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fluid resuscitation and trauma

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https://www.readbyqxmd.com/read/29722563/damage-associated-molecular-patterns-damps-in-resuscitated-hemorrhagic-shock-are-mitigated-by-peritoneal-fluid-administration
#1
Paul J Matheson, Mark A Eid, Matthew A Wilson, Victoria S Graham, Samuel A Matheson, Jessica Lee Weaver, Cynthia D Downard, Jason W Smith
INTRODUCTION: Conventional resuscitation (CR) of hemorrhagic shock (HS), a significant cause of trauma mortality, is I.V. blood and fluids. CR restores central hemodynamics, but vital organ flow can drop causing hypoperfusion, hypoxia, Damage-Associated Molecular Patterns (DAMPs), and remote organ dysfunction (i.e., lung). CR plus Direct Peritoneal Resuscitation (DPR) prevents intestinal and hepatic hypoperfusion. We hypothesized that DPR prevents lung injury in HS/CR by altering DAMPs...
May 3, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29721496/the-role-of-plasma-transfusion-in-massive-bleeding-protecting-the-endothelial-glycocalyx
#2
REVIEW
Stefano Barelli, Lorenzo Alberio
Massive hemorrhage is a leading cause of death worldwide. During the last decade several retrospective and some prospective clinical studies have suggested a beneficial effect of early plasma-based resuscitation on survival in trauma patients. The underlying mechanisms are unknown but appear to involve the ability of plasma to preserve the endothelial glycocalyx. In this mini-review, we summarize current knowledge on glycocalyx structure and function, and present data describing the impact of hemorrhagic shock and resuscitation fluids on glycocalyx...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29719851/an-unforeseeable-complication-posterior-ischemic-optic-neuropathy-after-penetrating-injury-to-the-heart
#3
Joseph J Eid, Brian C Cronin, Susan Seman
Trauma surgeons are currently encountering unusual adverse events after traumatic injuries. Ischemic optic neuropathy is a rare complication that may occur in trauma and burn patients that present in extremis and require massive resuscitation. A 29-year-old male patient sustains a penetrating injury to the heart that required primary repair. He remained hemodynamically stable and required a limited amount of resuscitative fluids and products. Postoperatively, the patient develops acute painless bilateral loss of vision...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29685615/effectiveness-and-safety-of-continuous-neuromuscular-blockade-in-trauma-patients-with-an-open-abdomen-a-follow-up-study
#4
Susan E Smith, Susan E Hamblin, Oscar D Guillamondegui, Oliver L Gunter, Bradley M Dennis
BACKGROUND: Neuromuscular blocking agents (NMBA) have been associated with decreased time to fascial closure following damage control laparotomy (DCL). Changes in resuscitation over the last decade bring this practice into question. METHODS: A retrospective cohort study of adults who underwent DCL between 2009 and 2015 was conducted at an ACS-verified level 1 trauma center. The study group (NMBA+) received continuous NMBA within 24 h of DCL. Data collected included demographics, resuscitative fluids, mortality, and complications...
April 18, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29668565/the-effects-of-genetic-3-mercaptopyruvate-sulfurtransferase-deficiency-in-murine-traumatic-hemorrhagic-shock
#5
Michael Gröger, Martin Wepler, Ulrich Wachter, Tamara Merz, Oscar McCook, Sandra Kress, Britta Lukaschewski, Sebastian Hafner, Markus Huber-Lang, Enrico Calzia, Michael Georgieff, Noriyuki Nagahara, Csaba Szabó, Peter Radermacher, Clair Hartmann
INTRODUCTION: Hemorrhagic shock is a major cause of death after trauma. An additional blunt chest trauma independently contributes to mortality upon the development of an acute lung injury (ALI) by aggravating pathophysiological consequences of hemorrhagic shock. The maintenance of hydrogen sulfide availability is known to play an important role during hemorrhage and ALI. We therefore tested the impact of a genetic 3-mercaptopyruvate sulfurtransferase mutation (Δ3-MST) in a resuscitated murine model of traumatic-hemorrhagic shock...
