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trauma hemorrhage control

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https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#1
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28615539/necroptosis-as-a-potential-therapeutic-target-in-multiple-organ-dysfunction-syndrome
#2
Yao-Li Cui, Li-Hua Qiu, Shi-Yong Zhou, Lan-Fang Li, Zheng-Zi Qian, Xian-Ming Liu, Hui-Lai Zhang, Xiu-Bao Ren, Yong-Qiang Wang
PURPOSE: To investigate how necroptosisis, i.e. programmed necrosis, is involved in MODS, and to examine whether Nec-1, a specific necroptosis inhibitor, ameliorates multiorgan injury in MODS. EXPERIMENTAL DESIGN: A model of MODS was established in six-week old SD rats using fracture trauma followed by hemorrhage. Control animals received sham surgery. Cell death form and necrosome formation were measured by fluorescence-activated cell sorting and western blotting...
May 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28614141/role-of-hemorrhagic-shock-in-experimental-polytrauma
#3
Stephanie Denk, Sebastian Weckbach, Philipp Eisele, Christian K Braun, Rebecca Wiegner, Julia J Ohmann, Lisa Wrba, Felix M Hoenes, Philipp Kellermann, Peter Radermacher, Ulrich Wachter, Sebastian Hafner, Oscar McCook, Anke Schultze, Annette Palmer, Sonja Braumüller, Florian Gebhard, Markus Huber-Lang
Hemorrhagic shock (HS) after tissue trauma increases the complication and mortality rate of polytrauma (PT) patients. Although several murine trauma models have been introduced, there is a lack of knowledge about the exact impact of an additional HS. We hypothesized that HS significantly contributes to organ injury, which can be reliably monitored by detection of specific organ damage markers.Therefore we established a novel clinically relevant PT plus HS model in C57BL/6 mice which were randomly assigned to control, HS, PT or PT+HS procedure (n = 8 per group)...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28611888/efficacy-and-safety-of-tranexamic-acid-in-prehospital-traumatic-hemorrhagic-shock-outcomes-of-the-cal-pat-study
#4
Michael M Neeki, Fanglong Dong, Jake Toy, Reza Vaezazizi, Joe Powell, Nina Jabourian, Alex Jabourian, David Wong, Richard Vara, Kathryn Seiler, Troy W Pennington, Joe Powell, Chris Yoshida-McMath, Shanna Kissel, Katharine Schulz-Costello, Jamish Mistry, Matthew S Surrusco, Karen R O'Bosky, Daved Van Stralen, Daniel Ludi, Karl Sporer, Peter Benson, Eugene Kwong, Richard Pitts, John T Culhane, Rodney Borger
INTRODUCTION: The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to assess the safety and impact on patient mortality of tranexamic acid (TXA) administration in cases of trauma-induced hemorrhagic shock. The current study further aimed to assess the feasibility of prehospital TXA administration by paramedics within the framework of North American emergency medicine standards and protocols. METHODS: This is an ongoing multi-centered, prospective, observational cohort study with a retrospective chart-review comparison...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28604841/evaluation-of-potential-changes-in-liver-and-lung-tissue-of-rats-in-an-ischemia-reperfusion-injury-model-modified-pringle-maneuver
#5
Silvio Henrique Freitas, Renata G S Dória, Rachel S Bueno, William B Rocha, Jair R E Filho, Julieta R E Moraes, Atanásio Serafin Vidane, Carlos E Ambrósio
In surgical procedures involving the liver, such as transplantation, resection, and trauma, a temporary occlusion of hepatic vessels may be required. This study was designed to analyze the lesions promoted by ischemia and reperfusion injury of the hepatic pedicle, in the liver and lung, using histopathological and immunohistochemical techniques. In total, 39 Wistar rats were divided into four groups: control group (C n = 3) and ischemia groups subjected to 10, 20, and 30 minutes of hepatic pedicle clamping (I10, n = 12; I20, n = 12; I30, n = 12)...
