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trauma hemorrhage control

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https://www.readbyqxmd.com/read/29448990/open-abdomen-in-liver-transplantation
#1
T Chan, M S Bleszynski, D S Youssef, M Segedi, S Chung, C H Scudamore, A K Buczkowski
INTRODUCTION: Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS: Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29443857/the-fast-exam-can-reliably-identify-patients-with-significant-intraabdominal-hemorrhage-in-life-threatening-pelvic-fractures
#2
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29439891/resuscitative-endovascular-balloon-occlusion-of-the-aorta-using-a-low-profile-device-is-easy-and-safe-for-emergency-physicians-in-cases-of-life-threatening-hemorrhage
#3
Takahiro Shoji, Takehiko Tarui, Takashi Igarashi, Yuki Mochida, Hiroyuki Morinaga, Yasuhiko Miyakuni, Yoshitaka Inoue, Yasuhiko Kaita, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10-14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed...
February 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29435313/comparison-of-the-efficacy-of-intravenous-tranexamic-acid-with-and-without-topical-administration-versus-placebo-in-urgent-endoscopy-rate-for-acute-gastrointestinal-bleeding-a-double-blind-randomized-controlled-trial
#4
Nader Tavakoli, Marjan Mokhtare, Shahram Agah, Ali Azizi, Mohsen Masoodi, Hassan Amiri, Mehrdad Sheikhvatan, Bahare Syedsalehi, Behdad Behnam, Mehran Arabahmadi, Maryam Mehrazi
Background: Tranexamic acid (TXA), a synthetic antifibrinolytic drug, is effective as a treatment for serious hemorrhage, including bleeding arising from major trauma and post-operative interventions. Significant acute gastrointestinal bleeding may have a poor outcome despite routine medical and endoscopic treatments. The aim of this study was to assess whether early intravenous and/or intravenous plus topical administration of TXA reduces the need for urgent endoscopy for acute gastrointestinal bleeding...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29432381/systematic-review-of-prehospital-tourniquet-use-in-civilian-limb-trauma
#5
David S Kauvar, Michael A Dubick, Thomas J Walters, John F Kragh
BACKGROUND: Military enthusiasm for limb tourniquet use in combat casualty care has resulted in acceptance by the trauma community for use in the prehospital care of civilian limb injuries. To date there has been no report synthesizing the published data on civilian tourniquet use. The objective of this systematic review was to compile and analyze the content and quality of published data on the civilian use of tourniquets in limb trauma. METHODS: The MEDLINE database was searched for studies on civilian limb tourniquet use in adults published between 2001 and 2017...
February 9, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29432043/prehospital-application-of-hemostatic-agents-in-iraq-and-afghanistan
#6
Steven G Schauer, Michael D April, Jason F Naylor, Joseph K Maddry, Allyson A Arana, Michael A Dubick, Andrew D Fisher, Cord W Cunningham, Anthony E Pusateri
INTRODUCTION: Hemorrhage is the leading cause of death on the battlefield. Development of chitosan- and kaolin-based hemostatic agents has improved hemorrhage control options. Sparse data exists on the use of these agents in the prehospital, combat setting. We describe recent use of these agents and compare patients receiving hemostatic to the baseline population. METHODS: We used a series of emergency department (ED) procedure codes to identify patients within the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016...
February 12, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29422067/predictors-of-hospital-mortality-in-adult-trauma-patients-receiving-extracorporeal-membrane-oxygenation-for-advanced-life-support-a-retrospective-cohort-study
#7
Meng-Yu Wu, Pin-Li Chou, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Using extracorporeal membrane oxygenation (ECMO) to provide advanced life support in adult trauma patients remains a controversial issue now. The study was aimed at identifying the independent predictors of hospital mortality in adult trauma patients receiving ECMO for advanced cardiopulmonary dysfunctions. METHODS: This retrospective study enrolled 36 adult trauma patients receiving ECMO due to advanced shock or respiratory failure in a level I trauma center between August 2006 and October 2014...
February 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29420582/ethyl-pyruvate-ameliorates-hepatic-injury-following-blunt-chest-trauma-and-hemorrhagic-shock-by-reducing-local-inflammation-nf-kappab-activation-and-hmgb1-release
#8
Nils Wagner, Scott Dieteren, Niklas Franz, Kernt Köhler, Katharina Mörs, Luka Nicin, Julia Schmidt, Mario Perl, Ingo Marzi, Borna Relja
BACKGROUND: The treatment of patients with multiple trauma including blunt chest/thoracic trauma (TxT) and hemorrhagic shock (H) is still challenging. Numerous studies show detrimental consequences of TxT and HS resulting in strong inflammatory changes, organ injury and mortality. Additionally, the reperfusion (R) phase plays a key role in triggering inflammation and worsening outcome. Ethyl pyruvate (EP), a stable lipophilic ester, has anti-inflammatory properties. Here, the influence of EP on the inflammatory reaction and liver injury in a double hit model of TxT and H/R in rats was explored...
2018: PloS One
https://www.readbyqxmd.com/read/29419325/anatomic-distribution-of-hematoma-following-pelvic-fracture
#9
Narin Uludag, Anna Tötterman, Mats Beckman, Anders Sundin
OBJECTIVE: To assess the extent of pelvic hemorrhage on CT and to estimate its significance on outcome in patients with blunt high-energy pelvic trauma. METHODS: 576 patients with blunt high energy pelvic fractures in 2005-2011 were identified in the hospital's Trauma Registry (a major Trauma Center). 60 of these met our further inclusion criteria of initial systolic blood pressure ≤100 mmHg and pelvic-related hemorrhage. CT scans of the patients were reviewed with regard to pelvic and abdominal retroperitoneal hemorrhage, type of fracture (Tile classification) and associated injuries...