April 17, 2018: Shock
https://www.readbyqxmd.com/read/29664514/-damage-control-resuscitation-in-pediatric-severe-trauma
#6
Adriana Wegner Araya
INTRODUCTION: Trauma is an important cause of morbidity and mortality in the pediatric population. It has the first place in mortality in our country without considering perinatal pathologies and congenital malformations. An important percentage of early and late deaths secondary to this cau se, as well as its sequelae, could be prevented with optimal and timely resuscitation. OBJECTIVE: To review the applicability of damage control resuscitation (DCR) in severe pediatric trauma, with emphasis on medical management...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29657727/preoperative-fluid-restriction-for-trauma-patients-with-hemorrhagic-shock-decreases-ventilator-days
#7
Shigenari Matsuyama, Ryusuke Miki, Hirotada Kittaka, Haruki Nakayama, Shota Kikuta, Satoshi Ishihara, Shinichi Nakayama
Aim: In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction. Methods: From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29627883/platelet-transfusion-increases-risk-for-acute-respiratory-distress-syndrome-in-non-massively-transfused-blunt-trauma-patients
#8
George Kasotakis, Nichole Starr, Erek Nelson, Bedabrata Sarkar, Peter Ashley Burke, Daniel George Remick, Ronald Gary Tompkins
PURPOSE: While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients. METHODS: The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified...
April 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29581692/rupture-of-cystic-artery-pseudoaneurysm-a-rare-complication-of-acute-cholecystitis
#9
P R V Praveen Kumar Sunkara, Parth Ketankumar Shah, Kamalesh Rakshit, Shuvro Roy Choudhary, N P Bohidar, Sanjay Kumar Dubey
Pseudoaneurysm (PA) of the cystic artery is rare. Most of the reported cases are iatrogenic and develop secondary to liver biopsy, laparoscopic cholecystectomy, ERCP, and liver transplant. Other reported causes include trauma, malignancy, arteriovenous malformations, and inflammation in the hepatobiliary and pancreatic system. Cystic artery psuedoaneurysm is usually asymptomatic but may also present as vague abdominal pain, intra-abdominal mass, and hemobilia. In the event of rupture, it may present as a catastrophic intra-peritoneal bleeding with hemorrhagic shock...
February 2018: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29552394/diffuse-optical-monitoring-of-peripheral-tissues-during-uncontrolled-internal-hemorrhage-in-a-porcine-model
#10
Karthik Vishwanath, Rajan Gurjar, David Wolf, Suzannah Riccardi, Michael Duggan, David King
Reliable, continuous and noninvasive blood flow and hemoglobin monitoring in trauma patients remains a critical, but generally unachieved goal. Two optical sensing methods - diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) - are used to monitor and detect internal hemorrhage. Specifically, we investigate if cutaneous perfusion measurements acquired using DCS and DRS in peripheral (thighs and ear-lobe) tissues could detect severe hemorrhagic shock in a porcine model. Four animals underwent high-grade hepato-portal injury in a closed abdomen, to induce uncontrolled hemorrhage and were subsequently allowed to bleed for 10 minutes before fluid resuscitation...
February 1, 2018: Biomedical Optics Express
https://www.readbyqxmd.com/read/29538238/multicenter-study-of-crystalloid-boluses-and-transfusion-in-pediatric-trauma-when-to-go-to-blood
#11
Stephanie F Polites, Rachel M Nygaard, Pooja N Reddy, Martin D Zielinski, Chad J Richardson, Terri A Elsbernd, Branden M Petrun, Sean L Weinberg, Sherrie Murphy, Donald D Potter, Denise B Klinkner, Christopher R Moir
BACKGROUND: The 9th edition of ATLS recommends up to three crystalloid boluses in pediatric trauma patients with consideration of transfusion after the second bolus however this approach is debated. We aimed to determine if requirement of more than one fluid bolus predicts the need for transfusion. METHODS: 2010-2016 highest tier activation patients <15 years of age from two ACS Level I pediatric trauma centers were identified from prospectively maintained trauma databases...
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29494777/prehospital-interventions-performed-on-pediatric-trauma-patients-in-iraq-and-afghanistan
#12
Steven G Schauer, Michael D April, Guyon J Hill, Jason F Naylor, Matthew A Borgman, Robert A De Lorenzo
BACKGROUND: United States (US) and coalition military medical units deployed to combat zones frequently encounter pediatric trauma patients. Pediatric patients may present unique challenges due to their anatomical and physiological characteristics and most military prehospital providers lack pediatric-specific training. A minimal amount of data exists to illuminate the prehospital care of pediatric patients in this environment. We describe the prehospital care of pediatric trauma patients in Iraq and Afghanistan...
