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Hemorrhagic shock

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https://www.readbyqxmd.com/read/28633808/impact-of-mr-guided-boiling-histotripsy-in-distinct-murine-tumor-models
#1
Martijn Hoogenboom, Dylan C Eikelenboom, Renske J E van den Bijgaart, Arend Heerschap, Pieter Wesseling, Martijn H den Brok, Jurgen J Fütterer, Gosse J Adema
Interest in mechanical high intensity focused ultrasound (HIFU) ablation is rapidly growing. Boiling histotripsy (BH) is applied for mechanical fragmentation of soft tissue into submicron fragments with limited temperature increase using the shock wave and cavitation effects of HIFU. Research on BH has been largely limited to ex vivo experiments. As a consequence, the in vivo pathology after BH treatment and the relation to preexistent tissue characteristics are not well understood. This study reports on in vivo MR guided BH treatment, either with 100 or 200 pulses per focal spot, in three different subcutaneous mouse tumor models: a soft-tissue melanoma (B16OVA), a compact growing thymoma (EL4), and a highly vascularized neuroblastoma (9464D)...
September 2017: Ultrasonics Sonochemistry
https://www.readbyqxmd.com/read/28632583/incremental-balloon-deflation-following-complete-resuscitative-endovascular-balloon-occlusion-of-the-aorta-results-in-steep-inflection-of-flow-and-rapid-reperfusion-in-a-large-animal-model-of-hemorrhagic-shock
#2
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Jeremy W Cannon, Todd E Rasmussen, Lucas P Neff, M Austin Johnson, Timothy K Williams
INTRODUCTION: To avoid potential cardiovascular collapse after resuscitative endovascular balloon occlusion of the aorta (REBOA), current guidelines recommend methodically deflating the balloon for 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632582/the-effect-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-multiple-injuries-model
#3
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
BACKGROUND: Despite clinical reports of poor outcomes, the degree to which resuscitative endovascular balloon occlusion of the aorta (REBOA) exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared with partial aortic occlusion (PAO) or no intervention. METHODS: Twenty-one swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#4
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28631110/expression-of-hsp27-and-hsp70-and-vacuolization-in-the-pituitary-glands-in-cases-of-fatal-hypothermia
#5
Elke Doberentz, Philipp Markwerth, Rebecca Wagner, Burkhard Madea
Hypothermia causes systemic cellular stress. The pituitary gland is an endocrine gland and plays an important role in thermoregulation. When the core body temperature drops, the pituitary gland is activated by stimulation of hypothalamic hormones. In this study, we investigated morphological alterations of the pituitary gland in cases of fatal hypothermia. Several morphological alterations of the anterior lobe of the pituitary gland, such as hemorrhage, vacuolization, and hyperemia, have been previously described in fatal hypothermia...
June 19, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28627649/hypoxia-serves-a-key-function-in-the-upregulated-expression-of-vascular-adhesion-protein%C3%A2-1-in%C3%A2-vitro-and-in-a-rat-model-of-hemorrhagic-shock
#6
Yuxing Zhang, Wei Yi, Jun Yao, Xiaojun Yu, Cheng Qian, Zhiqian Hu
Hemorrhagic shock following major trauma results in mortality, but the function of vascular adhesion protein‑1 (VAP‑1), implicated in intracranial hemorrhage, remains unknown. This study aimed to determine whether expression of the AOC3 gene and its encoded protein, VAP‑1, is altered by hypoxia. Rat hepatic sinusoidal endothelial cells (RHSECs) and rat intestinal microvascular endothelial cells (RIMECs) were transduced with a viral vector carrying AOC3, and AOC3 mRNA expression levels were measured by reverse transcription‑quantitative polymerase chain reaction...
June 8, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28624985/dusp1-and-kcnj2-mrna-upregulation-can-serve-as-a-biomarker-of-mechanical-asphyxia-induced-death-in-cardiac-tissue
#7
Yan Zeng, Li Tao, Jianlong Ma, Liujun Han, Yehui Lv, Pan Hui, Heng Zhang, Kaijun Ma, Bi Xiao, Qun Shi, Hongmei Xu, Long Chen
The incidence of death by asphyxia is second to the incidence of death by mechanical injury; however, death by mechanical asphyxia may be difficult to prove in court, particularly in cases in which corpses do not exhibit obvious signs of asphyxia. To identify a credible biomarker of asphyxia, we first examined the expression levels of 47,000 mRNAs in human cardiac tissue specimens from individuals who died of mechanical asphyxia and compared the expression levels with the levels of the corresponding mRNAs in specimens from individuals who died of craniocerebral injury using microarray...
