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trauma hemorrhage control

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https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#1
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28413267/vasopressors-do-they-have-any-role-in-hemorrhagic-shock
#2
REVIEW
Babita Gupta, Neha Garg, Rashmi Ramachandran
The priority in the management of patients with traumatic hemorrhagic shock is to control the bleeding with simultaneous volume resuscitation to maintain adequate tissue perfusion. Fluid replacement remains the mainstay of initial resuscitation in hemorrhagic shock. Traditionally, vasopressors are contraindicated in the early management of hemorrhagic shock due to their deleterious consequences, although vasopressors may have a role in resuscitation when vasoplegic shock ensues and blood pressure cannot be maintained by fluids alone...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28407781/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-protocol
#3
Alexandre Tran, Maher Matar, Ewout W Steyerberg, Jacinthe Lampron, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Hemorrhage is a major cause of early mortality following a traumatic injury. The progression and consequences of significant blood loss occur quickly as death from hemorrhagic shock or exsanguination often occurs within the first few hours. The mainstay of treatment therefore involves early identification of patients at risk for hemorrhagic shock in order to provide blood products and control of the bleeding source if necessary. The intended scope of this review is to identify and assess combinations of predictors informing therapeutic decision-making for clinicians during the initial trauma assessment...
April 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28400499/the-coherence-of-macrocirculation-microcirculation-and-tissue-metabolic-response-during-nontraumatic-hemorrhagic-shock-in-swine
#4
Halvor Langeland, Oddveig Lyng, Petter Aadahl, Nils-Kristian Skjærvold
Hemorrhagic shock is clinically observed as changes in macrocirculatory indices, while its main pathological constituent is cellular asphyxia due to microcirculatory alterations. The coherence between macro- and microcirculatory changes in different shock states has been questioned. This also applies to the hemorrhagic shock. Most studies, as well as clinical situations, of hemorrhagic shock include a "second hit" by tissue trauma. It is therefore unclear to what extent the hemorrhage itself contributes to this lack of circulatory coherence...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28399448/apparent-diffusion-coefficient-adc-of-the-vitreous-humor-and-susceptibility-weighted-imaging-swi-of-the-retina-in-abused-children-with-retinal-hemorrhages
#5
Misun Hwang, Samuel S Shin, Matthew A Thimm, Anish Ghodadra, Christin L Sylvester, Ken Nischal, Ashok Panigrahy, Giulio Zuccoli
This study speculated that the apparent diffusion coefficient (ADC) of the vitreous humor might be altered in the setting of abusive head trauma (AHT) with retinal hemorrhages (RH). Fourty-four subjects were analyzed (n=20 AHT cases; n=24 controls). There was no statistically significant difference in normalized ADC values between the cases and controls (-0.14 and -0.08 respectively, p=0.46), but analysis of RH by susceptibility weighted imaging (SWI) compared to dilated funduscopic exam demonstrated statistically significant correlation (p=0...
April 3, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28392170/translating-tactical-combat-casualty-care-lessons-learned-to-the-high-threat-civilian-setting-tactical-emergency-casualty-care-and-the-hartford-consensus
#6
REVIEW
David W Callaway
Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Committee for Tactical Emergency Casualty Care (C-TECC) adapted the lessons of TCCC to the civilian high-threat environment and provided important all-hazards response principles for austere, dynamic, and resource-limited environments...
April 6, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28386146/histological-and-immunohistochemical-basis-of-the-effect-of-aminoguanidine-on-renal-changes-associated-with-hemorrhagic-shock-in-a-rat-model
#7
Abdulmajeed Al Drees, Mahmoud Salah Khalil, Mona Soliman
Acute kidney failure is the main cause of death among patients with severe trauma due to massive blood loss and hemorrhagic shock (HS). Renal cell injury is caused by tissue ischemia. Renal ischemia initiates a complex and interconnected chain of events resulting in cell injury and renal cell necrosis. Nitric oxide plays a crucial role in renal function and can be inhibited by aminoguanidine (AG). We studied whether AG can ameliorate pathological renal changes associated with HS syndrome in a rat model and explored the AG protection mechanism...
February 28, 2017: Acta Histochemica et Cytochemica
https://www.readbyqxmd.com/read/28385479/opportunity-to-reduce-transfer-of-patients-with-mild-traumatic-brain-injury-and-intracranial-hemorrhage-to-a-level-1-trauma-center
#8
Brian J Yun, Benjamin A White, H Benjamin Harvey, Anand M Prabhakar, Jonathan D Sonis, McKinley Glover, Emily Vallillo, Sun Choi, Pierre Borczuk, Ali S Raja
OBJECTIVE: Current guidelines do not address the disposition of patients with mild traumatic brain injury (TBI) and resultant intracranial hemorrhage (ICH). Emergency medicine clinicians working in hospitals without neurosurgery coverage typically transfer patients with both to a trauma center with neurosurgery capability. Evidence is accruing which demonstrates that the risk of neurologic decompensation depends on the type of ICH and as a result, not every patient may need to be transferred...
