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trauma hemorrhage control

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https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#1
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28800150/heterozygosity-for-p2y12-receptor-gene-mutation-associated-with-postoperative-hemorrhage-in-a-greater-swiss-mountain-dog
#2
Rebecca S Flores, Mary K Boudreaux, Barbara Vasquez, Poppy Bristow, Lillian R Aronson, Kari Santoro-Beer, Mary Beth Callan
A 3-year-old, female Greater Swiss Mountain dog developed a hemoperitoneum following an exploratory laparotomy and ovariohysterectomy. Platelet count, PT, APTT, and plasma von Willebrand factor antigen concentration were within RIs. A buccal mucosal bleeding time (BMBT) was prolonged. Given the probability of a hereditary thrombopathia, the dog was administered desmopressin, fresh platelet transfusions, and aminocaproic acid to control hemorrhage. Subsequently, DNA testing for the P2Y12 receptor gene mutation identified the dog as being a heterozygote (carrier)...
August 11, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28795328/severe-hemorrhagic-shock-leads-to-a-delayed-fracture-healing-and-decreased-bone-callus-strength-in-a-mouse-model
#3
Katrin Bundkirchen, Christian Macke, Janin Reifenrath, Luisa Marilena Schäck, Sandra Noack, Borna Relja, Philipp Naber, Bastian Welke, Michael Fehr, Christian Krettek, Claudia Neunaber
BACKGROUND: Multiple trauma is frequently associated with hemorrhagic shock and fractures of the extremities. Clinically, the rate of impaired fracture healing (delayed healing and nonunion) seems to be increased in patients with multiple injuries compared with patients with isolated fractures. As the underlying pathogenesis remains poorly understood, we aimed to analyze the biomechanical properties during fracture healing in a murine model. QUESTIONS: The aim of this study was to determine whether fracture healing after severe hemorrhagic shock results in (1) delayed bridging as determined by macroscopic and radiographic assessment, (2) altered conditions of callus components as determined by µCT, and (3) decreased maximum bending moment measured by a three-point-bending test compared with ordinary fracture healing...
August 9, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28767544/compensatory-reserve-index-performance-of-a-novel-monitoring-technology-to-identify-the-bleeding-trauma-patient
#4
Michael Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwacha, David Wampler, Mark DeRosa, Brian Eastridge
INTRODUCTION: Hemorrhage is one of the most substantial causes of death after traumatic injury. Standard measures, including systolic blood pressure (SBP), are poor surrogate indicators of physiologic compromise until compensatory mechanisms have been overwhelmed. Compensatory Reserve Index (CRI) is a novel monitoring technology with the ability to assess physiologic reserve. We hypothesized CRI would be a better predictor of physiologic compromise secondary to hemorrhage than traditional vital signs...
August 1, 2017: Shock
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#5
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28737565/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-a-multidisciplinary-approach
#6
Carolina Nilsson, Linda Bilos, Tal Hörer, Artai Pirouzram
The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28731369/experimental-evaluation-of-tranexamic-acid-loaded-porous-starch-as-a-hemostatic-powder
#7
Chaoyun Xi, Liguo Zhu, Yuan Zhuang, Shufang Wang, Guixiang Sun, Yaqian Liu, Deqing Wang
We evaluated the effectiveness of a novel hemostatic powder called Tranexamic Acid-loaded Porous Starch (TAPS) developed recently on blood clotting activity and hemostasis. The effectiveness of TAPS was evaluated by comparing hemostatic properties with those of Quick-acting Styptic Powder (QSP) and Compound Microporous Polysaccharide Haemostatic powder (CMPHP). The blood clotting activities of human blood were analyzed by thromboela-stogram (TEG) assays in vitro. The hemostatic effectiveness in vivo was evaluated using a rat model with hepatic traumatic hemorrhage...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28727610/the-metabolopathy-of-tissue-injury-hemorrhagic-shock-and-resuscitation-in-a-rat-model
