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Treatment trauma bleeding

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https://www.readbyqxmd.com/read/28520687/3-nacl-adenosine-lidocaine-mg2-alm-bolus-and-4-hours-drip-infusion-reduces-noncompressible-hemorrhage-by-60-in-a-rat-model
#1
Hayley L Letson, Geoffrey P Dobson
BACKGROUND: Noncompressible torso hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine, and Mg (ALM) bolus and 0.9% NaCl/ALM "drip" on survivability and cardiac/gut/kidney function in a rat model of hepatic hemorrhage and shock. METHODS: Male Sprague-Dawley rats (428 ± 4 g) were anesthetized and randomly assigned to one of five groups (n = 16): (1) Sham, (2) No treatment, (3) Saline controls, (4) ALM therapy, and (5) Hextend...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#2
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503122/thrombosis-in-inherited-fibrinogen-disorders
#3
REVIEW
Wolfgang Korte, Man-Chiu Poon, Alfonso Iorio, Michael Makris
Although inherited fibrinogen disorders (IFD) are primarily considered to be bleeding disorders, they are associated with a higher thrombotic complication risk than defects in other clotting factors. Managing IFD patients with thrombosis is challenging as anticoagulant treatment may exacerbate the underlying bleeding risk which can be life-threatening. Due to the low prevalence of IFD, there is little information on pathophysiology or optimal treatment of thrombosis in these patients. We searched the literature for cases of thrombosis among IFD patients and identified a total of 128 patient reports...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28500652/freeze-dried-plasma-enhances-clot-formation-and-inhibits-fibrinolysis-in-the-presence-of-tissue-plasminogen-activator-similar-to-pooled-liquid-plasma
#4
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Angela Sauaia, Gregory Stettler, Monika Dzieciatkowska, Kirk Hansen, Anirban Banerjee, Christopher C Silliman
BACKGROUND: Systemic hyperfibrinolysis is an integral part of trauma-induced coagulopathy associated with uncontrolled bleeding. Recent data suggest that plasma-first resuscitation attenuates hyperfibrinolysis; however, the availability, transport, storage, and administration of plasma in austere environments remain challenging and have limited its use. Freeze-dried plasma (FDP) is a potential alternative due to ease of storage, longer shelf life, and efficient reconstitution. FDP potentially enhances clot formation and resists breakdown better than normal saline (NS) and albumin and similar to liquid plasma...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28497100/does-tranexamic-acid-reduce-bleeding-during-femoral-fracture-operation
#5
Mohammad Haghighi, Hossein Ettehad, Mohsen Mardani-Kivi, Ahmadreza Mirbolook, Bahram Naderi Nabi, Roya Moghaddam, Abbas Sedighinejad, Gita Khanjanian
BACKGROUND: Proximal Femoral shaft fractures are commonly associated with marked blood loss which can lead to postoperative acute anemia and some other complications. Tranexamic acid (TA) is an antifibrinolytic medication that reduces intra-and postoperative blood loss and transfusion requirements during some elective surgeries. The aim of this study is to evaluate the effect of intravenous Tranexamic acid (TA) on intraoperative blood loss and a subsequent need for transfusion in patients who were undergoing surgery for femoral shaft fractures in trauma setting...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28488554/-how-can-life-threatening-external-blood-loss-be-stopped-treatment-options-in-the-prehospital-phase
#6
L M G Geeraedts, T W H Rijnhout, S E van Oostendorp, G F Giannakopoulos, E C T H Tan
- 3,500 people die of injuries in the Netherlands every year; 40% of the deaths are attributable to bleeding.- Treatment of patients with life-threatening blood loss is part of the trauma care continuum: all the way from incident to hospital treatment.- This article presents an overview of all treatment options for stopping life-threatening external blood loss, divided in medical assistance phases. It also makes a distinction between different types of care providers, based on the presence or absence of their medical skills...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28485656/delayed-massive-epistaxis-from-traumatic-cavernous-carotid-false-aneurysms-a-report-of-two-unusual-cases
#7
Ncedile Mankahla, David LeFeuvre, Allan Taylor
Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28469698/the-impact-of-preoperative-etiology-on-emergent-pancreaticoduodenectomy-for-non-traumatic-patients
#8
Chun-Yi Tsai, Bo-Ru Lai, Shang-Yu Wang, Chien-Hung Liao, Yu-Yin Liu, Shih-Ching Kang, Chun-Nan Yeh, Yi-Yin Jan, Ta-Sen Yeh