June 17, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28624051/persistent-injury-associated-anemia-the-role-of-the-bone-marrow-microenvironment
#8
Jessica K Millar, Kolenkode B Kannan, Tyler J Loftus, Ines G Alamo, Jessica Plazas, Philip A Efron, Alicia M Mohr
BACKGROUND: The regulation of erythropoiesis involves hematopoietic progenitor cells, bone marrow stroma, and the microenvironment. Following severe injury, a hypercatecholamine state develops that is associated with increased mobilization of hematopoietic progenitor cells to peripheral blood and decreased growth of bone marrow erythroid progenitor cells that manifests clinically as a persistent injury-associated anemia. Changes within the bone marrow microenvironment influence the development of erythroid progenitor cells...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623248/dieulafoy-s-lesion-of-the-anal-canal-a-rare-cause-of-lower-gastrointestinal-bleeding
#9
Ahmed Khalid, Husham Abdelrahman, Syed Muhammad Ali, Ejaz Ahmed Latif, Hassan Al-Thani, Ayman El-Menyar
BACKGROUND Dieulafoy's lesion of the anal canal is an uncommon cause of lower gastrointestinal bleeding due to rupture of a submucosal artery. This could be an under-recognized cause of hemorrhagic shock in rare cases. CASE REPORT We present 2 cases admitted with bleeding per rectum and hemorrhagic shock, and both were diagnosed as Dieulafoy's lesion of the anal canal on sigmoidoscopy. One case was treated surgically and the second was managed endoscopically. CONCLUSIONS Dieulafoy's lesion of the anal canal can be a source of massive lower gastrointestinal bleeding...
June 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28615325/calcium-calmodulin-dependent-protein-kinase-regulates-the-pink1-parkin-and-dj-1-pathways-of-mitophagy-during-sepsis
#10
Xianghong Zhang, Du Yuan, Qian Sun, Li Xu, Emma Lee, Anthony J Lewis, Brian S Zuckerbraun, Matthew R Rosengart
During sepsis and shock states, mitochondrial dysfunction occurs. Consequently, adaptive mechanisms, such as fission, fusion, and mitophagy, are induced to eliminate damaged portions or entire dysfunctional mitochondria. The regulatory PINK1/Parkin and DJ-1 pathways are strongly induced by mitochondrial depolarization, although a direct link between loss of mitochondrial membrane potential (ΔΨ) and mitophagy has not been identified. Mitochondria also buffer Ca(2+), and their buffering capacity is dependent on ΔΨ...
June 14, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28614145/non-human-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-poly-traumatic-hemorrhagic-shock
#11
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, R Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable non-human primate (NHP) models of severe poly-traumatic hemorrhagic shock. METHODS: NHPs were randomized into five pressure-targeted severe hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF) and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24hrs...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28614141/role-of-hemorrhagic-shock-in-experimental-polytrauma
#12
Stephanie Denk, Sebastian Weckbach, Philipp Eisele, Christian K Braun, Rebecca Wiegner, Julia J Ohmann, Lisa Wrba, Felix M Hoenes, Philipp Kellermann, Peter Radermacher, Ulrich Wachter, Sebastian Hafner, Oscar McCook, Anke Schultze, Annette Palmer, Sonja Braumüller, Florian Gebhard, Markus Huber-Lang
Hemorrhagic shock (HS) after tissue trauma increases the complication and mortality rate of polytrauma (PT) patients. Although several murine trauma models have been introduced, there is a lack of knowledge about the exact impact of an additional HS. We hypothesized that HS significantly contributes to organ injury, which can be reliably monitored by detection of specific organ damage markers.Therefore we established a novel clinically relevant PT plus HS model in C57BL/6 mice which were randomly assigned to control, HS, PT or PT+HS procedure (n = 8 per group)...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28612239/dengue-hemorrhagic-fever-a-state-of-the-art-review-focused-in-pulmonary-involvement
#13
REVIEW
Renata Rocha de Almeida, Bernardo Paim, Solange Artimos de Oliveira, Arthur Soares Souza, Antônio Carlos Portugal Gomes, Dante Luiz Escuissato, Gláucia Zanetti, Edson Marchiori
Dengue fever is an arboviral disease transmitted to humans through the bites of infected female Aedes mosquitoes. Dengue virus is a member of the Flaviviridae family, and human infection can be caused by any of the four antigenically distinct serotypes (DENV 1-4). The infection has become recognized as the most important and prevalent arboviral disease in humans, endemic in almost 100 countries worldwide. Nearly 3 billion people live in areas with transmission risk. Autochthonous transmission of the virus in previously disease-free areas, increased incidence in endemic areas, and epidemic resurgence in controlled regions could increase the risk of contracting more severe forms of the disease, such as dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS)...
