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https://www.readbyqxmd.com/read/28985912/patterns-of-vasopressor-utilization-during-the-resuscitation-of-massively-transfused-trauma-patients
#1
Galinos Barmparas, Navpreet K Dhillon, Eric Jt Smith, Russell Mason, Nicolas Melo, Gretchen M Thomsen, Daniel R Margulies, Eric J Ley
BACKGROUND: The use of vasopressors (VP) in the resuscitation of massively transfused trauma patients might be considered a marker of inadequate resuscitation. We sought to characterize the utilization of VP in patients receiving massive transfusion and examine the association of their use with mortality. METHODS: Trauma patients admitted from January 2011 to October 2016 receiving massive transfusion, defined as 3 units of pRBC within the first hour from admission, were selected for analysis...
September 27, 2017: Injury
https://www.readbyqxmd.com/read/28984337/primary-splenic-pregnancy-a-rare-but-imperative-cause-of-hemoperitoneum-case-report-and-review-of-literature
#2
Ruchi Rathore, Shilpi Shilpi, Ratna Chopra, Namrata Nargotra
Primary splenic pregnancy is an extremely rare form of extratubal ectopic pregnancy. These cases often cause splenic rupture in very early course of their gestation thereby presenting with hemoperitoneum in emergencies. Owing to the higher risk of exsanguination and death caused by hemoperitoneum, it is essential to diagnose these cases for proper management and better prognosis of the patients. We present the case of a 23-year-old female, gravida 2, para 1, live issue 1 presenting to the emergency outpatient department with acute abdomen and hemoperitoneum...
October 6, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28968286/2017-military-supplement-hemoglobin-based-oxygen-carriers-current-state-of-the-art-and-novel-molecules
#3
Anirban Sen Gupta
In blood, the primary role of RBCs is to transport oxygen via highly regulated mechanisms involving hemoglobin (Hb). Hb is a tetrameric porphyrin protein comprising of two α- and two β-polypeptide chains, each containing an iron-containing heme group capable of binding one oxygen molecule. In military as well as civilian traumatic exsanguinating hemorrhage, rapid loss of RBCs can lead to sub-optimal tissue oxygenation and subsequent morbidity and mortality. In such cases, transfusion of whole blood or RBCs can significantly improve survival...
September 29, 2017: Shock
https://www.readbyqxmd.com/read/28964845/preperitoneal-pelvic-packing
#4
T Monchal, E Hornez, M Coisy, S Bourgouin, J de Roulhac, P Balandraud
Severe pelvic traumatisms are associated with elevated mortality because of the high risk of exsanguination from multiple sources of bleeding. Treatment should encompass resuscitation, bone stabilization and hemorrhage control by arterio-embolization or surgery. Pre-peritoneal packing has been described in hemodynamically unstable patients who need damage control. The surgical technique of this simple and effective procedure is fully described by the authors with some complementary useful technical advices.
September 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28957010/causes-of-normal-mortality-in-commercial-egg-laying-chickens
#5
Richard M Fulton
In a large population of animals, it is normal to have some die each day from causes not related to disease, which is often referred to as natural causes. In poultry production, this phenomenon is commonly referred to as daily mortality. In egg-producing chickens, many of the natural causes of death are associated with making an egg. The causes of normal mortality in commercial egg-laying chicken flocks have been described very little to date. A commercial chicken egg farm, housing approximately two million single-comb white leghorn chickens (Gallus gallus domesticus) in 16 egg-producing flocks, was visited on a monthly basis to monitor bird health, body conditioning, skeletal integrity, and causes of daily mortality in an attempt to provide early detection of health abnormalities...
September 2017: Avian Diseases
https://www.readbyqxmd.com/read/28953559/novel-concepts-for-damage-control-resuscitation-in-trauma
#6
Philbert Y Van, John B Holcomb, Martin A Schreiber
PURPOSE OF REVIEW: Traumatic injuries are a major cause of mortality worldwide. Damage control resuscitation or balanced transfusion of plasma, platelets, and red blood cells for the management of exsanguinating hemorrhage after trauma has become the standard of care. We review the literature regarding the use of alternatives to achieve the desired 1 : 1:1 ratio as availability of plasma and platelets can be problematic in some environments. RECENT FINDINGS: Liquid and freeze dried plasma (FDP) are logistically easier to use and may be superior to fresh frozen plasma...
