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lactate in trauma

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https://www.readbyqxmd.com/read/29751949/platelet-storage-lesions-what-more-do-we-know-now
#1
REVIEW
Monica Suet Ying Ng, John-Paul Tung, John Francis Fraser
Platelet concentrate (PC) transfusions are a lifesaving adjunct to control and prevent bleeding in cancer, hematologic, surgical, and trauma patients. Platelet concentrate availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. Platelet storage lesions are a series of biochemical, structural, and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage...
April 17, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29731163/predictors-of-organ-donation-among-patients-with-brain-death-in-the-intensive-care-unit
#2
M T Nakamura, G E Rodio, C Tchaicka, E F Padilha, A C Jorge, P A D Duarte
INTRODUCTION: Despite the improved care of potential organ donors with probable brain death (BD) in the intensive care unit (ICU), few epidemiologic and clinical data are available in developing countries. OBJECTIVES: To evaluate ICU patients with suspected BD aiming to identify factors possibly related to success (organ donation) or failure (nondonation). METHODS: Retrospective cohort study, from the patient records of an adult ICU of a Brazilian teaching hospital for 12 months...
March 9, 2018: Transplantation Proceedings
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
#3
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/29715519/oxidative-stress-contributes-to-fracture-cast-induced-inflammation-and-pain-in-a-rat-model-of-complex-regional-pain-syndrome
#4
Tian-Zhi Guo, Tzuping Wei, Ting-Ting Huang, Wade S Kingery, John David Clark
Clinical evidence suggests vitamin C (Vit C) may protect against the development of complex regional pain syndrome (CRPS) after fracture and/or surgery. Tibia fracture followed by 4 weeks cast immobilization (fracture/cast) in rats results in nociceptive, vascular, and bone changes resembling clinical CRPS. In the present study, fracture/cast rats were treated with the oxidative stress inhibitors Vit C, N-acetyl cysteine (NAC) or 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPOL) to examine their effects on CRPS-related nociceptive and vascular changes...
April 28, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29709584/resuscitative-endovascular-balloon-occlusion-of-the-aorta-implementation-and-preliminary-results-at-an-academic-level-i-trauma-center
#5
Marcus D Darrabie, Chasen A Croft, Scott C Brakenridge, Alicia M Mohr, Martin A Rosenthal, Frederick A Moore, R Stephen Smith
BACKGROUND: REBOA is a novel method of controlling subdiaphragmatic hemorrhage while improving hemodynamic stability. This procedure achieves many of the goals of resuscitative thoracotomy (RT), but is less invasive. Herein, we present the initial experience with REBOA at a level 1 academic trauma center. STUDY DESIGN: A retrospective review was performed. Orientation of surgeons and residents to REBOA was accomplished by an educational program including a hands-on simulation session (1...
April 11, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29702553/cytokine-and-chemokine-recovery-is-increased-by-colloid-perfusates-during-dermal-microdialysis
#6
Sven R Quist, Claudia Kirbs, Charlotte Kloft, Harald P Gollnick
Cytokines and chemokines play important roles in cell signalling, and microdialysis is a promising tool for monitoring these inflammation markers ex vivo. Therefore, the collecting of these mediators at the highest concentrations possible is crucial. Depending on the size of the mediator of interest, the collection of these high molecular mass molecules has thus far been difficult due to their low recovery, even when using high cut-off (100 kDa) microdialysis membranes. This study aimed to optimize the recovery of various cytokines and chemokines by validating the use of different perfusates in cutaneous microdialysis, and comparing intravenous (i...