June 13, 2017: Lung
https://www.readbyqxmd.com/read/28611888/efficacy-and-safety-of-tranexamic-acid-in-prehospital-traumatic-hemorrhagic-shock-outcomes-of-the-cal-pat-study
#14
Michael M Neeki, Fanglong Dong, Jake Toy, Reza Vaezazizi, Joe Powell, Nina Jabourian, Alex Jabourian, David Wong, Richard Vara, Kathryn Seiler, Troy W Pennington, Joe Powell, Chris Yoshida-McMath, Shanna Kissel, Katharine Schulz-Costello, Jamish Mistry, Matthew S Surrusco, Karen R O'Bosky, Daved Van Stralen, Daniel Ludi, Karl Sporer, Peter Benson, Eugene Kwong, Richard Pitts, John T Culhane, Rodney Borger
INTRODUCTION: The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to assess the safety and impact on patient mortality of tranexamic acid (TXA) administration in cases of trauma-induced hemorrhagic shock. The current study further aimed to assess the feasibility of prehospital TXA administration by paramedics within the framework of North American emergency medicine standards and protocols. METHODS: This is an ongoing multi-centered, prospective, observational cohort study with a retrospective chart-review comparison...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28603721/helping-prometheus-liver-protection-in-acute-hemorrhagic-shock
#15
REVIEW
Nils T Veith, Tina Histing, Michael D Menger, Tim Pohlemann, Thomas Tschernig
Acute hemorrhagic hypovolemic shock is caused by a significant high blood loss and leads to hemodynamic instability. The decrease in intravascular volume results in cellular hypoxia and finally in damage to organs such as the liver and the kidney. The liver plays a decisive role in the development or prevention of multiple organ failure after hemorrhagic shock. Despite the large number of experimental studies, the knowledge of pathophysiological mechanisms in the liver after hemorrhagic shock is incomplete...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28601315/age-related-mortality-in-blunt-traumatic-hemorrhagic-shock-the-killers-and-the-life-savers
#16
John O Hwabejire, Christine E Nembhard, Tolulope A Oyetunji, Theodros Seyoum, Mayowa P Abiodun, Suryanarayana M Siram, Edward E Cornwell, Wendy R Greene
BACKGROUND: There are sparse data on the association between age and mortality in hemorrhagic shock (HS). We examined this association in this study. MATERIALS AND METHODS: The Glue Grant database was analyzed. Patients aged ≥16 y with blunt traumatic HS were stratified into eight age groups (16-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥85 y) to identify the mortality inflection point. Subsequently, patients were restratified into young age (16-44 y), middle age (45-64 y), and elderly (≥65 y)...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601214/fluid-resuscitation-in-tactical-combat-casualty-care-yesterday-and-today
#17
REVIEW
Frank K Butler
The prevailing wisdom for the prehospital fluid resuscitation of trauma victims in hemorrhagic shock in 1992 was to administer 2 L of crystalloid solution as rapidly as possible. A review of the fluid resuscitation literature found that this recommendation was not well supported by the evidence at the time. Prehospital fluid resuscitation strategies were reevaluated in the 1993-1996 Tactical Combat Casualty Care (TCCC) research program. This article reviews the advances in prehospital fluid resuscitation as recommended by the original TCCC Guidelines and modified over the following 2 decades...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601210/tranexamic-acid-use-in-prehospital-uncontrolled-hemorrhage
#18
REVIEW
Benjamin R Huebner, Warren C Dorlac, Chris Cribari
The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-blinded, placebo-controlled study incorporating >20,000 patients, numerous limitations and weaknesses have been described. As a result, additional studies have followed, delineating the potential risks and benefits of TXA administration...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601205/remote-damage-control-resuscitation-in-austere-environments
#19
REVIEW
Ronald Chang, Brian J Eastridge, John B Holcomb
Hemorrhage is the leading cause of preventable military and civilian trauma death. Damage control resuscitation with concomitant mechanical hemorrhage control has become the preferred in-hospital treatment of hemorrhagic shock. In particular, plasma-based resuscitation with decreased volumes of crystalloids and artificial colloids as part of damage control resuscitation has improved outcomes in the military and civilian sectors. However, translation of these principles and techniques to the prehospital, remote, and austere environments, known as remote damage control resuscitation, is challenging given the resource limitations in these settings...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601204/battlefield-analgesia-in-tactical-combat-casualty-care
#20
REVIEW
Ian S Wedmore, Frank K Butler
At the start of the Afghanistan conflict, battlefield analgesia for US military casualties was achieved primarily through the use of intramuscular (IM) morphine. This is a suboptimal choice, since IM morphine is slow-acting, leading to delays in effective pain relief and the risk of overdose and death when dosing is repeated in order to hasten the onset of analgesia. Advances in battlefield analgesia, pioneered initially by Tactical Combat Casualty Care (TCCC), and the Army's 75th Ranger Regiment, have now been incorporated into the Triple-Option Analgesia approach...
June 2017: Wilderness & Environmental Medicine
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