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https://www.readbyqxmd.com/read/29208320/efficacy-of-a-massive-transfusion-protocol-for-hemorrhagic-trauma-resuscitation
#1
George Lim, Katrina Harper-Kirksey, Ram Parekh, Alex F Manini
OBJECTIVES: New paradigm shifts in trauma resuscitation recommend that early reconstitution of whole blood ratios with massive transfusion protocols (MTP) may be associated with improved survival. We performed a preliminary study on the efficacy of MTP at an urban, Level 1 trauma center and its impact on resuscitation goals. METHODS: A case-control study was performed on consecutive critically-ill trauma patients over the course of 1 year. The trauma captain designated patients as either MTP activation (cases) or routine care without MTP (controls) in matched, non-randomized fashion...
November 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#2
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29200079/external-validation-of-a-smartphone-app-model-to-predict-the-need-for-massive-transfusion-using-five-different-definitions
#3
E I Hodgman, M W Cripps, M J Mina, E M Bulger, M A Schreiber, K J Brasel, M J Cohen, P C Muskat, J G Myers, L H Alarcon, M H Rahbar, J B Holcomb, B A Cotton, E E Fox, D J Del Junco, C E Wade, H A Phelan
INTRODUCTION: Previously, a model to predict massive transfusion protocol (activation) was derived using a single-institution dataset. The PROMMTT database was used to externally validate this model's ability to predict both massive transfusion protocol (MTP) activation and massive transfusion (MT) administration using multiple MT definitions. METHODS: The app model was used to calculate the predicted probability of massive transfusion protocol activation or massive transfusion delivery...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29194339/risk-factors-for-the-development-of-acute-respiratory-distress-syndrome-following-hemorrhage
#4
Bryce R H Robinson, Mitchell J Cohen, John B Holcomb, Timothy A Pritts, Dina Gomaa, Erin E Fox, Richard D Branson, Rachael A Callcut, Bryan A Cotton, Martin A Schreiber, Karen J Brasel, Jean-Francois Pittet, Kenji Inaba, Jeffery D Kerby, Thomas M Scalea, Charlie E Wade, Eileen M Bulger
BACKGROUND: The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) study evaluated the effects of plasma and platelets on hemostasis and mortality after hemorrhage. The pulmonary consequences of resuscitation strategies that mimic whole blood, remain unknown. METHODS: A secondary analysis of the PROPPR study was performed. Injured patients predicted to receive a massive transfusion were randomized to 1:1:1 vs. 1:1:2 plasma-platelet-RBC ratios at 12 Level I North American trauma centers...
November 30, 2017: Shock
https://www.readbyqxmd.com/read/29190257/the-trauma-center-is-too-late-major-limb-trauma-without-a-pre-hospital-tourniquet-has-increased-death-from-hemorrhagic-shock
#5
Michelle H Scerbo, John B Holcomb, Ethan Taub, Keith Gates, Joseph D Love, Charles E Wade, Bryan A Cotton
BACKGROUND: To date, no civilian studies have demonstrated that pre-hospital (PH) tourniquets improve survival. We hypothesized that late, trauma center (TC) tourniquet use would increase death from hemorrhagic shock compared to early (PH) placement. METHODS: All patients arriving to a Level 1, urban TC between October 2008 and January 2016 with a tourniquet placed before (T-PH) or after arrival to the TC (T-TC) were evaluated. Cases were assigned the following designations: indicated (absolute indication [vascular injury requiring repair/ligation, operation within 2 hours for extremity injury, or traumatic amputation] or relative indication [major musculoskeletal/soft tissue injury requiring operation 2-8 hours after arrival, documented large blood loss]) or non-indicated...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29184859/risk-factors-for-massive-postpartum-bleeding-in-pregnancies-in-which-incomplete-placenta-previa-are-located-on-the-posterior-uterine-wall
#6
Hyun Jung Lee, Young Jai Lee, Eun Hee Ahn, Hyeon Chul Kim, Sang Hee Jung, Sung Woon Chang, Ji Yeon Lee
Objective: To identify factors associated with massive postpartum bleeding in pregnancies complicated by incomplete placenta previa located on the posterior uterine wall. Methods: A retrospective case-control study was performed. We identified 210 healthy singleton pregnancies with incomplete placenta previa located on the posterior uterine wall, who underwent elective or emergency cesarean section after 24 weeks of gestation between January 2006 and April 2016...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29180179/preoperative-thrombelastography-maximum-amplitude-predicts-massive-transfusion-in-liver-transplantation
#7
Peter J Lawson, Hunter B Moore, Ernest E Moore, Gregory R Stettler, Thomas J Pshak, Igal Kam, Christopher C Silliman, Trevor L Nydam
BACKGROUND: Massive transfusion (MT) is frequently required during liver transplantation. Risk stratification of transplant patients at risk for MT is an appealing concept but remains poorly developed. Thrombelastography (TEG) has recently been shown to reduce mortality when used for trauma resuscitation. We hypothesize that preoperative TEG can be used to risk stratify patients for MT. MATERIAL AND METHODS: Liver transplant patients had blood drawn before surgical incision and assayed via TEG...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29174516/delayed-hemolytic-transfusion-reaction-and-hyperhemolysis-syndrome-without-detectable-alloantibodies-or-autoantibodies-in-a-patient-with-sickle-cell-disease-a-fatal-case-report-and-literature-review
#8
B Nsimba, A Habibi, F Pirenne, P Bartolucci, D Tonduangu, C Duvoux, N De Prost, M Marcandetti, A Mekontso-Dessap, F Galactéros, P Morel
Delayed hemolytic transfusion reaction is a classic and still under diagnosed complication in patients with sickle cell disease who undergo blood transfusions, and this condition may lead to hyperhemolysis syndrome which is characterized by a massive destruction of both the donor's and patient's red blood cells. We reported the clinical and biological features, treatments and prevention measures of a case of a 47-year-old man of Martinican origin, with sickle cell disease (hemoglobin SS) and no history of alloimmunization, multiply transfused, who was admitted to the Sens Medical Center in July 2015 due to a vaso-occlusive crisis...
