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trauma hemorrhage control

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https://www.readbyqxmd.com/read/29905511/isolated-subdural-hematomas-in-mild-traumatic-brain-injury-part-2-a-preliminary-clinical-decision-support-tool-for-neurosurgical-intervention
#1
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE A paucity of studies have examined neurosurgical interventions in the mild traumatic brain injury (mTBI) population with intracranial hemorrhage (ICH). Furthermore, it is not understood how the dimensions of an ICH relate to the risk of a neurosurgical intervention. These limitations contribute to a lack of treatment guidelines. Isolated subdural hematomas (iSDHs) are the most prevalent ICH in mTBI, carry the highest neurosurgical intervention rate, and account for an overwhelming majority of all neurosurgical interventions...
June 15, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29901458/dating-of-traumatic-brain-injury-in-forensic-cases-using-immunohistochemical-markers-i-neurofilaments-and-%C3%AE-amyloid-precursor-protein
#2
María de Los Ángeles Romero Tirado, José Manuel Blanco Pampin, Rosalía Gallego Gómez
Studies about head trauma are experimental or have a clinical or prognosis purpose. In this study, we used samples from human autopsies to answer common medical-legal questions.We studied 21 problem cases and 4 controls. Samples were obtained directly from the injured area, fixed in 10% formalin during 24 hours and then preserved in 70% ethanol. This procedure optimizes the immunohistochemical technique.The neurofilament antibody shows beaded axons since the first moment; over time, they increase their density and diameter as survival time also increases...
June 13, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29898763/non-invasive-high-frequency-oscillatory-ventilation-versus-nasal-continuous-positive-airway-pressure-in-preterm-infants-with-respiratory-distress-syndrome-study-protocol-for-a-multi-center-prospective-randomized-controlled-trial
#3
Xing-Wang Zhu, Yuan Shi, Li-Ping Shi, Ling Liu, Jiang Xue, Rangasamy Ramanathan
BACKGROUND: Invasive mechanical ventilation (IMV) is associated with the development of adverse pulmonary and non-pulmonary outcomes in very premature infants. Various modes of non-invasive respiratory support are increasingly being used to decrease the incidence of bronchopulmonary dysplasia. The aim of this trial is to compare the effect of non-invasive high-frequency oscillatory ventilation (NHFOV) and nasal continuous positive airway pressure (NCPAP) in preterm infants with respiratory distress syndrome (RDS) as a primary non-invasive ventilation support mode...
June 14, 2018: Trials
https://www.readbyqxmd.com/read/29898436/endotracheal-intubation-and-in-hospital-mortality-after-intracerebral-hemorrhage
#4
Vasileios-Arsenios Lioutas, Sarah Marchina, Louis R Caplan, Magdy Selim, Joseph Tarsia, Luciana Catanese, Jonathan Edlow, Sandeep Kumar
BACKGROUND: Many patients with acute intracerebral hemorrhages (ICHs) undergo endotracheal intubation with subsequent mechanical ventilation (MV) for "airway protection" with the intent to prevent aspiration, pneumonias, and its related mortality. Conversely, these procedures may independently promote pneumonia, laryngeal trauma, dysphagia, and adversely affect patient outcomes. The net benefit of intubation and MV in this patient cohort has not been systematically investigated...
