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https://www.readbyqxmd.com/read/28030509/impact-of-early-operative-pelvic-fixation-on-long-term-self-reported-outcome-following-severe-pelvic-fracture
#1
John P Sharpe, Louis J Magnotti, Wade C Gobbell, Xin Huang, Edward A Perez, Timothy C Fabian, Martin A Croce
BACKGROUND: Traumatic disruption of the pelvic ring is a significant cause of life-threatening hemorrhage. For those patients who survive the initial injury, these fractures are associated with long periods of immobilization and intense rehabilitation. There is little published information available regarding long-term functional outcomes in these patients. This study evaluated the impact of severe pelvic fractures on those long-term outcomes. METHODS: All patients with severe pelvic fractures over an 18-year period were identified...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27955692/is-the-shock-index-based-classification-of-hypovolemic-shock-applicable-in-multiple-injured-patients-with-severe-traumatic-brain-injury-an-analysis-of-the-traumaregister-dgu-%C3%A2
#2
Matthias Fröhlich, Arne Driessen, Andreas Böhmer, Ulrike Nienaber, Alhadi Igressa, Christian Probst, Bertil Bouillon, Marc Maegele, Manuel Mutschler
BACKGROUND: A new classification of hypovolemic shock based on the shock index (SI) was proposed in 2013. This classification contains four classes of shock and shows good correlation with acidosis, blood product need and mortality. Since their applicability was questioned, the aim of this study was to verify the validity of the new classification in multiple injured patients with traumatic brain injury. METHODS: Between 2002 and 2013, data from 40 888 patients from the TraumaRegister DGU(®) were analysed...
December 12, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27938877/coagulopathy-and-transfusion-requirements-in-war-related-penetrating-traumatic-brain-injury-a-single-centre-study-in-a-french-role-3-medical-treatment-facility-in-afghanistan
#3
J Bordes, C Joubert, P Esnault, A Montcriol, C Nguyen, E Meaudre, R Dulou, A Dagain
INTRODUCTION: Traumatic brain injury associated coagulopathy is frequent, either in isolated traumatic brain injury in civilian practice and in combat traumatic brain injury. In war zone, it is a matter of concern because head and neck are the second most frequent site of wartime casualty burden. Data focusing on transfusion requirements in patients with war related TBI coagulopathy are limited. MATERIALS AND METHODS: A descriptive analysis was conducted of 77 penetrating traumatic brain injuries referred to a French role 3 medical treatment facility in Kabul, Afghanistan, deployed on the Kabul International Airport (KaIA), over a 30 months period...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/27911066/-conservative-management-of-liver-trauma-and-its-complications-current-gold-standard
#4
R Gander, J A Molino, S Santiago, A Laín, G Guillén, C Giné, G Royo, S López, M Pérez, I Díez, S Cañadas, J Lloret, J Bueno
INTRODUCTION: The liver is the second most frequently involved organ in abdominal trauma in children. The aim of this study was to review the characteristics of liver traumas (LT) in children, its treatment and complications. MATERIAL AND METHODS: Retrospective study of patients with LT treated between 2010-2014. We analyzed data regarding diagnosis, conservative management (CM), complications and treatment. RESULTS: Twenty-four patients of LT with a mean age of 9...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27798539/pediatric-minor-traumatic-brain-injury-with-intracranial-hemorrhage-identifying-low-risk-patients-who-may-not-benefit-from-icu-admission
#5
Erin Comer Burns, Beech Burns, Craig D Newgard, Amber Laurie, Rongwei Fu, Theresa Graif, Casey S Ward, Abbie Bauer, David Steinhardt, Laura M Ibsen, David M Spiro
BACKGROUND: Pediatric patients with any severity of traumatic intracranial hemorrhage (tICH) are often admitted to intensive care units (ICUs) for early detection of secondary injury. We hypothesize that there is a subset of these patients with mild injury and tICH for whom ICU care is unnecessary. OBJECTIVES: To quantify tICH frequency and describe disposition and to identify patients at low risk of inpatient critical care intervention (CCI). METHODS: We retrospectively reviewed patients aged 0 to 17 years with tICH at a single level I trauma center from 2008 to 2013...
October 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27776795/early-plasma-transfusion-is-associated-with-improved-survival-after-isolated-traumatic-brain-injury-in-patients-with-multifocal-intracranial-hemorrhage
#6
Ronald Chang, Lindley E Folkerson, Duncan Sloan, Jeffrey S Tomasek, Ryan S Kitagawa, H Alex Choi, Charles E Wade, John B Holcomb
BACKGROUND: Plasma-based resuscitation improves outcomes in trauma patients with hemorrhagic shock, while large-animal and limited clinical data suggest that it also improves outcomes and is neuroprotective in the setting of combined hemorrhage and traumatic brain injury. However, the choice of initial resuscitation fluid, including the role of plasma, is unclear for patients after isolated traumatic brain injury. METHODS: We reviewed adult trauma patients admitted from January 2011 to July 2015 with isolated traumatic brain injury...
