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transfusion traumatic brain injury

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https://www.readbyqxmd.com/read/29909182/diffuse-axonal-injury-dai-in-moderate-to-severe-head-injured-patients-pure-dai-vs-non-pure-dai
#1
Moinay Kim, Jae Sung Ahn, Wonhyoung Park, Suk Kyung Hong, Sang Ryong Jeon, Sung Woo Roh, Seungjoo Lee
OBJECTIVE: Diffuse axonal injury (DAI) is known to be associated with poor outcome. DAI often associates with other intracranial injuries but their distinct features have not been established. In this retrospective cohort study, we compared clinical outcomes between pure and non-pure DAI patients. PATIENTS AND METHODS: Total of 1047 traumatic brain injury (TBI) patients visited our institute between 2011 and 2017. Age ranged between 15-85 years old and Glasgow coma scale (GCS) score less than 13 were included...
June 10, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29875918/serum-levels-of-selenium-and-c-reactive-protein-in-comatose-patients-with-severe-traumatic-brain-injury-during-the-first-week-of-hospitalization-case-control-study
#2
Bahia Belatar, Fatna Laidi, Abdelah El Abidi, Rachid Eljaoudi, Fouzia Mamouch, Saad Kabbaj, Wajdi Maazouzi
Introduction: Mortality and morbidity related to traumatic brain injuries still remain high in patients. Many authors reported the importance of Selenium in maintaining the integrity of brain functions. This fact is supported by clinical evidence that therapy with selenium supplementation could help patients suffering from brain disorders like neurodegenerative diseases. The aim of our study was to assess the relationship between Selenium concentration in serum and evolution of comatose patients with severe traumatic brain injury, in the first week of admission, and the correlation between selenium and C-reactive protein...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29716619/the-impact-of-blood-type-o-on-mortality-of-severe-trauma-patients-a-retrospective-observational-study
#3
Wataru Takayama, Akira Endo, Hazuki Koguchi, Momoko Sugimoto, Kiyoshi Murata, Yasuhiro Otomo
BACKGROUND: Recent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. In this study, we evaluated the impact of the difference in the ABO blood type on mortality in patients with severe trauma. METHODS: A retrospective observational study was conducted in two tertiary emergency critical care medical centers in Japan. Patients with trauma with an Injury Severity Score (ISS) > 15 were included...
May 2, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#4
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29559063/early-craniectomy-improves-intracranial-and-cerebral-perfusion-pressure-after-severe-traumatic-brain-injury
#5
Casey J Allen, Daniel J Baldor, Mena M Hanna, Nicholas Namias, M Ross Bullock, Jonathan R Jagid, Kenneth G Proctor
After traumatic brain injury, decompressive craniectomy (DC) is a second-tier, late therapy for refractory intracranial hypertension. We hypothesize that early DC, based on CT evidence of intracranial hypertension, improves intracranial pressure (ICP) and cerebral perfusion pressure (CPP). From September 2008 to January 2015, 286 traumatic brain injury patients requiring invasive ICP monitoring at a single Level I trauma center were reviewed. DC and non-DC patients were propensity score matched 1:1, based on demographics, hemodynamics, injury severity score (ISS), Glasgow Coma Scale (GCS), transfusion requirements, and need for vasopressor therapy...
March 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29473174/variation-in-red-cell-transfusion-decisions-in-the-intensive-care-unit-a-nationwide-survey-in-the-netherlands
#6
F J Kranenburg, S A Willems, S Le Cessie, P J Marang-van de Mheen, J G van der Bom, M S Arbous
BACKGROUND AND OBJECTIVES: Most guidelines recommend a restrictive transfusion trigger of 7 g/dl. It is unclear whether this resulted in more uniform transfusion practices. The primary objective was to uncover the extent of variation in transfusion decisions within four scenarios of critically ill patients among critical care physicians in the Netherlands. MATERIALS AND METHODS: An online survey comprising four different hypothetical clinical scenarios was sent to all members of the Dutch Society of Intensive Care...
February 23, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29470527/value-of-diagnostic-and-therapeutic-laparoscopy-for-patients-with-blunt-abdominal-trauma-a-10-year-medical-center-experience
#7
Heng-Fu Lin, Ying-Da Chen, Shyr-Chyr Chen
Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006-2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B...