November 22, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29172950/the-safety-and-feasibility-of-three-dimensional-visualization-technology-assisted-right-posterior-lobe-allied-with-part-of-v-and-viii-sectionectomy-for-right-hepatic-malignancy-therapy
#9
Min Hu, Haoyu Hu, Wei Cai, Zhikang Mo, Nan Xiang, Jian Yang, Chihua Fang
BACKGROUND: Hepatectomy is the optimal method for liver cancer; the virtual liver resection based on three-dimensional visualization technology (3-DVT) could provide better preoperative strategy for surgeon. We aim to introduce right posterior lobe allied with part of V and VIII sectionectomy assisted by 3-DVT as a promising treatment for massive or multiple right hepatic malignancies to retain maximum residual liver volume on the basis of R0 resection. METHODS: Among 126 consecutive patients who underwent hepatectomy, 9 (7%) underwent right posterior lobe allied with part of V and VIII sectionectomy...
November 27, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29170313/16%C3%A2-investigating-the-effects-of-under-triage-by-existing-major-incident-triage-tools
#10
James Vassallo, Jason Smith
INTRODUCTION: Triage, the process of prioritising patients on the basis of clinical acuity, is a key principle in the effective management of a major incident. The overall effectiveness of the triage process is not only a balance between identifying those who need or don't need a life-saving intervention, but also those who are under or over-triaged as either incorrectly needing/not needing intervention. The primary aim of this study was to describe the implications of under-triage using existing major incident triage tools, including the 2013 National Ambulance Resilience Unit (NARU) Sieve...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170311/14%C3%A2-prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#11
Jackie Mclennan, Jason Smith, Kevin Mackway-Jones
BACKGROUND: The predominant cause of preventable death from trauma is bleeding. Many patients need resuscitation with massive blood transfusion (MBT). In some theatres of military operation there is limited blood product availability and walking donor panels can be required. This study aimed to produce a tool to predict the need for MBT using information available on patient arrival at the ED for patients sustaining battlefield trauma. METHODS: A retrospective database analysis was undertaken using the UK Joint Theatre Trauma Registry (JTTR) to provide derivation and validation datasets...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29161751/the-jellyfish-sign-a-new-sonographic-cervical-marker-to%C3%A2-predict-maternal-morbidity-in-abnormally-invasive-placenta-previa
#12
Emma Bertucci, Filomena Giulia Sileo, Giovanni Grandi, Valentina Fenu, Carlotta Cani, Luciano Mancini, Ema Mataca, Fabio Facchinetti
Purpose To investigate the value of a new cervical sonographic sign, called the jellyfish sign (JS), for predicting the risk of maternal morbidity in cases of abnormally invasive placenta (AIP) previa totalis. Materials and Methods Retrospective evaluation of transvaginal (TV) and transabdominal (TA) scans performed in all singleton pregnancies with placenta previa totalis. JS, i. e. the absence of the normal linear demarcation between the placenta previa and the cervix, was evaluated by TV scans. The presence/severity of AIP and outcomes of maternal morbidity were related to this sign...
November 21, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29132511/resuscitation-for-hypovolemic-shock
#13
REVIEW
Kyle J Kalkwarf, Bryan A Cotton
Hemorrhage is the leading cause of preventable deaths in trauma patients. After presenting a brief history of hemorrhagic shock resuscitation, this article discusses damage control resuscitation and its adjuncts. Massively bleeding patients in hypovolemic shock should be treated with damage control resuscitation principles including limited crystalloid, whole blood or balance blood component transfusion to permissive hypotension, preventing hypothermia, and stopping bleeding as quickly as possible.