2017: PloS One
https://www.readbyqxmd.com/read/28601210/tranexamic-acid-use-in-prehospital-uncontrolled-hemorrhage
#6
REVIEW
Benjamin R Huebner, Warren C Dorlac, Chris Cribari
The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-blinded, placebo-controlled study incorporating >20,000 patients, numerous limitations and weaknesses have been described. As a result, additional studies have followed, delineating the potential risks and benefits of TXA administration...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601205/remote-damage-control-resuscitation-in-austere-environments
#7
REVIEW
Ronald Chang, Brian J Eastridge, John B Holcomb
Hemorrhage is the leading cause of preventable military and civilian trauma death. Damage control resuscitation with concomitant mechanical hemorrhage control has become the preferred in-hospital treatment of hemorrhagic shock. In particular, plasma-based resuscitation with decreased volumes of crystalloids and artificial colloids as part of damage control resuscitation has improved outcomes in the military and civilian sectors. However, translation of these principles and techniques to the prehospital, remote, and austere environments, known as remote damage control resuscitation, is challenging given the resource limitations in these settings...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#8
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28599041/quikclot%C3%A2-combat-gauze%C3%A2-use-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#9
Steven G Schauer, Michael D April, Jason F Naylor, Andrew D Fisher, Cord W Cunningham, Kathy L Ryan, Krista C Thomas, Daniel B Brillhart, Jessie Renee D Fernandez, Mark A Antonacci
BACKGROUND: QuikClot® Combat Gauze® (QCCG) was fielded in 2008 to replace previous generations of hemostatic products. To the best of our knowledge, despite nearly a decade of use, there are no published data on use among US combatant forces. We describe the use of QCCG by ground forces in Afghanistan and compare patients who received QCCG compared with the remaining population in the database who did not receive QCCG. METHODS: Data were obtained from the Prehospital Trauma Registry (PHTR)...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598924/resuscitative-endovascular-balloon-occlusion-of-the-aorta-principles-initial-clinical-experience-and-considerations-for-the-anesthesiologist
#10
Srikanth Sridhar, Sam D Gumbert, Christopher Stephens, Laura J Moore, Evan G Pivalizza
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular technique that allows for temporary occlusion of the aorta in patients with severe, life-threatening, trauma-induced noncompressible hemorrhage arising below the diaphragm. REBOA utilizes a transfemoral balloon catheter inserted in a retrograde fashion into the aorta to provide inflow control and support blood pressure until definitive hemostasis can be achieved. Initial retrospective and registry clinical data in the trauma surgical literature demonstrate improvement in systolic blood pressure with balloon inflation and improved survival compared to open aortic cross-clamping via resuscitative thoracotomy...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598906/mortality-following-emergent-trauma-laparotomy-a-multicenter-retrospective-study-mortality-after-emergent-trauma-laparotomy
#11
John A Harvin, Tom Maxim, Kenji Inaba, Myriam A Martinez-Aguilar, David R King, Asad J Choudhry, Martin D Zielinski, Sam Akinyeye, S Rob Todd, Russell L Griffin, Jeffrey D Kerby, Joanelle A Bailey, David H Livingston, Kyle Cunningham, Deborah M Stein, Lindsay Cattin, Eileen M Bulger, A Wilson, Vicente J Undurraga Perl, Martin A Schreiber, Jill R Cherry-Bukowiec, Hasan B Alam, John B Holcomb
BACKGROUND: Two decades ago, hypotensive trauma patients requiring emergent laparotomy had a 40% mortality. In the interim, multiple interventions to decrease hemorrhage-related mortality have been implemented but few have any documented evidence of change in outcomes for patients requiring emergent laparotomy. The purpose of this study was to determine current mortality rates for patients undergoing emergent trauma laparotomy. METHODS: A retrospective cohort of all adult, emergent trauma laparotomies performed in 2012-2013 at 12 Level I trauma centers was reviewed...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28590357/rotem-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#12
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood (WB) by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28585119/the-effectiveness-of-hybrid-treatment-for-sever-multiple-trauma-a-case-of-multiple-trauma-for-damage-control-laparotomy-and-thoracic-endovascular-repair
