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https://www.readbyqxmd.com/read/29474273/damage-control-resuscitation-in-pediatric-trauma
#1
Meghan Gilley, Suzanne Beno
PURPOSE OF REVIEW: Damage control resuscitation is an overall management strategy used in trauma patients to rapidly restore physiologic stability, while mitigating hypothermia, coagulopathy and acidosis. We review the evidence and current practice of damage control resuscitation in pediatric trauma patients with a specific focus on fluid management. RECENT FINDINGS: There have been a number of studies over the last several years examining crystalloid fluid resuscitation, balanced blood product transfusion practice and hemostatic agents in pediatric trauma...
February 22, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29457430/-clinical-effect-of-superselective-arterial-embolization-for-the-treatment-of-massive-haemorrhage-from-pelvic-fracture
#2
Zheng-Qiu Lin, Xiu-Zhi Ye, Wei-Liang Wang, Guo-Qing Zhu, Bing-Ju Xie, Liang-le Liu
OBJECTIVE: To investigate feasibility and curative effect of superselective arterial embolization for the treatment of massive haemorrhage from pelvic fracture. METHODS: From March 2008 to February 2016, clinical data of 65 patients with massive haemorrhage from pelvic fracture were collected and analyzed, and patients were divided into non-embolic and embolic group according to whether perform vascular thrombosis. Thirty-three patients were in non-embolic group including 26 males and 7 females aged from 21 to 64 years old with an average of(39...
December 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29455018/acute-massive-pulmonary-thromboembolism-treated-by-selective-catheter-directed-thrombolysis
#3
Feng Hai, Chen Xueming, Zhang Zhiwen, Li Chenyu, Fang Jie, Zhang Zhe, Lian Lishan, Zhu Renming, Yu Hongzhi, Liu Bin
OBJECTIVE: To evaluate the safety and efficacy of selective catheter-directed thrombolysis in treating acute massive pulmonary thromboembolism (AMPTE). MATERIALS AND METHODS: Twenty-six AMPTE patients were enrolled between March 2010 and March 2013. A Uni*Fuse infusion system was inserted into the main pulmonary artery thrombus. The thrombolytic regimen included an intraoperative bolus injection of 250,000 IU urokinase, followed by continuous thrombolytic infusion of 5,000IU/kg...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29450751/left-lobe-mobilization-strategy-of-right-sided-major-hepatectomy-for-treatment-of-a-tumor-causing-severe-inferior-vena-cava-compression-a-novel-strategy-using-the-modified-liver-hanging-maneuver
#4
Kenichiro Araki, Norio Kubo, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Hiroyuki Kuwano, Ken Shirabe
BACKGROUND: Massive bleeding during major hepatectomy is associated with greater mortality and morbidity.1 Our previous study shows that inferior vena cava (IVC) compression by tumor and an anterior approach without the liver-hanging maneuver (LHM) are risk factors for massive bleeding.2 The LHM is useful for controlling bleeding in deeper parenchymal transection planes.3 However, severe compression of the IVC by tumor makes it difficult to insert a hanging tape.4 The study shows a novel modified LHM strategy for severe IVC compression to minimize intraoperative bleeding...
February 14, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29449604/intravenous-synthetic-platelet-synthoplate-nanoconstructs-reduce-bleeding-and-improve-golden-hour-survival-in-a-porcine-model-of-traumatic-arterial-hemorrhage
#5
DaShawn A Hickman, Christa L Pawlowski, Andrew Shevitz, Norman F Luc, Ann Kim, Aditya Girish, Joyann Marks, Simi Ganjoo, Stephanie Huang, Edward Niedoba, Ujjal D S Sekhon, Michael Sun, Mitchell Dyer, Matthew D Neal, Vikram S Kashyap, Anirban Sen Gupta
Traumatic non-compressible hemorrhage is a leading cause of civilian and military mortality and its treatment requires massive transfusion of blood components, especially platelets. However, in austere civilian and battlefield locations, access to platelets is highly challenging due to limited supply and portability, high risk of bacterial contamination and short shelf-life. To resolve this, we have developed an I.V.-administrable 'synthetic platelet' nanoconstruct (SynthoPlate), that can mimic and amplify body's natural hemostatic mechanisms specifically at the bleeding site while maintaining systemic safety...