BACKGROUND: Emergent pancreaticoduodenectomy is a life-saving procedure in certain clinical scenarios when all the conservative treatment fails. The indications can be limited into perforation and bleeding. To clarify the impact of etiology on surgical outcomes of emergent pancreaticoduodenectomy for non-trauma, we analyzed our patients and performed a literature review. METHODS: We reviewed 931 consecutive pancreaticoduodenectomies performed at our institute between January 2001 and July 2015...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28467584/the-geriatric-polytrauma-risk-profile-and-prognostic-factors
#9
Holger Rupprecht, Hans Jürgen Heppner, Kristina Wohlfart, Alp Türkoglu
BACKGROUND: In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. METHODS: Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS)...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28466615/angiographic-embolization-in-pediatric-abdominal-trauma
#10
Yechiel Sweed, Jonathan Singer-Jordan, Sorin Papura, Norman Loberant, Alon Yulevich
BACKGROUND: Trauma is the leading cause of childhood morbidity and mortality. Abdominal bleeding is one of the common causes of mortality due to trauma. Angiography and embolization are well recognized as the primary treatments in certain cases of acute traumatic hemorrhage in adults; however, evidence is lacking in the pediatric population. OBJECTIVES: To assess the safety and efficacy of transcatheter arterial embolization (TAE) for blunt and penetrating abdominal and pelvic trauma in the pediatric age group...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28465988/thrombotic-risk-after-a-major-bleeding-during-anticoagulation-a-clinical-case
#11
Serenella Conti, Marco Ciuffetti, Maria Cristina Vedovati
We report on a 81-year-old female admitted to the emergency department for the occurrence of abdominal pain after a minor trauma. She was on treatment with warfarin for atrial fibrillation. The abdominal computed tomography (CT) angiography revealed a retroperitoneal hematoma (RH) of the left iliopsoas muscle with no evidence of active bleeding. The international normalized ratio exceeded the upper recommended anticoagulation limit. Prothrombin complex concentrates (PCCs) were used for anticoagulation reversal...
January 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#12
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28457980/reversal-of-trauma-induced-coagulopathy-using-first-line-coagulation-factor-concentrates-or-fresh-frozen-plasma-retic-a-single-centre-parallel-group-open-label-randomised-trial
#13
Petra Innerhofer, Dietmar Fries, Markus Mittermayr, Nicole Innerhofer, Daniel von Langen, Tobias Hell, Gottfried Gruber, Stefan Schmid, Barbara Friesenecker, Ingo H Lorenz, Mathias Ströhle, Verena Rastner, Susanne Trübsbach, Helmut Raab, Benedikt Treml, Dieter Wally, Benjamin Treichl, Agnes Mayer, Christof Kranewitter, Elgar Oswald
BACKGROUND: Effective treatment of trauma-induced coagulopathy is important; however, the optimal therapy is still not known. We aimed to compare the efficacy of first-line therapy using fresh frozen plasma (FFP) or coagulation factor concentrates (CFC) for the reversal of trauma-induced coagulopathy, the arising transfusion requirements, and consequently the development of multiple organ failure. METHODS: This single-centre, parallel-group, open-label, randomised trial was done at the Level 1 Trauma Center in Innsbruck Medical University Hospital (Innsbruck, Austria)...
April 27, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28456509/effect-of-early-tranexamic-acid-administration-on-mortality-hysterectomy-and-other-morbidities-in-women-with-post-partum-haemorrhage-woman-an-international-randomised-double-blind-placebo-controlled-trial
#14
(no author information available yet)
BACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries...
April 26, 2017: Lancet
https://www.readbyqxmd.com/read/28451716/-interventional-radiology-in-the-head-and-neck-region
#15
C Mayer, E Hattingen, H Schild, F Bootz, A Schröck
In interventional neuroradiology, endovascular embolization represents an important and helpful tool in the treatment of multiple head and neck diseases. These interventional procedures may be performed with curative intent, to reduce the surgical risk within a multimodal treatment concept, or to improve or at least maintain a good quality of life within a palliative therapy concept. In addition to a good understanding of disease pathology, knowledge of vascular anatomy, including collateral vessels and dangerous extracranial-intracranial anastomoses, is essential for successful treatment, as is implementation of an established technique using appropriate material...