March 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28379869/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-anesthesiologist-a-case-report-and-literature-review
#9
Bianca M Conti, Justin E Richards, Rishi Kundi, Jason Nascone, Thomas M Scalea, Maureen McCunn
The most common preventable cause of death after trauma is exsanguination due to uncontrolled hemorrhage. Traditionally, anterolateral emergency department thoracotomy is used for temporary control of noncompressible torso hemorrhage and to increase preload after trauma. Resuscitative endovascular balloon occlusion of the aorta is a minimally invasive technique that achieves similar goals. It is therefore imperative for the anesthesiologist to understand physiologic implications during resuscitative endovascular aortic occlusion and after balloon deflation...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28366792/serum-macrophage-migration-inhibitory-factor-concentrations-correlate-with-prognosis-of-traumatic-brain-injury
#10
Ding-Bo Yang, Wen-Hua Yu, Xiao-Qiao Dong, Zu-Yong Zhang, Quan Du, Qiang Zhu, Zhi-Hao Che, Hao Wang, Yong-Feng Shen, Li Jiang
BACKGROUND: Macrophage migration inhibitory factor (MIF) is a well-known pro-inflammatory cytokine. Serum MIF concentrations are associated with the severity and prognosis of ischemic stroke. METHODS: In this prospective, observational study, white blood cell (WBC) count and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and MIF among 108 severe traumatic brain injury (TBI) patients and 108 controls were measured...
March 30, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28347674/serum-thioredoxin-and-in-hospital-major-adverse-events-after-traumatic-brain-injury
#11
Xiao-Qiao Dong, Wen-Hua Yu, Zu-Yong Zhang, Ding-Bo Yang, Quan Du, Hao Wang, Yong-Feng Shen, Li Jiang, Zhi-Hao Che, Qiang Zhu
BACKGROUND: In-hospital major adverse events (IMAEs), mainly including acute lung injury, acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction, are associated with poor prognosis after traumatic brain injury (TBI). Thioredoxin, a potent anti-oxidant, has been identified as an oxidative stress marker. This study was designed to explore the association of serum thioredoxin concentrations with IMAEs of patients with severe TBI. METHODS: This prospective, observational study recruited a total of 108 healthy controls and 108 patients with severe TBI...
March 24, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28346013/the-physiology-of-blood-loss-and-shock-new-insights-from-a-human-laboratory-model-of-hemorrhage
#12
Alicia M Schiller, Jeffrey T Howard, Victor A Convertino
The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28342652/effective-hospital-wide-education-in-hemorrhage-control
#13
James R Hegvik, Sarah K Spilman, Sherry D Olson, Carrie A Gilchrist, Richard A Sidwell
BACKGROUND: Uncontrolled hemorrhage is the leading cause of potentially preventable traumatic death. Bleeding victims must receive immediate medical attention to save lives, and the first opportunity to control bleeding after trauma often comes from bystanders. Educating the general public is important for improving outcomes for hemorrhaging victims, and it is imperative for all people, including those with no clinical training, to have the knowledge to respond until trained medical specialists arrive...
March 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28341000/arterial-spin-labeling-perfusion-imaging-of-children-with-subdural-hemorrhage-perfusion-abnormalities-in-abusive-head-trauma
#14
Alex Mun-Ching Wong, Chih-Hua Yeh, Ho-Ling Liu, Tai-Wei Wu, Kuang-Lin Lin, Huei-Shyong Wang, Cheng-Hong Toh
BACKGROUND AND PURPOSE: Perfusion abnormalities have not been well described in children with subdural hemorrhage (SDH). We investigated whether patients with abusive head trauma (AHT+) had more perfusion abnormalities than those without (AHT-). MATERIALS AND METHODS: We reviewed the perfusion MR studies of 12 infants with SDH and 21 controls. The perfusion images were obtained using a pseudo-continuous arterial spin-labeling sequence with volumetric fast spin-echo readout...
March 21, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#15
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28338600/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-a-aast-multi-institutional-study
#16
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk for severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational multi-center study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (SBP<90 or HR>120 and base deficit > 5, and the ability to review pelvic imaging...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338595/3-0-nacl-adenosine-lidocaine-mg-2-alm-bolus-and-4-hours-drip-infusion-reduces-non-compressible-hemorrhage-by-60-in-a-rat-model
#17
Hayley L Letson, Geoffrey P Dobson
BACKGROUND: Noncompressible torso hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg (ALM) bolus and 0.9% NaCl/ALM 'drip' on survivability and cardiac/gut/kidney function in a rat model of hepatic hemorrhage and shock. METHODS: Male Sprague-Dawley rats (428±4 g) were anesthetized and randomly assigned to one of five groups (n=16): 1) Sham, 2) No Treatment, 3) Saline controls, 4) ALM therapy and 5) Hextend®...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333833/leadership-and-a-casualty-response-system-for-eliminating-preventable-death
#18
Russ S Kotwal, Harold R Montgomery, Ethan A Miles, Curtis C Conklin, Michael T Hall, Stanley A McChrystal
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are non-survivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, in order to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by non-medical combatant leaders within the 75th Ranger Regiment, U...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28332220/perspectives-on-risk-assessment-of-risk-profiles-and-outcomes-among-women-planning-community-birth-in-the-united-states
#19
Marit L Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J Cox, Lawrence Leeman
BACKGROUND: There is little agreement on who is a good candidate for community (home or birth center) birth in the United States. METHODS: Data on n=47 394 midwife-attended, planned community births come from the Midwives Alliance of North America Statistics Project. Logistic regression quantified the independent contribution of 10 risk factors to maternal and neonatal outcomes. Risk factors included: primiparity, advanced maternal age, obesity, gestational diabetes, preeclampsia, postterm pregnancy, twins, breech presentation, history of cesarean and vaginal birth, and history of cesarean without history of vaginal birth...
March 22, 2017: Birth
https://www.readbyqxmd.com/read/28318991/bleeding-control-using-hemostatic-dressings-lessons-learned
#20
REVIEW
Brad L Bennett
Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effectiveness, determine the evidence for transitioning of this technology to prehospital civilian application, and provide recommendations about potential use in the wilderness/austere setting...
March 16, 2017: Wilderness & Environmental Medicine
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