April 27, 2018: Materials
https://www.readbyqxmd.com/read/29675023/increased-plasma-levels-of-danger-associated-molecular-patterns-are-associated-with-immune-suppression-and-postoperative-infections-in-patients-undergoing-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#7
Guus P Leijte, Hettie Custers, Jelle Gerretsen, Amon Heijne, Johannes Roth, Thomas Vogl, Gert J Scheffer, Peter Pickkers, Matthijs Kox
Introduction: Danger-associated molecular patterns (DAMPs) can elicit immune responses and may subsequently induce an immune-suppressed state. Previous work showed that increased plasma levels of DAMPs are associated with immune suppression and increased susceptibility toward infections in trauma patients. Like trauma, major surgical procedures, such as cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC), are also thought to cause profound DAMP release...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29605431/combination-of-blood-lactate-level-with-assessment-of-blood-consumption-abc-scoring-system-a-more-accurate-predictor-of-massive-transfusion-requirement
#8
Wongsakorn Chaochankit, Osaree Akaraborworn, Burapat Sangthong, Komet Thongkhao
PURPOSE: Exsanguination is the most common leading cause of death in trauma patients. The massive transfusion (MT) protocol may influence therapeutic strategies and help provide blood components in timely manner. The assessment of blood consumption (ABC) score is a popular MT protocol but has low predictability. The lactate level is a good parameter to reflect poor tissue perfusion or shock states that can guide the management. This study aimed to modify the ABC scoring system by adding the lactate level for better prediction of MT...
March 3, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29602488/femoral-arterial-and-central-venous-catheters-in-the-trauma-resuscitation-room
#9
S R Hamada, M Fromentin, M Ronot, T Gauss, A Harrois, J Duranteau, C Paugam-Burtz
BACKGROUND: Arterial and central venous femoral catheters (fAC-CVC) use during the initial management of severe trauma patients is not a standard technique in most trauma centers. Arguments in favor of their use are: continuous monitoring of blood pressure, safe drug administration, easy blood sampling and potentially large bore venous access. The lack of evidence makes the practice heterogeneous. The aim of the present study was to describe the use and complications of fAC-CVC in the trauma bay in two centers where they are routinely used...
March 23, 2018: Injury
https://www.readbyqxmd.com/read/29583119/management-of-intra-abdominal-vascular-injury-in-trauma-laparotomy-a-south-african-experience
#10
Ross Weale, Victor Kong, Vassil Manchev, Wanda Bekker, George Oosthuizen, Petra Brysiewicz, Grant Laing, John Bruce, Damian Clarke
BACKGROUND: Intra-abdominal vascular injury (IAVI) is uncommon but continues to be associated with high mortality rates despite technological advances in the past decades. In light of these ongoing developments, we reviewed our contemporary experience with IAVI in an attempt to clarify and refine our management strategies and the outcome of these patients. METHODS: We retrospectively reviewed the charts of all patients admitted between January 2011 and December 2014 at a major trauma centre in South Africa who were found to have an IAVI during laparotomy for trauma...
April 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#11
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29560047/prehospital-lactate-predicts-need-for-resuscitative-care-in-non-hypotensive-trauma-patients
#12
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/29544906/repeat-lactate-level-predicts-mortality-better-than-rate-of-clearance
#13
Zachary D W Dezman, Angela C Comer, Gordon S Smith, Peter F Hu, Colin F Mackenzie, Thomas M Scalea, Jon Mark Hirshon
BACKGROUND: Lactate clearance has been developed into a marker of resuscitation in trauma, but no study has compared the predictive power of the various clearance calculations. Our objective was to determine which method of calculating lactate clearance best predicted 24-hour and in-hospital mortality after injury. STUDY DESIGN: Retrospective chart review of patients admitted to a Level-1 trauma center directly from the scene of injury from 2010 to 2013 who survived >15min, had an elevated lactate at admission (≥3mmol/L), followed by another measurement within 24h of admission...
March 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29538230/enhanced-platelet-function-in-cold-stored-whole-blood-supplemented-with-resveratrol-or-cytochrome-c
#14
Michael L Ekaney, Gabrielle Gonzalez Gray, Iain H McKillop, Susan L Evans
BACKGROUND: Limited availability and use of whole blood (WB) following trauma is driven by perceptions that hemostatic function is limited by platelet dysfunction within 5 days storage. We sought to define the hemostatic function of WB stored at 4°C for up to 25 days, elucidate changes in metabolic parameters and mitochondrial dysfunction in platelets in WB, and the effect of supplementation using resveratrol (Res) or cytochrome c (Cyt c). METHODS: WB was collected, aliquoted, and stored at 4°C without agitation...