February 8, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29408171/serum-s100a12-as-a-prognostic-biomarker-of-severe-traumatic-brain-injury
#10
Ma-Jing Feng, Wei-Bin Ning, Wei Wang, Zhong-Hua Lv, Xin-Bing Liu, Yong Zhu, Wei Gao, Hong-Ze Jin, Shu-Shan Gao
BACKGROUND: S100A12 is related to acute brain injury and inflammation. We investigated the clinical prognostic value of serum S100A12 in patients with severe traumatic brain injury (sTBI). METHODS: Serum S100A12, S100B, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) concentrations were measured in 102 healthy controls and 102 sTBI patients. We recorded 30-day mortality and in-hospital major adverse events (IMAEs) including acute lung injury, acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction...
January 31, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29401352/fibrinogen-concentrate-in-the-special-operations-forces-environment
#11
Steven Sanders, Homer Tien, Jeannie Callum, Barto Nascimento, Henry Peng, Chris Funk, Joanne Schmid, Sandro Rizoli, Shawn Rhind, Andrew Beckett
Introduction: Hemorrhage is the most common cause of death among Special Operations Force (SOF) soldiers. Bringing remote damage control resuscitation into the far-forward combat environment is logistically challenging, as it requires blood products that generally require a robust cold chain. Alternatively, lyophilized products such as fibrinogen concentrate, which does not require thawing or blood group compatibility testing before use, might be advantageous in damage control resuscitation in the battlefield...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29384773/tranexamic-acid-promise-or-panacea-the-impact-of-air-medical-administration-of-tranexamic-acid-on-morbidity-mortality-and-length-of-stay
#12
Brian G Cornelius, Karen McCarty, Kristi Hylan, Angela Cornelius, Keith Carter, Kenneth W G Smith, Srdan Ristic, Daniel Vining, Urska Cvek, Marjan Trutschl
The MATTERs and CRASH-2 studies demonstrate that tranexamic acid (TXA) reduces mortality in patients with traumatic hemorrhage. However, their results, conducted in foreign countries and with U.S. military soldiers, provoke concerns over generalizability to civilian trauma patients in the United States was reported. The evaluation of patient outcomes following treatment with TXA by a civilian air medical program. A retrospective chart review of trauma patients transported by air service to a Level 1 trauma center was conducted...
January 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29383264/acute-duodenal-intramural-hematoma-complicated-by-acute-pancreatitis-a-rare-complication-of-endoscopic-epinephrine-injection-therapy
#13
Emmanuel Ofori, Tagore Sunkara, Eric Then, Febin John, Vinaya Gaduputi
Intramural duodenal hematoma (IDH) is a rare complication in endoscopic management of ulcer hemorrhage. Usually noted in cases of blunt abdominal trauma, non-traumatic IDHs have been reported in individuals on anticoagulation, with blood disorders, pancreatic diseases and in endoscopic procedures such as biopsy, sclerotherapy and argon plasma coagulation. Patients may be asymptomatic or present with acute blood loss anemia, abdominal pain or vomiting. We report a case of an 83-year-old man with melena and syncope who underwent endoscopy for bleeding ulcer control and subsequently developed acute pancreatitis due to an acute IDH...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29375943/penetrating-obturator-artery-injury-after-gunshot-wounds-a-successful-multidisciplinary-trauma-team-approach-to-a-potentially-lethal-injury
#14
Tareq I Maraqa, Ji-Sun J Shin, Ismael Diallo, Gul R Sachwani-Daswani, Leo C Mercer
Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A 23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries...
November 17, 2017: Curēus
https://www.readbyqxmd.com/read/29370067/effect-of-door-to-angioembolization-time-on-mortality-in-pelvic-fracture-every-hour-of-delay-counts
#15
Kazuhide Matsushima, Alice Piccinini, Morgan Schellenberg, Vincent Cheng, Patrick Heindel, Aaron Strumwasser, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Angioembolization (AE) is widely used for hemorrhagic control in patients with pelvic fracture. The latest version of the Resources for Optimal Care of theInjured Patient issued by the American College of Surgeons Committee on Trauma requires interventional radiologists to be available within 30 minutes to perform an emergent AE. However, the impact of time-to-AE on patient outcomes remains unknown. We hypothesized that a longer time-to-AE would be significantly associated with increased mortality in patients with pelvic fracture...
January 24, 2018: Journal of Trauma and Acute Care Surgery
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
#16
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-vs-conventional-resuscitation-strategies-in-adult-trauma-patients-with-hemorrhagic-shock-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
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...
January 24, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29337650/the-association-of-external-transfer-status-with-adverse-outcomes-in-otolaryngology
#18
Krish Suresh, Christopher J Gouveia, Robert C Kern, John D Cramer
Objective To compare rates of morbidity and mortality in patients treated by otolaryngologists who undergo interhospital transfers vs those who do not and to quantify conditions requiring interhospital transfers in this population. Study Design Cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Subjects and Methods We identified patients requiring surgery by otolaryngologists in the National Surgical Quality Improvement Program database from 2006 to 2013. We compared patients who were transferred from an outside institution to those admitted from home...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#19
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29319648/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-hemorrhage-control-in-trauma-patients-an-evidence-based-review
#20
Molly Sambor
Traditionally, resuscitative efforts for uncontrolled noncompressible torso hemorrhage are achieved by cross-clamping the proximal aorta via thoracotomy to deliver temporary hemodynamic stability during injury repair. A less commonly used method of promoting early resuscitation and hemorrhagic control in trauma patients is resuscitative endovascular balloon occlusion of the aorta (REBOA). The focus of this literature review is to examine the effectiveness of REBOA in the management of noncompressible pelvic hemorrhage when compared with traditional methods of hemorrhage control in trauma patients...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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