September 26, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28953551/the-survival-benefit-of-a-novel-trauma-workflow-that-includes-immediate-whole-body-computed-tomography-surgery-and-interventional-radiology-all-in-one-trauma-resuscitation-room-a-retrospective-historical-control-study
#7
Takahiro Kinoshita, Kazuma Yamakawa, Hiroki Matsuda, Yoshiaki Yoshikawa, Daiki Wada, Toshimitsu Hamasaki, Kota Ono, Yasushi Nakamori, Satoshi Fujimi
OBJECTIVE: The aim of this study was to evaluate the impact of a novel trauma workflow, using an interventional radiology (IVR)-computed tomography (CT) system in severe trauma. BACKGROUND: In August 2011, we installed an IVR-CT system in our trauma resuscitation room. We named it the Hybrid emergency room (ER), as it enabled us to perform all examinations and treatments required for trauma in a single place. METHODS: This retrospective historical control study conducted in Japan included consecutive severe (injury severity score ≥16) blunt trauma patients...
September 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28952957/complications-of-intravenous-catheterization-in-horses
#8
A Schoster
Intravenous catheterization is a necessity for continuous administration of intravenous fluids and for intermittent intravenous access to avoid discomfort and potential complications of repeated needle insertions into the vein. Intravenous catheterization is commonly performed and well tolerated in horses, but catheter associated complications have been reported. The most commonly reported complication is thrombophlebitis, but others such as venous air embolism, exsanguination and catheter fragmentation may also occur...
September 2017: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/28940542/metal-railing-fences-and-accidental-death
#9
Karen J Heath, Allan D Cala, Roger W Byard
Two cases of accidental deaths caused by the sharp ends of fence or gate posts are reported. Case 1: A 47-year-old man was found hanging by his ankle in an inverted position on fencing. He had attempted a shortcut to a railway platform by climbing over a metal rail fence. He had slipped and been impaled through his ankle by the sharp end of the fence post, resulting in death from positional asphyxia. Case 2: An 18-year-old male slipped while climbing over a gate and died after being impaled on a spear tip finial, which had lacerated his external iliac vein...
September 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28935925/interference-of-stress-with-the-somatotropic-axis-in-pigs-lights-on-new-biomarkers
#10
Elisa Wirthgen, Martin Kunze, Sébastien Goumon, Christina Walz, Christine Höflich, Marion Spitschak, Julia Brenmoehl, Ellen Kanitz, Margret Tuchscherer, Winfried Otten, Ulrike Gimsa, Peter Schön, Christian Manteuffel, Armin Tuchscherer, Ralf Pfuhl, Cornelia C Metges, Bernd Stabenow, Sandra Erdmann, Kathleen Schluricke, Luigi Faucitano, Andreas Hoeflich
The acceptance of animal products is increasingly associated with standardized animal welfare, which relates to appropriate animal husbandry from birth to slaughter. In particular, shipment to the slaughterhouse is considered as a critical process exposing the animals to a number of, in part severe, stressors. New biomarkers may be useful for the assessment of animal welfare. The IGF-system has been assessed in a commercial pig transport in conjunction with established markers of stress response. Furthermore, the effect of repeated restraint as an experimental model for repeated acute stress was investigated...
September 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28933334/-damage-control-surgery-in-polytrauma-patients-with-pelvic-fractures-is-it-possible-to-use-internal-fixation
#11
L Havlůj, V Džupa, R Gürlich
Current polytrauma management is multidisciplinary, with Damage Control Surgery (DCS), Damage Control Orthopaedics (DCO) and Damage Control Resuscitation (DCR) being applied in the first few hours after injury. The most severe group of polytrauma patients are those with circulatory instability and massive blood loss as a consequence of unstable pelvic fractures. In treating these patients, of crucial importance is the speed and quality of stabilisation of pelvic fracture fragments. The authors present two case reports of polytrauma patients with unstable pelvic fractures, in whom open reduction and internal fixation was performed on the anterior fracture segment through extended laparotomy in order to stop bleeding into the abdominopelvic cavity as part of the DCS approach...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28932257/a-novel-method-for-multiple-bowel-injuries-a-pilot-canine-experiment
#12
Jun Ke, Weihang Wu, Nan Lin, Weijin Yang, Zhicong Cai, Wei Wu, Dongsheng Chen, Yu Wang
BACKGROUND: Intestinal ligation is the cornerstone for damage control in abdominal emergency, yet it may lead to bowel ischemia. Although intestinal ligation avoids further peritoneal cavity pollution, it may lead to an increased pressure within the bowel segments and rapid bacterial translocation. In this study, we showed that severed intestine could be readily reconnected by using silicon tubes and be secured by using rubber bands in a canine model. METHODS: Adult Beagle dogs, subject to multiple intestinal transections and hemorrhagic shock by exsanguination, randomly received conventional ligation vs...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28890789/evaluation-of-blood-metabolites-reflects-presence-or-absence-of-liver-abscesses-in-beef-cattle
#13
Alaina G C Macdonald, Stéphanie L Bourgon, Rupert Palme, Stephen P Miller, Yuri R Montanholi
Liver abscesses constitute a prominent concern regarding animal health and profitability of the beef industry. Our objective was to evaluate potential biliary and blood indicators of liver abscesses. Twenty-nine beef bulls (initially averaging 356±70.5 kg and 253±30 days of age) were fed a high-concentrate diet during a performance test of 112 days, during which blood was collected at nine time points spaced 0.5-13 days apart within 56 days before slaughter. At the abattoir, blood and bile were collected and livers were inspected for liver abscesses...