April 27, 2017: HNO
https://www.readbyqxmd.com/read/28445186/the-hip-fracture-patient-on-warfarin-evaluating-blood-loss-and-time-to-surgery
#16
Matthew R Cohn, Ashley E Levack, Nikunj N Trivedi, Jordan C Villa, David S Wellman, John P Lyden, Dean G Lorich, Joseph M Lane
OBJECTIVES: To compare blood loss, delay of surgery, and short term adverse events in (1) patients admitted on warfarin versus non-anticoagulated controls and (2) warfarin patients with day of surgery (DOS) INR of 1.5 or greater versus below 1.5. DESIGN: Retrospective cohort. SETTING: Academic level I trauma center. PATIENTS/PARTICIPANTS: One hundred twenty four patients treated surgically for hip fractures including patients presenting on warfarin (n=62) and matched controls (n=62)...
April 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28424818/dose-requirements-for-idarucizumab-reversal-of-dabigatran-in-a-lethal-porcine-trauma-model-with-continuous-bleeding
#17
Markus Honickel, Henri M Spronk, Rolf Rossaint, Christian Stoppe, Joanne van Ryn, Hugo Ten Cate, Oliver Grottke
Idarucizumab is licensed for emergency reversal of dabigatran. A single 5 g dose is usually sufficient, but higher doses may sometimes be required and optimum dosing has not been defined. It was the aim of this study to investigate the effect of idarucizumab, given once or as a split dose, after double trauma in pigs anticoagulated with dabigatran. Dabigatran etexilate (30 mg/kg bid) was given to 18 male pigs orally for 3 days. On day 4, animals were randomised 1:1:1 to receive idarucizumab 60+0, 60+60 or 120+0 mg/kg...
April 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28419361/effect-of-electrical-stunning-frequency-and-current-waveform-in-poultry-welfare-and-meat-quality
#18
T S Siqueira, T D Borges, R M M Rocha, P T Figueira, F B Luciano, R E F Macedo
This study aimed to evaluate the effects of different stunning frequencies and electrical current waveforms on chicken welfare and meat quality. Two-hundred-thirty-two Cobb broilers, 48 d of age and 2.76 ± 0.47 live-weight, were randomly assigned into 4 stunning treatments - 2 frequencies (300 Hz and 650 Hz) and 2 current waveforms (direct current [DC] and alternating current [AC]). Broilers were electrically stunned in a water bath in a commercial slaughterhouse (70 V, 100 mA). The electronarcosis and stunning efficiency were confirmed by assessment of visual parameters (absence of rhythmic breathing, ocular reflex, and coordinated wing flapping) and blood parameters (lactate, glucose, creatine kinase, sodium, and potassium), which were measured after bleeding...
April 17, 2017: Poultry Science
https://www.readbyqxmd.com/read/28415664/clinical-application-of-the-supraorbital-key-hole-approach-to-the-treatment-of-unilateral-dominant-bilateral-frontal-contusions
#19
Shuguang Zhang, Chunfa Qian, Guan Sun, Xiaoliang Li
We compared the surgical efficacy of the supraorbital key-hole approach (SKA) to conventional unilateral frontotemporal craniotomy (UFTC) for the treatment of patients with unilateral-dominant bilateral frontal contusions (BFCs). A retrospective analysis of 62 patients with unilateral-dominant BFCs who underwent surgery at our institute between 2014 and 2017 was performed. There were 26 patients who underwent SKA (group A) and 36 who underwent UFTC (group B). Postoperative computed tomography scans showed satisfactory evacuation of the frontal cerebral contusions in both groups (p > 0...
March 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28407781/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-protocol
#20
Alexandre Tran, Maher Matar, Ewout W Steyerberg, Jacinthe Lampron, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Hemorrhage is a major cause of early mortality following a traumatic injury. The progression and consequences of significant blood loss occur quickly as death from hemorrhagic shock or exsanguination often occurs within the first few hours. The mainstay of treatment therefore involves early identification of patients at risk for hemorrhagic shock in order to provide blood products and control of the bleeding source if necessary. The intended scope of this review is to identify and assess combinations of predictors informing therapeutic decision-making for clinicians during the initial trauma assessment...
April 13, 2017: Systematic Reviews
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