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Trauma resuscitation

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https://www.readbyqxmd.com/read/29470190/blood-transfusion-management-in-the-severely-bleeding-military-patient
#1
Jennifer M Gurney, Philip C Spinella
PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient...
February 20, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#2
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
February 22, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29466513/the-experience-of-an-academic-league-the-positive-impact-on-knowledge-about-trauma-and-emergency
#3
Luciana Thurler Tedeschi, Luiz Paulo Junqueira Rigolon, Flávio DE Oliveira Mendes, Marianna Martini Fischmann, Isabella DE Almeida Klein, Valéria Troncoso Baltar
OBJECTIVE: to evaluate the knowledge growth of the members of the Trauma, Resuscitation and Emergency League in comparison with a nonparticipating group, with similar characteristics, at the Fluminense Federal University. METHODS: we evaluated 50 league members and 50 non-members (control group) through questionnaires applied at the beginning and end of a school year. We used a generalized linear model, with interaction effect between groups and tests (multiple comparisons with Bonferroni correction)...
February 19, 2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29462083/tourniquet-usage-in-pre-hospital-care-and-resuscitation-of-pediatric-trauma-patients-pediatric-trauma-society-position-statement
#4
Aaron Cunningham, Marc Auerbach, Mark Cicero, Mubeen Jafri
BACKGROUND: Recent mass casualty events in the United States have highlighted the need for public preparedness to prevent death from uncontrolled hemorrhage. The Pediatric Trauma Society (PTS) reviewed the literature regarding pediatric tourniquet usage with the aim to provide recommendations about the utility of this adjunct for hemorrhage control in children. METHODS: Search terms "pediatric" and "tourniquet" were used to query the US National Library of Medicine National Institutes of Health for pertinent literature...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29461464/protective-effects-of-the-complement-inhibitor-compstatin-cp40-in-hemorrhagic-shock
#5
Martijn van Griensven, Daniel Ricklin, Stephanie Denk, Rebecca Halbgebauer, Christian K Braun, Anke Schultze, Felix Hönes, Sofia Koutsogiannaki, Alexandra Primikyri, Edimara Reis, David Messerer, Sebastian Hafner, Peter Radermacher, Ali-Reza Biglarnia, Ranillo R G Resuello, Joel V Tuplano, Benjamin Mayer, Kristina Nilsson, Bo Nilsson, John D Lambris, Markus Huber-Lang
Trauma-induced hemorrhagic shock (HS) plays a decisive role in the development of immune, coagulation, and organ dysfunction often resulting in a poor clinical outcome. Imbalanced complement activation is intricately associated with the molecular danger response and organ damage after HS. Thus, inhibition of the central complement component C3 as turnstile of both inflammation and coagulation is hypothesized as a rational strategy to improve the clinical course after HS.Applying intensive care conditions, anaesthetized, monitored, and protectively ventilated non-human primates (NHP; cynomolgus monkeys) received a pressure-controlled severe HS (60 min at MAP 30 mmHg) with subsequent volume resuscitation...
February 14, 2018: Shock
https://www.readbyqxmd.com/read/29460456/acute-haemolysis-dic-and-renal-failure-after-transfusion-of-uncross-matched-blood-during-trauma-resuscitation-illustrative-case-and-literature-review
#6
J Fiorellino, A L Elahie, T E Warkentin
AIMS/OBJECTIVES: The aims of this study were to report a patient with acute haemolytic transfusion reaction (HTR) after transfusing uncross-matched red blood cell (RBC) units and to identify the frequency of this complication. BACKGROUND: Uncross-matched RBC units are commonly transfused in emergencies, but the frequency of acute HTR is unknown. METHODS: We describe a male stabbing victim who received three units of uncross-matched RBC units complicated by acute intravascular HTR, disseminated intravascular coagulation (DIC) and renal failure...
February 19, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29458321/differential-effects-of-isotonic-and-hypotonic-4-albumin-solution-on-intracranial-pressure-and-renal-perfusion-and-function
#7
Naoya Iguchi, Junko Kosaka, Joseph Bertolini, Clive N May, Yugeesh R Lankadeva, Rinaldo Bellomo
OBJECTIVES: Albumin is used to resuscitate trauma patients but may increase intracranial pressure (ICP). Its effects on renal blood flow and function are unknown. Our aim was to examine the effects of hypertonic albumin on ICP and renal function, and if any effects are due to the hypotonicity of the solution containing albumin or to albumin itself. DESIGN, SETTING AND SUBJECTS: Cross-over, randomised controlled experimental study of six adult Merino ewes in the animal facility of a research institute...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29456087/successful-interprofessional-approach-to-development-of-a-resuscitative-endovascular-balloon-occlusion-of-the-aorta-program-at-a-community-trauma-center
#8
Zaffer Qasim, Kevin Bradley, Heather Panichelli, Josie Robinson, Susan Coffey Zern
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a relatively innovative procedure designed to control critical non-compressible torso hemorrhage. In the United States, this procedure is currently in active use at only a small number of trauma centers. OBJECTIVE: We describe how we developed our REBOA program at an independent academic-affiliated community trauma center. DISCUSSION: Through a close interprofessional and multidisciplinary collaboration led by emergency physicians and trauma surgeons, we were able to successfully develop our program...