#8
Anne L Slaughter, Geoffrey R Nunns, Angelo D'Alessandro, Anirban Banerjee, Kirk C Hansen, E E Moore, Christopher C Silliman, Travis Nemkov, Hunter B Moore, Miguel Fragoso, Kiara Leasia, Erik D Peltz
INTRODUCTION: The metabolic consequences of trauma induce significant clinical pathology. In this study we evaluate the independent, metabolic contributions of tissue injury (TI) and combined tissue injury and hemorrhagic shock (TI / HS) using MS-metabolomics in a controlled animal model of critical injury. METHODS: Sprague-Dawley rats (n = 14) underwent TI alone or TI / HS, followed by resuscitation with normal saline and shed blood. Plasma was collected (baseline, post-laparotomy, post-HS, post-resuscitation) for Ultra High Pressure Liquid Chromatography (UHPLC) MS-metabolomics...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28715950/efficacy-of-the-novel-medical-adhesive-mar-vivo-107-in-an-acute-porcine-liver-resection-model
#9
Hirokazu Tanaka, Kenji Fukushima, Pramod Kadaba Srinivasan, Kerstin Pawlowsky, Babette Koegel, Koichiro Hata, Yonson Ku, Shinji Uemoto, René H Tolba
BACKGROUND: Despite modern surgical techniques, insufficient hemostasis after liver trauma is still a major cause of morbidity and mortality after injury. Therefore, efficient hemostatic agents are indicated. In this study, we evaluated the hemostatic efficacy of a novel synthetic wound adhesive (MAR-VIVO-107) based on polyurethane/polyurea, compared with a widely used fibrin adhesive (Tisseel). MATERIALS AND METHODS: Twelve German Landrace pigs were randomly assigned to 2 groups...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28715360/contemporary-management-of-subclavian-and-axillary-artery-injuries-a-western-trauma-association-multicenter-review
#10
Christine J Waller, Thomas H Cogbill, Kara J Kallies, Luis D Ramirez, Justin M Cardenas, S Rob Todd, Kayla J Chapman, Marshall A Beckman, Jason L Sperry, Vincent P Anto, Evert A Eriksson, Stuart M Leon, Rahul J Anand, Maura Pearlstein, Lisa Capano-Wehrle, Clay Cothren Burlew, Charles J Fox, Daniel C Cullinane, Jennifer C Roberts, Paul B Harrison, Gina M Berg, James M Haan, Kelly Lightwine
BACKGROUND: Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. METHODS: A multicenter, retrospective review of patients with subclavian or axillary artery injuries from 1/1/2004-12/31/2014 was completed at 11 participating Western Trauma Association institutions...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697025/reboa-for-the-ivc-resuscitative-balloon-occlusion-of-the-inferior-vena-cava-rebovc-to-abate-massive-hemorrhage-in-retro-hepatic-vena-cava-injuries
#11
Cassandra L Reynolds, Adam C Celio, Lindsay C Bridges, Catalina Mosquera, Brian O'Connell, Michael R Bard, Connie M DeLa'o, Eric A Toschlog
BACKGROUND: The use of resuscitative endovascular balloon occlusion as a maneuver for occlusion of the aorta is well described. This technique has life-saving potential in other cases of traumatic hemorrhage. Retro-hepatic inferior vena cava (IVC) injuries have a high rate of mortality, in part, due to the difficulty in achieving total vascular isolation. This studies purpose was to investigate the ability of resuscitative balloon occlusion of the IVC (REBOVC) to control supra-hepatic IVC hemorrhage in a swine model of trauma...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28688660/impact-of-tranexamic-acid-on-coagulation-and-inflammation-in-murine-models-of-traumatic-brain-injury-and-hemorrhage
#12
Ryan M Boudreau, Mark Johnson, Rosalie Veile, Lou Ann Friend, Holly Goetzman, Timothy A Pritts, Charles C Caldwell, Amy T Makley, Michael D Goodman
BACKGROUND: Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28682946/cerebral-alterations-following-experimental-multiple-trauma-and-hemorrhagic-shock
#13
Nina Vogt, Christiane Herden, Elke Roeb, Martin Roderfeld, Daphne Eschbach, Thorsten Steinfeldt, Hinnerk Wulf, Steffen Ruchholtz, Eberhard Uhl, Karsten Schöller