#13
Naofumi Bunya, Keisuke Harada, Yosuke Kuroda, Tsubasa Toyohara, Takashi Toyohara, Narumi Kubota, Ryuichiro Kakizaki, Hideto Irifune, Shuji Uemura, Eichi Narimatsu
BACKGROUND: Time is a crucial factor for the successful early management of the multi-trauma patient. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. CASE PRESENTATION: We describe the early successful treatment of a 54-year-old male who sustained multiple injuries when he was hit by a 1000 kg bale of wheat that fell from a height...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28559534/granulocyte-colony-stimulating-factor-g-csf-accelerates-wound-healing-in-hemorrhagic-shock-rats-by-enhancing-angiogenesis-and-attenuating-apoptosis
#14
Hong Huang, Qi Zhang, Jiejie Liu, Haojie Hao, Chaoguang Jiang, Weidong Han
BACKGROUND Following severe trauma, treatment of cutaneous injuries is often delayed by inadequate blood supply. The aim of the present study was to determine whether granulocyte-colony stimulating factor (G-CSF) protects endothelial cells (ECs) and enhances angiogenesis in a rat model of hemorrhagic shock (HS) combined with cutaneous injury after resuscitation. MATERIAL AND METHODS The HS rats with full-thickness defects were resuscitated and randomly divided into a G-CSF group (200 μg/kg body weight), a normal saline group, and a blank control group...
May 31, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28552329/updated-concepts-on-the-pathophysiology-and-the-clinical-management-of-trauma-hemorrhage-and-coagulopathy
#15
REVIEW
Marc Maegele, Zheng-Tao Gu, Qiao-Bing Huang, Hong Yang
Uncontrolled hemorrhage and subsequent trauma-induced coagulopathy (TIC) are still the principle causes for preventable death after trauma and early detection and aggressive management have been associated with reduced mortality. Despite increasing knowledge about trauma resuscitation, best practice to treat this newly defined entity is still under debate. A synopsis of best current knowledge with reference to the updated European trauma guideline on the management of severe trauma hemorrhage and TIC is presented...
May 17, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28551485/spontaneous-submental-hematoma-a-pseudo-ludwig-s-phenomenon-in-101-year-old-patient-case-report-and-literature-review
#16
Uthman Alamoudi, Yasser Alsallumi, Matthew H Rigby, S Mark Taylor, Jonathan R B Trites, Robert D Hart
OBJECTIVE: Submental hematoma or pseudo-Ludwig's phenomenon, is a rare entity seen in anticoagulated patients and can precipitate upper airway obstruction. Our objective is to present a rare case of spontaneous submental hematoma due to poorly controlled hypertension in elderly patient and to perform a literature review. CASE REPORT: 101-year-old female presented to emergency room with sudden painful swelling in the floor of mouth and slurred speech. Not on anticoagulation and no history of trauma or known allergies...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28547840/performance-of-norwegian-civilian-emts-and-army-medics-in-penetrating-trauma-a-controlled-simulation-based-assessment
#17
S W Blix, J Melau, I Lund-Kordahl
BACKGROUND: Penetrating trauma kills rapidly. Thorough and efficient examination and aggressive hemorrhage control is important to save lives. The aim of this study was to assess the skills of civilian Emergency Medical Technicians (EMTs) in bleeding examination and control compared to Army Medics. Our hypothesis was that civilian pre-hospital systems perform at a lower level compared to an expert group, and did not have sufficient focus on education and training in examination and treatment of penetrating injuries...
May 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28538623/impact-of-a-novel-pi3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#18
George E Black, Kyle K Sokol, Donald M Moe, Jon Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhalo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental PI3-kinase inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage associated molecular patterns (DAMPs) METHODS: 16 swine were studied using LY294002 (LY), a non-selective PI3-KI: Animals were assigned to Trauma only (TO, N=3); LY drug only (LYO, N=3); and Experimental (N=10), trauma + drug (LY+T) groups...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#19
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#20
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
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