June 13, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29889964/methods-for-early-control-of-abdominal-hemorrhage-an-assessment-of-potential-benefit
#5
Paul M Cantle, Matthew J Hurley, Michael D Swartz, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage (NCTH) after injury is associated with a mortality increase that is unchanged during the past 20 years. Current treatment consists of rapid transport and emergent intervention. Three early hemorrhage control interventions that may improve survival are placement of a resuscitative endovascular balloon occlusion of the aorta (REBOA), injection of intracavitary self-expanding foam, and application of the Abdominal Aortic Junctional Tourniquet (AAJT™)...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29889959/junctional-tourniquet-use-during-combat-operations-in-afghanistan-the-prehospital-trauma-registry-experience
#6
Steven G Schauer, Michael D April, Andrew D Fisher, Cord W Cunningham, Jennifer Gurney
BACKGROUND: Hemorrhage is the leading cause of potentially preventable death on the battlefield. Although the resurgence of limb tourniquets revolutionized hemorrhage control in combat casualties in the recent conflicts, the mortality rate for patients with junctional hemorrhage is still high. Junctional tourniquets (JTQs) offer a mechanism to address the high mortality rate. The success of these devices in the combat setting is unclear given a dearth of existing data. METHODS: From the Prehospital Trauma Registry (PHTR) and the Department of Defense Trauma Registry, we extracted cases of JTQ use in Afghanistan...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29889818/effects-of-psychosocial-stress-on-subsequent-hemorrhagic-shock-and-resuscitation-in-male-mice
#7
Dominik Langgartner, Ulrich Wachter, Clair Hartmann, Michael Gröger, Josef Vogt, Tamara Merz, Oscar McCook, Marina Fink, Sandra Kress, Michael Georgieff, Julia F Kunze, Peter L Radermacher, Stefan O Reber, Martin Wepler
BACKGROUND: Hypoxemia and tissue ischemia during hemorrhage as well as formation of oxygen and nitrogen radicals during resuscitation promote hyperinflammation and, consequently, trigger severe multiple-organ-failure (MOF). Individuals diagnosed with stress-related disorders or reporting a life history of psychosocial stress are characterized by chronic low-grade inflammation and a reduced glucocorticoid (GC) signaling. We hypothesized that exposure to chronic psychosocial stress during adulthood prior to hemorrhagic shock increases oxidative/nitrosative stress and therefore the risk of developing MOF in mice...
June 8, 2018: Shock
https://www.readbyqxmd.com/read/29889637/intraoperative-and-postoperative-complications-of-partial-maxillectomy-for-the-treatment-of-oral-tumors-in-dogs
#8
Roxane H MacLellan, Jennifer E Rawlinson, Sangeeta Rao, Deanna R Worley
OBJECTIVE To characterize and identify factors associated with intraoperative and postoperative complications of maxillectomy in dogs with oral tumors. DESIGN Retrospective cohort study. ANIMALS 193 dogs that underwent maxillectomy for oral tumor excision from 2000 through 2011. PROCEDURES Data were extracted from the medical records regarding dog signalment, tumor location and size, histologic findings, clinical stage, maxillectomy category, surgical approach, and additional treatments provided. These factors were examined for associations with recorded intraoperative and postoperative outcomes...
June 15, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29885914/successful-treatment-of-massive-hemothorax-with-class-iv-shock-using-aortography-with-transcatheter-embolization-of-actively-bleeding-posterior-left-intercostal-arteries-after-penetrating-left-chest-trauma-a-case-for-the-hybrid-or
#9
Carolyn Moore, Golda Kwayisi, Prince Esiobu, Keren A Bashan-Gilzenrat, Leslie R Matthews, Jonathan Nguyen, Nathaniel Moriarty, Michael Liggon, Kahdi Udobi, Assad Taha, Ed Childs, Omar Danner
Hemothorax is a common occurrence after blunt or penetrating injury to the chest. Posterior intercostal vessel hemorrhage as a cause of major intrathoracic bleeding is an infrequent source of massive bleeding. Selective angiography with trans-catheter embolization may provide a minimally invasive and efficient method of controlling bleeding refractory to surgical treatment. PRESENTATION OF CASE: A 19 year-old male sustained a gunshot wound to his left chest with massive hemothorax and refractory hemorrhage...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29866414/shock-index-predicted-mortality-in-geriatric-patients-with-influenza-in-the-emergency-department
#10
Jui-Yuan Chung, Chien-Chin Hsu, Jiann-Hwa Chen, Wei-Lung Chen, Hung-Jung Lin, How-Ran Guo, Chien-Cheng Huang
BACKGROUND: The shock index is a rapid and simple tool used to predict mortality in patients with acute illnesses including sepsis, multiple trauma, and postpartum hemorrhage. However, its ability to predict mortality in geriatric patients with influenza in the emergency department (ED) remains unclear. This study was conducted to clarify this issue. METHODS: We conducted a retrospective case-control study, recruiting geriatric patients (≥ 65 years) with influenza visiting the ED of a medical center between January 01, 2010 and December 31, 2015...