2018: PloS One
https://www.readbyqxmd.com/read/29459342/hemoglobin-thresholds-and-red-blood-cell-transfusion-in-adult-patients-with-moderate-or-severe-traumatic-brain-injuries-a-retrospective-cohort-study
#8
Amélie Boutin, Lynne Moore, Robert S Green, Ryan Zarychanski, Mete Erdogan, François Lauzier, Shane English, Dean A Fergusson, Michael Butler, Lauralyn McIntyre, Michaël Chassé, Paule Lessard Bonaventure, Caroline Léger, Philippe Desjardins, Donald Griesdale, Jacques Lacroix, Alexis F Turgeon
PURPOSE: We aimed to evaluate the association between transfusion practices and clinical outcomes in patients with traumatic brain injury. MATERIAL AND METHODS: We conducted a retrospective cohort study of adult patients with moderate or severe traumatic brain injury admitted to the intensive care unit (ICU) of a level I trauma center between 2009 and 2013. The associations between hemoglobin (Hb) level, red blood cell (RBC) transfusion and clinical outcomes were estimated using robust Poisson models and proportional hazard models with time-dependent variables, adjusted for confounders...
January 31, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29443859/over-resuscitation-with-plasma-is-associated-with-sustained-fibrinolysis-shutdown-and-death-in-pediatric-traumatic-brain-injury
#9
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29434566/assessment-of-platelet-function-in-traumatic-brain-injury-a-retrospective-observational-study-in-the-neuro-critical-care-setting
#10
Caroline Lindblad, Eric Peter Thelin, Michael Nekludov, Arvid Frostell, David W Nelson, Mikael Svensson, Bo-Michael Bellander
Background: Despite seemingly functional coagulation, hemorrhagic lesion progression is a common and devastating condition following traumatic brain injury (TBI), stressing the need for new diagnostic techniques. Multiple electrode aggregometry (MEA) measures platelet function and could aid in coagulopathy assessment following TBI. The aims of this study were to evaluate MEA temporal dynamics, influence of concomitant therapy, and its capabilities to predict lesion progression and clinical outcome in a TBI cohort...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29369437/best-practice-in-critical-care-anaemia-in-acute-and-critical-illness
#11
REVIEW
A B Docherty, A F Turgeon, T S Walsh
Anaemia is common in critical illness, and standard treatment is red blood cell (RBC) transfusion, typically using a restrictive transfusion threshold of 70 g L-1 . However, there are subgroups of patients in whom it is biologically plausible that a higher transfusion threshold may be beneficial, namely, acute sepsis, traumatic brain injury and coexisting cardiovascular disease. In this review article, we will discuss the pathophysiology of anaemia, as well as its prevalence and time course. We will explore the limitations of using haemoglobin concentration as a surrogate for oxygen delivery and the concept of the critical haemoglobin concentration...
April 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29369066/transfusion-practices-in-traumatic-brain-injury
#12
James M East, Julien Viau-Lapointe, Victoria A McCredie
PURPOSE OF REVIEW: The aim of this review is to summarize the recent studies looking at the effects of anemia and red blood cell transfusion in critically-ill patients with traumatic brain injury (TBI), describe the transfusion practice variations observed worldwide, and outline the ongoing trials evaluating restrictive versus liberal transfusion strategies for TBI. RECENT FINDINGS: Anemia is common among critically-ill patients with TBI, it is also thought to exacerbate secondary brain injury, and is associated with an increased risk of poor outcome...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341793/platelet-transfusion-does-not-improve-outcomes-in-patients-with-brain-injury-on-antiplatelet-therapy
#13
Jeremy L Holzmacher, Cassandra Reynolds, Mayur Patel, Patrick Maluso, Seth Holland, Nathaniel Gamsky, Henry Moore, Elizabeth Acquista, Matthew Carrick, Richard Amdur, Heather Hancock, Michael Metzler, Julie Dunn, Babak Sarani
INTRODUCTION: Platelet dysfunction following traumatic brain injury (TBI) is associated with worse outcomes. The efficacy of platelet transfusion to reverse antiplatelet medication (APM) remains unknown. Thrombelastography platelet mapping (TEG-PM) assesses platelet function. We hypothesize that platelet transfusion can reverse the effects of APM but does not improve outcomes following TBI. METHODS: An observational study at six US trauma centres was performed. Adult patients on APM with CT evident TBI after blunt injury were enrolled...
2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29337920/acute-traumatic-endotheliopathy-in-isolated-severe-brain-injury-and-its-impact-on-clinical-outcome
#14
Venencia Albert, Arulselvi Subramanian, Deepak Agrawal, Hara Prasad Pati, Siddhartha Datta Gupta, Asok Kumar Mukhopadhyay
STUDY DESIGN: Prospective observational cohort. OBJECTIVE: To investigate the difference in plasma levels of syndecan-1 (due to glycocalyx degradation) and soluble thrombomodulin (due to endothelial damage) in isolated severe traumatic brain injury (TBI) patients with/without early coagulopathy. A secondary objective was to compare the effects of the degree of TBI endotheliopathy on hospital mortality among patients with TBI-associated coagulopathy (TBI-AC). METHODS: Data was prospectively collected on isolated severe TBI (sTBI) patients with Glasgow Coma Scale (GCS) ≤8 less than 12 h after injury admitted to a level I trauma centre...