Multiple trauma (MT) associated with hemorrhagic shock (HS) might lead to cerebral hypoperfusion and brain damage. We investigated cerebral alterations using a new porcine MT/HS model without traumatic brain injury (TBI) and assessed the neuroprotective properties of mild therapeutic hypothermia. Male pigs underwent standardized MT with HS (45% or 50% loss of blood volume) and resuscitation after 90/120 minutes (T90/T120). In additional groups (TH90/TH120) mild hypothermia (33°C) was induced following resuscitation...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28673368/compliance-of-tranexamic-acid-administration-to-trauma-patients-at-a-level-one-trauma-centre
#14
Abeer Ghawnni, Angela Coates, Julian Owen
Introduction Current practice for the treatment of traumatic hemorrhage includes fluid resuscitation and the administration of blood products. The administration of tranexamic acid (TXA) within 8 hours of injury has been shown to significantly reduce mortality in a large, prospective, randomized controlled trial. As a result, TXA is widely used in trauma centres to manage trauma patients with major bleeding. The primary aim of this study was to assess the compliance of TXA administration at a level-one trauma centre in Hamilton, Ontario, Canada...
July 4, 2017: CJEM
https://www.readbyqxmd.com/read/28668564/serum-periostin-concentrations-and-outcomes-after-severe-traumatic-brain-injury
#15
Xiao-Qiao Dong, Wen-Hua Yu, Quan Du, Hao Wang, Qiang Zhu, Ding-Bo Yang, Zhi-Hao Che, Yong-Feng Shen, Li Jiang
BACKGROUND: Periostin, a neurite outgrowth-promoting factor, is increasingly expressed in rat brain tissues after cerebral ischemia or subarachnoid hemorrhage. However, periostin concentrations are undetermined in peripheral blood from patients with traumatic brain injury (TBI). METHODS: In this prospective, observational study, serum periostin concentrations were measured in 130 controls and 130 severe TBI patients. We investigated its association with trauma severity reflected by Glasgow Coma Scale (GCS) score and prognosis (i...
June 28, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28661715/patient-characteristics-and-temporal-trends-in-police-transport-of-blunt-trauma-patients-a-multicenter-retrospective-cohort-study
#16
Elinore J Kaufman, Sara F Jacoby, Catherine E Sharoky, Brendan G Carr, M Kit Delgado, Patrick M Reilly, Daniel N Holena
BACKGROUND: Police transport (PT) of penetrating trauma patients has the potential to decrease prehospital times for patients with life-threatening hemorrhage and is part of official policy in Philadelphia, Pennsylvania. We hypothesized that rates of PT of bluntly injured patients have increased over the past decade. METHODS: We used Pennsylvania Trauma Outcomes Study registry data from 2006-15 to identify bluntly injured adult patients transported to all 8 trauma centers in Philadelphia...
June 29, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28657831/case-report-life-saving-application-of-commercial-tourniquet-in-pediatric-extremity-hemorrhage
#17
David W Callaway, Andrew Puciaty, Josh Robertson, Tony Hannon, Sarah E Fabiano
Hemorrhage is the leading preventable cause of death in civilian and military trauma. Recent data from the ongoing conflicts in Iraq and Afghanistan suggest that early and aggressive tourniquet utilization is a safe and effective way to dramatically reduce mortality from extremity hemorrhage. As a result, prehospital tourniquet use is now endorsed by a majority of professional emergency medicine, emergency medical service and trauma professional societies. However, there currently exists scant evidence supporting the efficacy of commercially available tourniquets in controlling extremity hemorrhage in pediatric trauma patients...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#18
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
#19
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
#20
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
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