May 29, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29851904/high-dose-fxiii-administration-induces-effective-hemostasis-for-trauma-associated-coagulopathy-tac-both-in-vitro-and-in-rat-hemorrhagic-shock-in-vivo-models
#11
Futoshi Nagashima, Satoshi Inoue, Hiroyuki Koami, Toru Miike, Yuichiro Sakamoto, Keita Kai
BACKGROUND: Trauma associated coagulopathy (TAC) is an early and primary complication in severe trauma patients. FXIII is reported to stabilize a clot in the late phase of the coagulation cascade. The goal of this study was to investigate whether the administration of FXIII improves the condition of TAC both in vitro and in vivo. METHODS: We evaluated the effects of different doses, including a very high dose of FXIII (3.6- 32.4 IU/ml) on tissue-plasminogen activator (t-PA) induced hyperfibrinolysis and the combined condition of dilutional coagulopathy and t-PA induced hyperfibrinolysis in vitro...
May 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29799823/trauma-hemostasis-and-oxygenation-research-network-position-paper-on-the-role-of-hypotensive-resuscitation-as-part-of-remote-damage-control-resuscitation
#12
Thomas Woolley, Patrick Thompson, Emrys Kirkman, Richard Reed, Sylvain Ausset, Andrew Beckett, Christopher Bjerkvig, Andrew P Cap, Tim Coats, Mitchell Cohen, Marc Despasquale, Warren Dorlac, Heidi Doughty, Richard Dutton, Brian Eastridge, Elon Glassberg, Anthony Hudson, Donald Jenkins, Sean Keenan, Christophe Martinaud, Ethan Miles, Ernest Moore, Giles Nordmann, Nicolas Prat, Joseph Rappold, Michael C Reade, Paul Rees, Rory Rickard, Martin Schreiber, Stacy Shackelford, Håkon Skogran Eliassen, Jason Smith, Mike Smith, Philip Spinella, Geir Strandenes, Kevin Ward, Sarah Watts, Nathan White, Steve Williams
The Trauma Hemostasis and Oxygenation Research (THOR) Network has developed a consensus statement on the role of permissive hypotension in remote damage control resuscitation (RDCR). A summary of the evidence on permissive hypotension follows the THOR Network position on the topic. In RDCR, the burden of time in the care of the patients suffering from noncompressible hemorrhage affects outcomes. Despite the lack of published evidence, and based on clinical experience and expertise, it is the THOR Network's opinion that the increase in prehospital time leads to an increased burden of shock, which poses a greater risk to the patient than the risk of rebleeding due to slightly increased blood pressure, especially when blood products are available as part of prehospital resuscitation...
June 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29794847/data-driven-development-of-rotem-and-teg-algorithms-for-the-management-of-trauma-hemorrhage-a-prospective-observational-multicenter-study
#13
Kjersti Baksaas-Aasen, Susan Van Dieren, Kirsten Balvers, Nicole P Juffermans, Pål A Næss, Claire Rourke, Simon Eaglestone, Sisse R Ostrowski, Jakob Stensballe, Simon Stanworth, Marc Maegele, Carel Goslings, Pär I Johansson, Karim Brohi, Christine Gaarder
OBJECTIVE: Developing pragmatic data-driven algorithms for management of trauma induced coagulopathy (TIC) during trauma hemorrhage for viscoelastic hemostatic assays (VHAs). BACKGROUND: Admission data from conventional coagulation tests (CCT), rotational thrombelastometry (ROTEM) and thrombelastography (TEG) were collected prospectively at 6 European trauma centers during 2008 to 2013. METHODS: To identify significant VHA parameters capable of detecting TIC (defined as INR > 1...