January 16, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29318345/accidental-hypothermia-as-an-independent-risk-factor-of-poor-neurological-outcome-in-older-multiply-injured-patients-with-severe-traumatic-brain-injury-a-matched-pair-analysis
#15
M Winkelmann, W Soechtig, C Macke, C Schroeter, J D Clausen, C Zeckey, C Krettek, P Mommsen
PURPOSE: Patients with multiple injuries are particularly susceptible to accidental hypothermia which is correlated with an increased risk of post-traumatic complications and mortality; however, its impact on neurological outcome in cases where there is concomitant traumatic brain injury is underexplored. METHODS: We analyzed severely injured patients (ISS ≥ 16) including a moderate-to-severe traumatic brain injury (AISHead  ≥ 3). The primary endpoint was objective neurological recovery, expressed as Glasgow Outcome Scale (GOS) score at time of discharge...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29313313/relationship-of-coagulopathy-and-platelet-dysfunction-to-transfusion-needs-after-traumatic-brain-injury
#16
Grace Martin, Dhavan Shah, Nora Elson, Ryan Boudreau, Dennis Hanseman, Timothy A Pritts, Amy T Makley, Brandon Foreman, Michael D Goodman
BACKGROUND: Coagulopathy and platelet dysfunction commonly develop after traumatic brain injury (TBI). Thromboelastography (TEG) and platelet function assays (PFAs) are often performed at the time of admission; however, their roles in assessing post-TBI coagulopathy have not been investigated. We hypothesized that compared to blunt TBI, penetrating TBI would (1) demonstrate greater coagulopathy by TEG, (2) be associated with abnormal PFA results, and (3) require more blood product transfusions...
January 8, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29303442/blossoming-contusions-identifying-factors-contributing-to-the-expansion-of-traumatic-intracerebral-hemorrhage
#17
Joseph A Carnevale, David J Segar, Andrew Y Powers, Meghal Shah, Cody Doberstein, Benjamin Drapcho, John F Morrison, John R Williams, Scott Collins, Kristina Monteiro, Wael F Asaad
OBJECTIVE Traumatic brain injury (TBI) remains a significant cause of neurological morbidity and mortality. Each year, more than 1.7 million patients present to the emergency department with TBI. The goal of this study was to evaluate the prognosis of traumatic cerebral intraparenchymal hemorrhage (tIPH), to develop subclassifications of these injuries that relate to prognosis, and to provide a more comprehensive assessment of hemorrhagic progression contusion (HPC) by analyzing the rate at which tIPH "blossom" (i...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29210926/hospital-readmissions-after-pediatric-trauma
#18
Aline B Maddux, Peter E DeWitt, Peter M Mourani, Tellen D Bennett
OBJECTIVES: To determine the rate, etiology, and timing of unplanned and planned hospital readmissions and to identify risk factors for unplanned readmission in children who survive a hospitalization for trauma. DESIGN: Multicenter retrospective cohort study of a probabilistically linked dataset from the National Trauma Data Bank and the Pediatric Health Information System database, 2007-2012. SETTING: Twenty-nine U.S. children's hospitals...
January 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29180981/cerebral-microdialysis-monitoring-to-improve-individualized-neurointensive-care-therapy-an-update-of-recent-clinical-data
#19
REVIEW
Laurent Carteron, Pierre Bouzat, Mauro Oddo
Cerebral microdialysis (CMD) allows bedside semicontinuous monitoring of patient brain extracellular fluid. Clinical indications of CMD monitoring are focused on the management of secondary cerebral and systemic insults in acute brain injury (ABI) patients [mainly, traumatic brain injury (TBI), subarachnoid hemorrhage, and intracerebral hemorrhage (ICH)], specifically to tailor several routine interventions-such as optimization of cerebral perfusion pressure, blood transfusion, glycemic control and oxygen therapy-in the individual patient...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29114277/contributing-factors-for-coagulopathy-in-traumatic-brain-injury
#20
Ajit Shrestha, Ramesh Man Joshi, Upendra Prasad Devkota
Context: In traumatic brain injury patients, coagulation disorder causes secondary brain injury, thereby increasing mortality and morbidity. Aims: The aim of this study is to identify the factors responsible for coagulopathy in traumatic brain injury. Settings and Design: This prospective longitudinal study from June 2012 included 100 patients with moderate and severe head injury presenting to National Institute of Neurological and Allied Sciences, Kathmandu, over 1-year period...
October 2017: Asian Journal of Neurosurgery
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