February 2017: Surgery
https://www.readbyqxmd.com/read/27757915/the-impact-of-red-blood-cell-transfusion-on-cerebral-tissue-oxygen-saturation-in-severe-traumatic-brain-injury
#7
Victoria A McCredie, Simone Piva, Marlene Santos, Wei Xiong, Airton Leonardo de Oliveira Manoel, Andrea Rigamonti, Gregory M T Hare, Martin G Chapman, Andrew J Baker
BACKGROUND: There are a range of opinions on the benefits and thresholds for the transfusion of red blood cells in critically ill patients with traumatic brain injury (TBI) and an urgent need to understand the neurophysiologic effects. The aim of this study was to examine the influence of red blood cell transfusions on cerebral tissue oxygenation (SctO2) in critically ill TBI patients. METHODS: This prospective observational study enrolled consecutive TBI patients with anemia requiring transfusion...
October 18, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27731885/transfusion-thresholds-and-other-strategies-for-guiding-allogeneic-red-blood-cell-transfusion
#8
REVIEW
Jeffrey L Carson, Simon J Stanworth, Nareg Roubinian, Dean A Fergusson, Darrell Triulzi, Carolyn Doree, Paul C Hebert
BACKGROUND: There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. OBJECTIVES: The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomized to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all conditions...
October 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27716419/the-impact-of-mild-induced-hypothermia-on-the-rate-of-transfusion-and-the-mortality-in-severely-injured-patients-a-retrospective-multi-centre-study
#9
Kai Oliver Jensen, Leonhard Held, Andrea Kraus, Frank Hildebrand, Philipp Mommsen, Ladislav Mica, Guido A Wanner, Peter Steiger, Rudolf M Moos, Hans-Peter Simmen, Kai Sprengel
BACKGROUND: Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. METHODS: In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included...
October 6, 2016: European Journal of Medical Research
https://www.readbyqxmd.com/read/27680103/the-effects-of-anaemia-and-transfusion-on-patients-with-traumatic-brain-injury-a-review
#10
Sarah Travers, Simon Martin, N Scott Litofsky
BACKGROUND: Anaemia in traumatic brain injury (TBI) is frequently encountered. Neurosurgical texts continue to recommend transfusion for hematocrit below 30%, despite clear evidence to do so. Transfusion should increase oxygen delivery to the brain, but it may also increase morbidity and mortality. METHODS: This study reviewed the relevant literature to better understand the risks of anaemia and benefits of correction of anaemia by transfusion. RESULTS: Of the 21 studies reviewed, eight found that anaemia was harmful to patients with TBI; five found no significant outcome; seven found transfusion was associated with higher rates of morbidity and mortality; two found that transfusion lowered mortality and increased brain tissue oxygen levels; and ten found no correlation between transfusion and outcome...
2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27630085/plasma-cytokines-il-6-il-8-and-il-10-are-associated-with-the-development-of-acute-respiratory-distress-syndrome-in-patients-with-severe-traumatic-brain-injury
#11
Imo P Aisiku, Jose-Miguel Yamal, Pratik Doshi, Julia S Benoit, Shankar Gopinath, Jerry C Goodman, Claudia S Robertson
BACKGROUND: Patients with severe traumatic brain injury (TBI) are at risk of the development of acute respiratory distress syndrome (ARDS). TBI and ARDS pathophysiologic mechanisms are known to independently involve significant inflammatory responses. The literature on the association between plasma inflammatory cytokines and ARDS in patients with TBI is sparse. METHODS: The study was a secondary analysis of the safety of a randomized trial of erythropoietin and transfusion threshold in patients with severe TBI...