February 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29438206/surgical-outcome-after-less-rigid-fixation-in-open-cranial-vault-remodeling-for-craniosynostosis
#6
Khai Luen Koh, Ali Zain
: Open cranial vault remodeling techniques require rigid fixation with hardware such as plates and screws; however, complications can occur. The purpose of this study was to assess the surgical outcome after open reconstruction for craniosynostosis with less rigid fixation using nonabsorbable suture. METHODS: Retrospective review of patients who underwent open craniofacial reconstruction for craniosynostosis at the Hospital Kuala Lumpur between January 2011 and December 2016 were performed...
February 12, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29437067/the-impact-of-external-fixation-on-mortality-in-patients-with-an-unstable-pelvic-ring-fracture-a-propensity-matched-cohort-study
#7
T Ohmori, T Kitamura, T Nishida, T Matsumoto, T Tokioka
AIM: There is not adequate evidence to establish whether external fixation (EF) of pelvic fractures leads to a reduced mortality. We used the Japan Trauma Data Bank database to identify isolated unstable pelvic ring fractures to exclude the possibility of blood loss from other injuries, and analyzed the effectiveness of EF on mortality in this group of patients. PATIENTS AND METHODS: This was a registry-based comparison of 1163 patients who had been treated for an isolated unstable pelvic ring fracture with (386 patients) or without (777 patients) EF...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29435306/a-strategy-for-the-clinical-remission-of-acute-lymphoblastic-leukemia-elicited-by-treatment-of-%C3%AE-thalassemia-major-a-case-report
#8
Miguel A Palomo-Colli, Marta Zapata-Tarres, Osvaldo D Castelán-Martínez, Luis E Juárez-Villegas, Lourdes P Córdova-Hurtado
Acute lymphoblastic leukemia (ALL) has been suggested as a long-term complication in patients with β-thalassemia major (β-TM). A 12-months-old male patient was diagnosed with β-TM. The patient required a blood transfusion weekly for 2 years. At the age of 4 years, a splenectomy was performed due to massive splenomegaly and frequent transfusion requirements. The histopathological analysis of the spleen revealed extensive hemosiderosis. ALL-L1 with the T immunophenotype and without central nervous system (CNS) involvement was diagnosed when the patient was 5 years old, and treated with anti-leukemic combination chemotherapy and CNS radiotherapy...
February 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29415812/prediction-of-massive-bleeding-in-a-prehospital-setting-validation-of-six-scoring-systems
#9
L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, H Domínguez-Aguado, R Viejo-Moreno, J Barea-Mendoza, R Gómez-Soler, I Casado-Flores, M Chico-Fernández
OBJECTIVE: To validate the diagnostic ability of six different scores to predict massive bleeding in a prehospital setting. DESIGN: Retrospective cohort. SETTING: Prehospital attention of patients with severe trauma. SUBJECTS: Subjects with more than 15 years, a history of severe trauma (defined by code 15 criteria), that were initially assisted in a prehospital setting by the emergency services between January 2010 and December 2015 and were then transferred to a level one trauma center in Madrid...
February 4, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29404656/-hypovolemic-and-hemorrhagic-shock
#10
H Lier, M Bernhard, B Hossfeld
The term "shock" refers to a life-threatening circulatory failure caused by an imbalance between the supply and demand of cellular oxygen. Hypovolemic shock is characterized by a reduction of intravascular volume and a subsequent reduction in preload. The body compensates the loss of volume by increasing the stroke volume, heart frequency, oxygen extraction rate, and later by an increased concentration of 2,3-diphosphoglycerate with a rightward shift of the oxygen dissociation curve. Hypovolemic hemorrhagic shock impairs the macrocirculation and microcirculation and therefore affects many organ systems (e...