2017: Veterinary Record Open
https://www.readbyqxmd.com/read/28884115/management-of-peripheral-and-truncal-venous-injuries
#14
REVIEW
Triantafillos G Giannakopoulos, Efthymios D Avgerinos
Civilian injuries are increasing according to the World Health Organization, and this is attributed mainly to road traffic accidents and urban interpersonal violence. Vascular injuries are common in these scenarios and are associated with high morbidity and mortality rates. Associated peripheral venous trauma is less likely to lead to death and controversy remains whether ligation or repair should be the primary approach. Conversely, non-compressible truncal venous insult can be lethal due to exsanguination, thus a high index of suspicion is crucial...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28863083/for-the-patient-evolution-in-the-management-of-vascular-trauma
#15
David V Feliciano
There has been an evolution in the diagnosis and management of vascular trauma over the past 100 years. The primary stimulus to these changes has been the increased volume of patients with cervical, truncal, and peripheral vascular injuries during military conflicts and in civilian life.Patients with "hard" signs of a vascular injury are taken to surgery emergently with a few exceptions to be described. In contrast, patients with "soft" signs of a vascular injury undergo a careful physical examination including measurement of vascular index to determine if radiologic imaging is necessary...
August 31, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28832081/primary-splenic-pregnancy-a-rare-but-imperative-cause-of-hemoperitoneum-case-report-and-review-of-literature
#16
Ruchi Rathore, Shilpi Shilpi, Ratna Chopra, Namrata Nargotra
Primary splenic pregnancy is an extremely rare form of extratubal ectopic pregnancy. These cases often cause splenic rupture in very early course of their gestation thereby presenting with hemoperitoneum in emergencies. Owing to the higher risk of exsanguination and death caused by hemoperitoneum, it is essential to diagnose these cases for proper management and better prognosis of the patients. We present the case of a 23-year-old female, gravida 2, para 1, live issue 1 presenting to the emergency outpatient department with acute abdomen and hemoperitoneum...
2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28817528/resuscitative-endovascular-balloon-occlusion-of-the-aorta-a-new-weapon-to-combat-exsanguinating-hemorrhage
#17
Richard P Dutton, Frank Herbstreit
No abstract text is available yet for this article.
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28766283/management-of-aorto-esophageal-fistula-secondary-after-thoracic-endovascular-aortic-repair-a-review-of-literature
#18
REVIEW
Kaname Uno, Tomoyuki Koike, Seiichi Takahashi, Daisuke Komazawa, Tooru Shimosegawa
Aorto-esophageal fistula (AEF) is a rare and lethal entity, and the difficulty of making diagnosis of AEF is well-known. As promising results in the short-term effectiveness of thoracic endovascular aortic repair (TEVAR) promote its usage, the occurrence of AEF after TEVAR (post-TEVAR AEF) increases as one of the major complications. Therefore, we provide a review concerning the management strategy of post-TEVAR AEF. Although its representative symptom was reported as the triad of mid-thoracic pain and sentinel hematemesis followed by massive hematemesis, the symptom-free interval between sentinel hemorrhage and massive exsanguination is unpredictable...
August 1, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28739243/heaven-criteria-derivation-of-a-new-difficult-airway-prediction-tool
#19
Daniel P Davis, David J Olvera
OBJECTIVE: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. METHODS: A retrospective descriptive analysis was performed in a population of air medical rapid sequence intubation patients requiring more than 1 attempt...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28728381/blood-haematology-muscle-ph-and-serum-cortisol-changes-in-pigs-with-different-levels-of-drip-loss
#20
Nunyarat Koomkrong, Chaiwat Boonkaewwan, Watchara Laenoi, Autchara Kayan
Objective: An experiment was conducted to study the blood haematology, muscle pH and serum cortisol changes in pigs with different levels of drip loss. Methods: Two groups (low and high) of 20 animals were selected from 100 pigs based on drip loss. All [Duroc × (Large White × Landrace)] pigs were slaughtered according to standard slaughtering procedures. At exsanguinations, blood samples were taken for the haematological parameters and serum cortisol analysis...
June 26, 2017: Asian-Australasian Journal of Animal Sciences
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