March 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29481934/differences-in-aortic-diameter-measurements-with-intravascular-ultrasound-and-computed-tomography-after-blunt-traumatic-aortic-injury
#13
Maria Ceja-Rodriguez, Augustus Realyvasquez, Joseph Galante, William C Pevec, Misty Humphries
BACKGROUND: Intravascular ultrasound (IVUS) has been recommended as an adjunct to thoracic endovascular aortic repair (TEVAR) as computed tomography (CT) in injured patients may inaccurately determine the true aortic diameter. We hypothesize that CT and IVUS offer discordant measurements of aortic diameter in trauma patients and that each modality may result in different graft size estimates for TEVAR. METHODS: Patients treated by TEVAR for blunt aortic injury from June 2011 to 2016 were reviewed...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477687/postoperative-development-of-abdominal-compartment-syndrome-among-patients-undergoing-endovascular-aortic-repair-for-ruptured-abdominal-aortic-aneurysms
#14
Elizabeth Miranda, Miguel Manzur, Sukgu Han, Sung Wan Ham, Fred A Weaver, Vincent L Rowe
BACKGROUND: Abdominal compartment syndrome (ACS) has a reported incidence of 9%-14% among trauma patients. However, in patients with similar hemodynamic changes, the incidence of ACS remains unclear. Our aim was to determine the incidence of ACS among patients undergoing endovascular aortic repair (EVAR) for ruptured abdominal aortic aneurysms (rAAAs) and to identify associated risk factors. METHODS: A retrospective review was performed for consecutive patients who underwent EVAR for rAAA from March 2010 to November 2016 at our institution...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29474273/damage-control-resuscitation-in-pediatric-trauma
#15
Meghan Gilley, Suzanne Beno
PURPOSE OF REVIEW: Damage control resuscitation is an overall management strategy used in trauma patients to rapidly restore physiologic stability, while mitigating hypothermia, coagulopathy and acidosis. We review the evidence and current practice of damage control resuscitation in pediatric trauma patients with a specific focus on fluid management. RECENT FINDINGS: There have been a number of studies over the last several years examining crystalloid fluid resuscitation, balanced blood product transfusion practice and hemostatic agents in pediatric trauma...
June 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#16
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/29424792/in-depth-characterization-of-the-effects-of-cigarette-smoke-exposure-on-the-acute-trauma-response-and-hemorrhage-in-mice
#17
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/29415981/acute-exertional-compartment-syndrome-with-rhabdomyolysis-case-report-and-review-of-literature
#18
Brandon McKinney, Christopher Gaunder, Ross Schumer
BACKGROUND Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. CASE REPORT We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. He was diagnosed with compartment syndrome and rhabdomyolysis. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure...
February 8, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29370063/fresh-whole-blood-resuscitation-does-not-exacerbate-skeletal-muscle-edema-and-long-term-functional-deficit-after-ischemic-injury-and-hemorrhagic-shock
#19
Amit Aurora, Janet L Roe, Nsini A Umoh, Michael Dubick, Joseph C Wenke, Thomas J Walters
BACKGROUND: Hemorrhagic shock due to extremity vascular injuries is common in combat injuries. Fluid resuscitation is the standard treatment for severe hemorrhage. Tourniquets (TK) used for hemorrhage control cause ischemia-reperfusion (I/R) injury that induces edema formation in the injured muscle. Resuscitation fluids affect edema formation; however, its effect on long-term functional response remains unknown. The objectives of this study are 1) compare acute muscle damage; 2) determine long-term functional recovery of ischemic muscle, and 3) compare local and systemic inflammatory response including the expression of junctional proteins following early resuscitation with Hextend (HEX) and Fresh Whole Blood (FWB) using a rodent model of combined hemorrhage and TK-induced limb I/R...
January 24, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29370058/permissive-hypotension-versus-conventional-resuscitation-strategies-in-adult-trauma-patients-with-hemorrhagic-shock-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
Alexandre Tran, Jeffrey Yates, Aaron Lau, Jacinthe Lampron, Maher Matar
BACKGROUND: Aggressive fluid resuscitation in trauma promotes deleterious effects such as clot disruption, dilutional coagulopathy and hypothermia. Animal studies suggest that permissive hypotension maintains appropriate organ perfusion, reduces bleeding and improves mortality. This review assesses the efficacy and safety of permissive hypotension in adult trauma patients with hemorrhagic shock. METHODS: We searched the MEDLINE and EMBASE databases from inception to May 2017 for randomized controlled trials comparing permissive hypotension vs...
May 2018: Journal of Trauma and Acute Care Surgery
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