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29127751/-the-benefit-of-new-angiogenesis-bevacizumab-and-aflibercept-inhibitors-for-multiple-angiomatosis-therapy-a%C3%A2-case-report
#14
Dagmar Brančíková, Lenka Ostřížková, Zdeněk Adam, Tomáš Nebeský, Luděk Pour, Zdeněk Král, Jiří Mayer
Angiomatosis is a term for multiple, gradually proliferating hemangiomas (angiodysplasia), affecting multiple organs or tissues at the same time. We describe a 12-year course of treatment of a patient with multiple hemangiomas located in the abdomen, retroperitoneum, oesophagus, mediastinum and also in vertebrae. The diagnosis was made in 2005 within probatory laparotomy, at the age of 28 years. The treatment was commenced right after making the diagnosis with interferon α. Due to its adverse effects (fatigue, anorexia), the use of interferon α was limited to the first year, after which the interferon dose was gradually being reduced until it was discontinued completely...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29108404/assessment-of-rotational-thromboelastometry-for-the-prediction-of-red-blood-cell-requirements-in-orthotopic-liver-transplantation
#15
Antoni Sabate, Annabel Blasi, Marta Costa, Raquel Reyes, Joan Beltran, Ferran Torres
BACKGROUND: In liver transplantation most studies were designed to predict massive transfusion rather than whether or not transfusion is required. We hypothesized that (presurgery) data from thromboelastometry may predict perioperative blood requirements. METHODS: A post-hoc analysis of data from a controlled trial was performed with the primary end point of predicting zero red blood cells. Of the 92 patients studied, 6 were excluded because of incomplete EXTEM and / or FIBTEM data...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#16
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29107853/the-effect-of-tranexamic-acid-to-reduce-blood-loss-and-transfusion-on-off-pump-coronary-artery-bypass-surgery-a-systematic-review-and-cumulative-meta-analysis
#17
REVIEW
Zhao Dai, Haichen Chu, Shiduan Wang, Yongxin Liang
STUDY OBJECTIVE: To assess the safety and efficacy of tranexamic acid (TA) on off-pump coronary artery bypass (OPCAB) surgery. DESIGN: Meta-analysis. SETTING: Operating room, OPCAB surgery, all surgeries were elective measurements. Searching the following data sources respectively: PubMed/MEDLINE, the Cochrane Library, EMBASE and reference lists of identified articles, we performed a meta-analysis of postoperative 24h blood loss, postoperative allogeneic transfusion, re-operation for massive bleeding, postoperative mortality, and postoperative thrombotic complications...
November 3, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29071337/evaluation-of-military-use-of-tranexamic-acid-and-associated-thromboembolic-events
#18
Luke R Johnston, Carlos J Rodriguez, Eric A Elster, Matthew J Bradley
Importance: Since publication of the CRASH-2 and MATTERs studies, the US military has included tranexamic acid (TXA) in clinical practice guidelines. While TXA was shown to decrease mortality in trauma patients requiring massive transfusion, improper administration and increased risk of venous thromboembolism remain a concern. Objective: To determine the appropriateness of TXA administration by US military medical personnel based on current Joint Trauma System clinical practice guidelines and to determine if TXA administration is associated with venous thromboembolism...
October 25, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29067758/scoring-model-to-predict-massive-post-partum-bleeding-in-pregnancies-with-placenta-previa-a-retrospective-cohort-study
#19
Ji Yeon Lee, Eun Hee Ahn, Sukho Kang, Myung Jin Moon, Sang Hee Jung, Sung Woon Chang, Hee Young Cho
AIM: We aimed to identify factors associated with massive post-partum bleeding in pregnancies with placenta previa and to establish a scoring model to predict post-partum severe bleeding. METHODS: A retrospective cohort study was performed in 506 healthy singleton pregnancies with placenta previa from 2006 to 2016. Cases with intraoperative blood loss (≥2000 mL), packed red blood cells transfusion (≥4), uterine artery embolization, or hysterectomy were defined as massive bleeding...
October 25, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29059118/early-haemorrhage-control-and-management-of-trauma-induced-coagulopathy-the-importance-of-goal-directed-therapy
#20
Jakob Stensballe, Hanne H Henriksen, Pär I Johansson
PURPOSE OF REVIEW: The aim of this study was to discuss the recent developments in trauma-induced coagulopathy and the evolvement of goal-directed therapy. RECENT FINDINGS: Mortality from major trauma continues to be a worldwide problem, and massive haemorrhage remains a major cause in 40% of potentially preventable trauma deaths. Development of trauma-induced coagulopathy challenges 25-35% of the patients further increasing trauma mortality. The pathophysiology of coagulopathy in trauma reflects at least two distinct mechanisms: Acute traumatic coagulopathy, consisting of endogenous heparinization, activation of the protein C pathway, hyperfibrinolysis and platelet dysfunction, and resuscitation associated coagulopathy...
December 2017: Current Opinion in Critical Care
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