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29515645/evaluation-of-capillary-leakage-after-vasopressin-resuscitation-in-a-hemorrhagic-shock-model
#15
Roberto Bini, Osvaldo Chiara, Stefania Cimbanassi, Giorgio Olivero, Antonella Trombetta, Paolo Cotogni
Background: Hemorrhagic shock (HS) is a major threat to patients with trauma and spontaneous bleeding. The aim of the study was to investigate early effects of vasopressin on metabolic and hemodynamic parameters and endothelium permeability by measuring capillary leakage compared to those of other resuscitation strategies in a HS model. Methods: Forty-five Sprague-Dawley rats were randomized into five groups: S group ( n  = 5), sham-operated rats without shock or resuscitation; HS group ( n  = 10), HS and no resuscitation; RL group ( n  = 10), HS and resuscitation with Ringer's lactate (RL); RLB group ( n  = 10), HS and resuscitation with two-third shed blood plus RL; and vasopressin group ( n  = 10), HS and resuscitation with RL, followed by continuous infusion of 0...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29507715/a-comparison-of-a-novel-time-based-summary-measure-of-dairy-cow-health-against-cumulative-disease-frequency
#16
Craig S McConnel, Ashleigh A McNeil, Joleen C Hadrich, Jason E Lombard, Jane Heller, Franklyn B Garry
Background: There is an increasing push for dairy production to be scientifically grounded and ethically responsible in the oversight of animal health and well-being. Addressing underlying challenges affecting the quality and length of productive life necessitates novel assessment and accountability metrics. Human medical epidemiologists developed the Disability-Adjusted Life Year metric as a summary measure of health addressing the complementary nature of disease and death. The goal of this project was to develop and implement a dairy Disease-Adjusted Lactation (DALact) summary measure of health, as a comparison against cumulative disease frequency...
2018: Irish Veterinary Journal
https://www.readbyqxmd.com/read/29507415/mechanical-complications-and-outcomes-following-invasive-emergency-procedures-in-severely-injured-trauma-patients
#17
Manuel F Struck, Johannes K M Fakler, Michael Bernhard, Thilo Busch, Patrick Stumpp, Gunther Hempel, André Beilicke, Sebastian N Stehr, Christoph Josten, Hermann Wrigge
This study aimes to determine the complication rates, possible risk factors and outcomes of emergency procedures performed during resuscitation of severely injured patients. The medical records of patients with an injury severity score (ISS) >15 admitted to the University Hospital Leipzig from 2010 to 2015 were reviewed. Within the first 24 hours of treatment, 526 patients had an overall mechanical complication rate of 26.2%. Multivariate analysis revealed out-of-hospital airway management (OR 3.140; 95% CI 1...
March 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29461323/hyperglycemia-and-elevated-lactate-in-trauma-where-do-we-go-from-here
#18
Melissa L Bellomy, Robert E Freundlich
No abstract text is available yet for this article.
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29451642/damage-control-surgery-are-we-losing-control-over-indications
#19
Silvânia Klug Pimentel, Tulio Rucinski, Melina Paula DE Araújo Meskau, Guilherme Pasquini Cavassin, Nathan Harmuch Kohl
OBJECTIVE: to analyze the surgeons' subjective indications for damage control surgery, correlating with objective data about the patients' physiological state at the time the surgery was chosen. METHODS: we carried out a prospective study between January 2016 and February 2017, with 46 trauma victims who were submitted to damage control surgery. After each surgery, we applied a questionnaire to the attending surgeon, addressing the motivations for choosing the procedure...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29450690/mortality-rates-of-patients-undergoing-emergency-laparotomy-in-an-irish-university-teaching-hospital
#20
Aoife C Kiernan, Peadar S Waters, Sean Tierney, Paul Neary, Maria Donnelly, Dara O Kavanagh, Bridget Egan
INTRODUCTION: Emergency laparotomy (EL) is a commonly performed operation with increased morbidity and mortality. Currently, there is a lack of published outcomes following emergency laparotomy within an Irish population. The aim of this study was to assess our outcomes and compare these to predefined outcomes from NELA. METHODS: A review of a prospectively maintained database of all patients who underwent an emergency laparotomy between January 1st 2015 and October 31st 2016 was performed...
February 15, 2018: Irish Journal of Medical Science
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