February 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29392728/soluble-antigens-in-plasma-allow-mismatched-transfusion-without-hemolysis
#11
James Sikora, Jason Gregory, Alan George, Simon Clayton, Baiming Zou, Matthew Robinson, Faisal Mukhtar, Joseph P Pelletier
BACKGROUND: Universal plasma is a scarce resource when a massive transfusion protocol has been initiated. Previous studies have reported success using group A plasma in place of the universal plasma, group AB. It is unclear why there are not more reports of hemolytic reactions occurring from this practice. One possible explanation is the presence of water-soluble antigens in the patient plasma that bind to, and neutralize, the soluble antibodies present in the transfused plasma. STUDY DESIGN AND METHODS: Expired units of plasma were used to make dilutions that consisted of mixtures of group A and B plasma and saline...
February 1, 2018: Transfusion
https://www.readbyqxmd.com/read/29389749/trauma-and-transfusion-in-the-geriatric-patient
#12
Corey Scott Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
January 30, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29386766/teratoma-arising-from-hepato-duodenal-ligament-in-the-newborn-with-transection-of-portal-vein-hepatic-artery-and-common-bile-duct-a-surgical-challenge
#13
V R Ravikumar, G Rajamani, Vijayakumar Raju, Rajani Sundar, Sowmya Ravikumar, Raghul Maniam
A 7-day-old neonate presented with a large intra-abdominal mass adherent to the hilum of the liver encasing the portal triad. During excision, the portal vein, hepatic artery, and common bile duct were injured. The repair was done promptly and needed massive blood transfusion. Histopathology revealed immature teratoma Grade III. Survival in neonate following total transection of portal triad is rare and has not been reported.
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29383943/complications-of-surgery-for-infectious-lung-cavities
#14
Gildardo Cortés-Julián, Luis C Valencia, Silviano Ríos-Pascual, Marco A de la Rosa-Abarroa, Enrique Guzmán-de Alba
Background Infectious lung cavities are a common entity for the respiratory physician. Sometimes these lesions require surgical treatment, but surgery is challenging, and complications are common. Methods Patients with infectious lung cavities amenable to surgical treatment were included in a case-control study. The control group included patients with no complications. The cases group comprised patients with any of the following complications up to 90 days after surgery: death, persistence of hemoptysis, empyema, operative blood loss > 500 mL, vascular lesion requiring repair, massive transfusion (>5 units of packed red blood cells per 48 h) or reoperation for bleeding, postoperative mechanical ventilation, intensive care unit stay > 48 h, prolonged air leak, and persistent atelectasis...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29373264/disseminated-fusariosis-emerged-from-prolonged-local-genital-infection-after-cord-blood-transplantation
#15
Kohei Okada, Tomoyuki Endo, Daigo Hashimoto, Tomoyuki Saga, Takahide Ara, Reiki Ogasawara, Atsushi Yasumoto, Makoto Ibata, Mutsumi Takahata, Akio Shigematsu, Takeshi Kondo, Yasunori Muraosa, Toshifumi Nomura, Hiromi Kanno-Okada, Satoshi Hashino, Shinya Tanaka, Katsuhiko Kamei, Takanori Teshima
Disseminated fusariosis (DF) is a rare life threatening fungal infection in immunocompromised hosts. We herein report a case of a fatal DF mimicking varicella zoster virus (VZV) infection that was emerged from a localized genital infection during cord blood transplantation (CBT) in a patient with severe aplastic anemia (SAA). The patient developed an ulcer following small painful vesicles mimics herpes simplex virus infection (HSV) on the glans penis before CBT, but a Fusarium species was identified. Despite administration of voriconazole, liposomal amphotericin B and granulocyte transfusion, the lesion was extended to extensive skin looked like VZV infection and the patients died after CBT...