February 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29445882/procedure-rates-performed-by-emergency-medicine-residents-a-retrospective-review
#9
Joshua T Bucher, Christopher Bryczkowski, Grant Wei, Renee L Riggs, Anoop Kotwal, Brian Sumner, Jonathan V McCoy
BACKGROUND: The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency. METHODS: The study took place in an academic level I trauma center with multiple residency and fellowship programs including surgery, surgical critical care, trauma, medicine, pulmonary/critical care, anesthesiology and others...
February 14, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29445066/epidemiology-of-pediatric-out-of-hospital-cardiac-arrest-at-school-an-investigation-of-a-nationwide-registry-in-japan
#10
Kosuke Kiyohara, Junya Sado, Tetsuhisa Kitamura, Mamoru Ayusawa, Masahiko Nitta, Taku Iwami, Ken Nakata, Yasuto Sato, Noriko Kojimahara, Naohito Yamaguchi, Tomotaka Sobue, Yuri Kitamura
BACKGROUND: A better understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring in school settings is important to establish an evidence-based strategy for prevention and better prognosis.Methods and Results:The Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS) is a nationwide prospective observational study linking databases from 2 nationally representative registries, the Injury and the Accident Mutual Aid Benefit System of The Japan Sport Council and the All-Japan Utstein Registry of the Fire and Disaster Management Agency...
February 15, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29443857/the-fast-exam-can-reliably-identify-patients-with-significant-intraabdominal-hemorrhage-in-life-threatening-pelvic-fractures
#11
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440235/do-patients-with-blunt-thoracic-aortic-injury-present-to-hospital-with-unstable-vital-signs-a-systematic-review-and-meta-analysis
#12
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
February 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29439891/resuscitative-endovascular-balloon-occlusion-of-the-aorta-using-a-low-profile-device-is-easy-and-safe-for-emergency-physicians-in-cases-of-life-threatening-hemorrhage
#13
Takahiro Shoji, Takehiko Tarui, Takashi Igarashi, Yuki Mochida, Hiroyuki Morinaga, Yasuhiko Miyakuni, Yoshitaka Inoue, Yasuhiko Kaita, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10-14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed...
February 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29434652/the-open-abdomen-in-trauma-and-non-trauma-patients-wses-guidelines
#14
REVIEW
Federico Coccolini, Derek Roberts, Luca Ansaloni, Rao Ivatury, Emiliano Gamberini, Yoram Kluger, Ernest E Moore, Raul Coimbra, Andrew W Kirkpatrick, Bruno M Pereira, Giulia Montori, Marco Ceresoli, Fikri M Abu-Zidan, Massimo Sartelli, George Velmahos, Gustavo Pereira Fraga, Ari Leppaniemi, Matti Tolonen, Joseph Galante, Tarek Razek, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Andrew Peitzman, Zaza Demetrashvili, Michael Sugrue, Salomone Di Saverio, Ingo Martzi, Kjetil Soreide, Walter Biffl, Paula Ferrada, Neil Parry, Philippe Montravers, Rita Maria Melotti, Francesco Salvetti, Tino M Valetti, Thomas Scalea, Osvaldo Chiara, Stefania Cimbanassi, Jeffry L Kashuk, Martha Larrea, Juan Alberto Martinez Hernandez, Heng-Fu Lin, Mircea Chirica, Catherine Arvieux, Camilla Bing, Tal Horer, Belinda De Simone, Peter Masiakos, Viktor Reva, Nicola DeAngelis, Kaoru Kike, Zsolt J Balogh, Paola Fugazzola, Matteo Tomasoni, Rifat Latifi, Noel Naidoo, Dieter Weber, Lauri Handolin, Kenji Inaba, Andreas Hecker, Yuan Kuo-Ching, Carlos A Ordoñez, Sandro Rizoli, Carlos Augusto Gomes, Marc De Moya, Imtiaz Wani, Alain Chichom Mefire, Ken Boffard, Lena Napolitano, Fausto Catena
Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29432320/segmental-tibia-fractures-an-analysis-of-complication-and-healing-rates
#15
Robert M Corey, Nathan K Park, Lisa K Cannada
OBJECTIVES: To determine the most commonly associated injuries, complications, and healing rates of patients sustaining segmental tibial shaft fractures. DESIGN: Retrospective review. SETTING: Two Level I trauma centers. PATIENTS: One hundred and eight patients with segmental tibial shaft fractures were identified between 2005-2013. INTERVENTION: None. MAIN OUTCOME MEASURES: Demographics, injury characteristics, treatments, and complications...