May 23, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29787545/recent-advances-in-austere-combat-surgery-use-of-aortic-balloon-occlusion-as-well-as-blood-challenges-by-special-operations-medical-forces-in-recent-combat-operations
#14
D Marc Northern, Justin D Manley, Regan Lyon, Daniel Farber, Benjamin J Mitchell, Kristopher J Filak, Jonathan Lundy, Joe J DuBose, Todd E Rasmussen, John B Holcomb
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) for control of non-compressible torso hemorrhage is a technology that is increasingly being utilized in the combat casualty setting. Its use in the resource restricted environment holds potential to improve hemorrhage control, decrease blood product utilization, decrease morbidity, and improve combat mortality. The objective of this report is to present the single largest series of REBOA use on severely injured combat casualties...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787542/hemorrhagic-shock-alters-fracture-callus-composition-and-activates-the-il6-and-rankl-opg-pathway-in-mice
#15
Katrin Bundkirchen, Christian Macke, Nina Angrisani, Luisa M Schäck, Sandra Noack, Michael Fehr, Christian Krettek, Claudia Neunaber
BACKGROUND: Fracture and hemorrhagic shock often lead to impaired fracture healing. To elucidate underlying pathogenesis this study aims to analyze histological properties during fracture healing after hemorrhagic shock and involved signaling pathways in mice. METHODS: Male C57BL/6NCrl mice were assigned into five groups. Control group underwent no interventions. Sham group got a catheter and external fixator but neither blood loss nor osteotomy. Trauma-hemorrhage (TH) group received a pressure controlled hemorrhagic shock, osteotomy (Fx) group an osteotomy and fixator, and combined trauma (THFx) group both hemorrhagic shock and externally fixed osteotomy...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29785654/a-systematic-review-and-meta-analysis-of-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-management-of-major-exsanguination
#16
REVIEW
B L S Borger van der Burg, Thijs T C F van Dongen, J J Morrison, P P A Hedeman Joosten, J J DuBose, T M Hörer, R Hoencamp
BACKGROUND: Circulatory collapse is a leading cause of mortality among traumatic major exsanguination and in ruptured aortic aneurysm patients. Approximately 40% of patients die before hemorrhage control is achieved. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct designed to sustain the circulation until definitive surgical or endovascular repair. A systematic review was conducted for the current clinical use of REBOA in patients with hemodynamic instability and to discuss its potential role in improving prehospital and in-hospital outcome...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#17
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29777581/in-vivo-performance-of-a-visible-wavelength-optical-sensor-for-monitoring-intestinal-perfusion-and-oxygenation
#18
Mitchell B Robinson, Anna M Wisniowiecki, Ryan J Butcher, Mark A Wilson, M Nance Ericson, Gerard L Cote
Traumatic injury resulting in hemorrhage is a prevalent cause of death worldwide. The current standard of care for trauma patients is to restore hemostasis by controlling bleeding and administering intravenous volume resuscitation. Adequate resuscitation to restore tissue blood flow and oxygenation is critical within the first hours following admission to assess severity and avoid complications. However, current clinical methods for guiding resuscitation are not sensitive or specific enough to adequately understand the patient condition...
May 2018: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29745356/noninfectious-hospital-adverse-events-decline-after-elimination-of-contact-precautions-for-mrsa-and-vre
#19
Elise M Martin, Brandy Bryant, Tristan R Grogan, Zachary A Rubin, Dana L Russell, David Elashoff, Daniel Z Uslan
OBJECTIVETo evaluate the impact of discontinuing routine contact precautions (CP) for endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) on hospital adverse events.DESIGNRetrospective, nonrandomized, observational, quasi-experimental study.SETTINGAcademic medical center with single-occupancy rooms.PARTICIPANTSInpatients.METHODSWe compared hospital reportable adverse events 1 year before and 1 year after discontinuation of routine CP for endemic MRSA and VRE (preintervention and postintervention periods, respectively)...
May 10, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29741715/forward-surgical-team-experience-fste-is-associated-with-increased-confidence-with-combat-surgeon-trauma-skills
#20
D Joshua Mancini, Brian P Smith, Travis M Polk, C William Schwab
Introduction: Little is known regarding the confidence of military surgeons prior to combat zone deployment. Military surgeons are frequently deployed without peers experienced in combat surgery. We hypothesized that forward surgical team experience (FSTE) increases surgeon confidence with critical skill sets. Methods: We conducted a national survey of military affiliated personnel. We used a novel survey instrument that was piloted and validated by experienced military surgeons to collect demographics, education, practice patterns, and confidence parameters for trauma and surgical critical care skills...
May 8, 2018: Military Medicine
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