January 16, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29359471/a-high-plasma-red-blood-cell-transfusion-ratio-during-liver-transplantation-is-associated-with-decreased-blood-utilization
#16
M B Pagano, R A Metcalf, J R Hess, J Reyes, J D Perkins, M I Montenovo
BACKGROUND: During massive transfusion, the volume ratio of administered plasma (PL Vol) to red blood cell (RBC Vol) appears to be associated with reduced blood utilization and improved survival. The aim of this study was to evaluate the optimal component ratio in the setting of liver transplantation. METHODS: This is a retrospective chart review of patients who underwent liver transplantation and received at least 500 ml of red blood cells from January 2013 through December 2015...
January 22, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29334571/use-of-french-lyophilized-plasma-transfusion-in-severe-trauma-patients-is-associated-with-an-early-plasma-transfusion-and-early-transfusion-ratio-improvement
#17
Cédric Nguyen, Julien Bordes, Pierre-Julien Cungi, Pierre Esnault, Michael Cardinale, Quentin Mathais, Jean Cotte, Sébastien Beaume, Anne Sailliol, Bertrand Prunet, Eric Meaudre
BACKGROUND: Early transfusion of high ratio of fresh frozen plasma (FFP) and red blood cells (RBC) is associated with mortality reduction. However, time to reach high ratio is limited by the need to thaw the FFP. French lyophilized plasma (FLYP) used by French army and available in military teaching hospital does not need to be thawed and is immediately available. We hypothesize that the use of FLYP may reduce time to reach a plasma:RBC ratio of 1/1. METHODS: A retrospective study performed in a Level 1 trauma center between January 2012 and December 2015...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29332316/how-do-i-implement-a-whole-blood-program-for-massively-bleeding-patients
#18
Mark H Yazer, Andrew P Cap, Philip C Spinella, Louis Alarcon, Darrell J Triulzi
Building on the successful military experience, interest has been rekindled in transfusing whole blood (WB) early in the resuscitation of traumatically injured civilians, often before their ABO group is known. WB efficiently provides treatment for shock and coagulopathy, as well as platelet hemostatic function, to patients losing large volumes of blood. Unlike group O uncrossmatched red blood cells (RBCs), group O WB contains a substantial amount of plasma, which is incompatible with the RBCs of all non-group O recipients...
January 14, 2018: Transfusion
https://www.readbyqxmd.com/read/29318368/increased-levels-of-advanced-glycation-end-products-positively-correlate-with-iron-overload-and-oxidative-stress-markers-in-patients-with-%C3%AE-thalassemia-major
#19
Maryam Sadat Mirlohi, Hamid Yaghooti, Saeed Shirali, Ali Aminasnafi, Samaneh Olapour
The impaired biosynthesis of the β-globin chain in β-thalassemia leads to the accumulation of unpaired alpha globin chains, failure in hemoglobin formation, and iron overload due to frequent blood transfusion. Iron excess causes oxidative stress and massive tissue injuries. Advanced glycation end products (AGEs) are harmful agents, and their production accelerates in oxidative conditions. This study was conducted on 45 patients with major β-thalassemia who received frequent blood transfusions and chelation therapy and were compared to 40 healthy subjects...
January 9, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29290382/hypothermia-ph-and-postoperative-red-blood-cell-transfusion-in-massively-transfused-adult-cardiac-surgery-patients-a-retrospective-cohort-study
#20
Brittney Williams, Evan Chriss, Jennifer Kaplan, Alexander Cartron, Bradley Taylor, James Gammie, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: To determine the relationships between hypothermia and pH at surgery end and postoperative red blood cell (RBC) transfusion in massively transfused adult cardiac surgery patients. DESIGN: Retrospective cohort study. SETTING: Single tertiary care, academic medical center. PARTICIPANTS: A total of 395 adult patients having cardiac surgery with cardiopulmonary bypass who were massively transfused during an 8-year period...
November 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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