January 24, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29428034/impact-of-trauma-certified-registered-nurse-anesthetists-team-on-intra-operative-resuscitation-and-postoperative-outcomes-of-trauma-patients
#16
Juan Duchesne, Chad Majoue, Marquinn Duke, Rosemarie Robledo, Chad Achord, Leslie McHale, Brandy Davis, Lusine Nahapetyan
A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS)...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29427061/deep-coma-does-not-always-predict-poor-outcomes-among-patients-with-polytrauma
#17
Jen-Fu Huang, Chun-Hsiang Ou Yang, Chih-Yuan Fu, Yu-Tung Wu
PURPOSES: This study aimed to clarify the prognosis of polytrauma patients presenting to the emergency department (ED) with a Glasgow Coma Scale score (GCS) of 3. METHODS: A trauma registry system has been established at our institution since 2009. The current study reviewed patients in the registry who presented to the ED with a GCS of 3 from January 2011 to December 2015. Surviving and non-surviving patients were compared to identify the prognostic factors of patient survival...
February 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29424792/in-depth-characterization-of-the-effects-of-cigarette-smoke-exposure-on-the-acute-trauma-response-and-hemorrhage-in-mice
#18
Clair Hartmann, Michael Gröger, Jan-Philipp Noirhomme, Angelika Scheuerle, Peter Möller, Ulrich Wachter, Markus Huber-Lang, Benedikt Nussbaum, Birgit Jung, Tamara Merz, Oscar McCook, Sandra Kress, Bettina Stahl, Enrico Calzia, Michael Georgieff, Peter Radermacher, Martin Wepler
INTRODUCTION: Hemorrhagic shock accounts for a large amount of trauma-related mortality. The severity of trauma can be further aggravated by an additional blunt chest trauma (TxT), which independently contributes to mortality upon the development of an acute lung injury (ALI). Besides, cigarette smoke (CS) exposure before TxT enhanced posttraumatic inflammation, thereby aggravating ALI. We therefore aimed to characterize the impact of an acute and/or chronic lung injury on organ dysfunction in a murine model of traumatic hemorrhagic shock (HS)...
February 8, 2018: Shock
https://www.readbyqxmd.com/read/29421694/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-resuscitative-thoracotomy-in-select-patients-with-hemorrhagic-shock-early-results-from-the-american-association-for-the-surgery-of-trauma-aortic-occlusion-in-resuscitation-for-trauma-and-acute-care
#19
Megan Brenner, Kenji Inaba, Alberto Aiolfi, Joseph DuBose, Timothy Fabian, Tiffany Bee, John B Holcomb, Laura Moore, David Skarupa, Thomas M Scalea
BACKGROUND: Aortic occlusion (AO) is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage. STUDY DESIGN: AAST AORTA registry identified trauma patients without penetrating thoracic injury undergoing AO at the level of the descending thoracic aorta (RT or Zone 1 REBOA) in the Emergency Department (ED). Survival outcomes relative to the timing of CPR need and admission hemodynamic status were examined...
February 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29420582/ethyl-pyruvate-ameliorates-hepatic-injury-following-blunt-chest-trauma-and-hemorrhagic-shock-by-reducing-local-inflammation-nf-kappab-activation-and-hmgb1-release
#20
Nils Wagner, Scott Dieteren, Niklas Franz, Kernt Köhler, Katharina Mörs, Luka Nicin, Julia Schmidt, Mario Perl, Ingo Marzi, Borna Relja
BACKGROUND: The treatment of patients with multiple trauma including blunt chest/thoracic trauma (TxT) and hemorrhagic shock (H) is still challenging. Numerous studies show detrimental consequences of TxT and HS resulting in strong inflammatory changes, organ injury and mortality. Additionally, the reperfusion (R) phase plays a key role in triggering inflammation and worsening outcome. Ethyl pyruvate (EP), a stable lipophilic ester, has anti-inflammatory properties. Here, the influence of EP on the inflammatory reaction and liver injury in a double hit model of TxT and H/R in rats was explored...
2018: PloS One
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