterial-embolization-for-the-treatment-of-massive-haemorrhage-from-pelvic-fracture
#18
Zheng-Qiu Lin, Xiu-Zhi Ye, Wei-Liang Wang, Guo-Qing Zhu, Bing-Ju Xie, Liang-le Liu
OBJECTIVE: To investigate feasibility and curative effect of superselective arterial embolization for the treatment of massive haemorrhage from pelvic fracture. METHODS: From March 2008 to February 2016, clinical data of 65 patients with massive haemorrhage from pelvic fracture were collected and analyzed, and patients were divided into non-embolic and embolic group according to whether perform vascular thrombosis. Thirty-three patients were in non-embolic group including 26 males and 7 females aged from 21 to 64 years old with an average of(39...
December 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29455018/acute-massive-pulmonary-thromboembolism-treated-by-selective-catheter-directed-thrombolysis
#19
Feng Hai, Chen Xueming, Zhang Zhiwen, Li Chenyu, Fang Jie, Zhang Zhe, Lian Lishan, Zhu Renming, Yu Hongzhi, Liu Bin
BACKGROUND: To evaluate the safety and efficacy of selective catheter-directed thrombolysis (SCDT) in treating acute massive pulmonary thromboembolism (AMPTE). METHODS: Twenty-six AMPTE patients were enrolled between March 2010 and March 2013. A Uni*Fuse infusion system was inserted into the main pulmonary artery thrombus. The thrombolytic regimen included an intraoperative bolus injection of 250,000 IU urokinase, followed by continuous thrombolytic infusion of 5,000 IU/kg per (every) 24 hr urokinase for 72 hr postoperatively...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29415489/identification-of-pancreatic-injury-in-patients-with-elevated-amylase-or-lipase-level-using-a-decision-tree-classifier-a-cross-sectional-retrospective-analysis-in-a-level-i-trauma-center
#20
Cheng-Shyuan Rau, Shao-Chun Wu, Peng-Chen Chien, Pao-Jen Kuo, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh, Hang-Tsung Liu
BACKGROUND: In trauma patients, pancreatic injury is rare; however, if undiagnosed, it is associated with high morbidity and mortality rates. Few predictive models are available for the identification of pancreatic injury in trauma patients with elevated serum pancreatic enzymes. In this study, we aimed to construct a model for predicting pancreatic injury using a decision tree (DT) algorithm, along with data obtained from a population-based trauma registry in a Level I trauma center...
February 6, 2018: International Journal of Environmental Research and Public Health
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