September 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27602897/compared-to-warfarin-direct-oral-anticoagulants-are-associated-with-lower-mortality-in-patients-with-blunt-traumatic-intracranial-hemorrhage-a-tqip-study
#12
James M Feeney, Elizabeth Santone, Monica DiFiori, Lilla Kis, Vijay Jayaraman, Stephanie C Montgomery
BACKGROUND: Falls represent the leading cause of traumatic brain injury in adults older than 65, with nearly one third experiencing a fall each year. Evidence suggests that up to 0.5% of anticoagulated patients suffer from intracranial hemorrhage (ICH) annually. Direct oral anticoagulants (DOACs) have become an increasingly popular alternative to warfarin for anticoagulation; however, there is a dearth of research regarding the safety of DOACs, in particular on the outcome of traumatic ICH while taking DOACs...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27445560/the-effect-of-hemoglobin-levels-on-mortality-in-pediatric-patients-with-severe-traumatic-brain-injury
#13
Kevin F Yee, Andrew M Walker, Elaine Gilfoyle
Objective. There is increasing evidence of adverse outcomes associated with blood transfusions for adult traumatic brain injury patients. However, current evidence suggests that pediatric traumatic brain injury patients may respond to blood transfusions differently on a vascular level. This study examined the influence of blood transfusions and anemia on the outcome of pediatric traumatic brain injury patients. Design. A retrospective cohort analysis of severe pediatric traumatic brain injury (TBI) patients was undertaken to investigate the association between blood transfusions and anemia on patient outcomes...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27399524/326%C3%A2-cerebral-contusions-catalysts-and-counteractants
#14
Joseph Carnevale, David J Segar, Benjamin Drapcho, Cody Doberstein, John F Morrison, Wael Asaad
INTRODUCTION: Annually in the United States, an estimated 1.7 million people experience traumatic brain injury (TBI), resulting in 1.4 million emergency department visits, 270 000 hospitalizations, and 53 000 deaths. The most common mass lesions associated with TBI are hematomas and contusions. Currently, there is no proven treatment protocol for contusion management. This retrospective study seeks to provide a more comprehensive assessment of the hemorrhagic progressions of contusions (HPC) by analyzing the rate at which contusions blossom depending on a variety of factors...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27389129/bundles-of-care-for-resuscitation-from-hemorrhagic-shock-and-severe-brain-injury-in-trauma-patients-translating-knowledge-into-practice
#15
Shahid Shafi, Ashley W Collinsworth, Kathleen M Richter, Hasan B Alam, Lance B Becker, Malcolm R Bullock, James M Ecklund, John Gallagher, Raj Gandhi, Elliott R Haut, Zachary L Hickman, Heidi Hotz, James McCarthy, Alex B Valadka, John Weigelt, John B Holcomb
No abstract text is available yet for this article.
October 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27256295/association-between-relative-anemia-and-early-functional-recovery-after-severe-traumatic-brain-injury-tbi
#16
Kevin R Carr, Michelle Rodriguez, Alex Ottesen, Joel Michalek, Colin Son, Vaibhav Patel, David Jimenez, Ali Seifi
BACKGROUND: Severe traumatic brain injury is associated with a multi-systemic response and changes in metabolic demand. Patients requiring intracranial pressure monitoring or cerebrospinal fluid diversion, often signifies a greater severity of injury. For this group, the association between RBC transfusion, transfusion thresholds, and clinical recovery is unknown. In this study, we studied the association between transfusion and clinical recovery for severe traumatic brain injury patients requiring external ventricular drain or intracranial pressure monitor placement...
October 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27162923/cranioplasty-results-after-application-of-anti-adhesive-films-orthowrap%C3%A2-in-traumatic-decompressive-craniectomy
#17
Hosseinali Khalili, Aydin Omidvar, Fariborz Ghaffarpasand, Golnaz Yadollahikhales
OBJECTIVE: To determine the effects of application of anti-adhesive films (OrthoWrap™) in traumatic decompressive craniectomy on prevention of adhesion formation and facilitation of subsequent cranioplasty. METHODS: This was a retrospective cohort study being performed in ShahidRajaei hospital (Shiraz Level I trauma center) during a 12-month period (from March 2012 to April 2013) including 93 patients undergoing traumatic decompressivecraniectomy.Patients who received OrthoWrap™ during the initial craniectomy (n=44) were compared to those who did not (n=49)...
January 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27099065/ratio-based-resuscitation-in-trauma-patients-with-traumatic-brain-injury-is-there-a-similar-effect
#18
COMPARATIVE STUDY
Tahereh Orouji Jokar, Mazhar Khalil, Peter Rhee, Narong Kulvatunyou, Viraj Pandit, Terence O'Keeffe, Andrew Tang, Bellal Joseph
The use of 1:1:1 (packed red blood cells: fresh frozen plasma: platelets) transfusion ratio has been shown to improve survival in severely injured trauma patients. The aim of this study was to assess the outcomes in patients with traumatic brain injury (TBI) receiving 1:1:1 ratio-based blood product transfusion (RBT). We hypothesized that RBT improves survival in patients with TBI as only major injury. We performed a 3-year retrospective analysis of all patients with TBI as only major injury presenting to our Level I trauma center...
March 2016: American Surgeon
https://www.readbyqxmd.com/read/27058046/alcohol-intoxication-reduces-systemic-interleukin-6-levels-and-leukocyte-counts-after-severe-tbi-compared-with-not-intoxicated-tbi-patients
#19
Nils Wagner, Annahita Akbarpour, Katharina Mörs, Maika Voth, Philipp Störmann, Birgit Auner, Mark Lehnert, Ingo Marzi, Borna Relja
BACKGROUND: The effect of alcohol consumption on inflammatory state and outcome in brain-injured patients remains controversial. We analyzed the influence of positive blood alcohol concentration (BAC) on inflammatory changes, inhospital complications, and mortality in traumatic brain injury (TBI) patients. PATIENTS AND METHODS: Patients with an Injury Severity Score (ISS) at least 16 and Abbreviated Injury Scale of head (AIS-head) at least 3 were included upon arrival in the emergency room and grouped according to positive BAC (>0...
September 2016: Shock
https://www.readbyqxmd.com/read/27032012/early-initiation-of-extracorporeal-membrane-oxygenation-improves-survival-in-adult-trauma-patients-with-severe-adult-respiratory-distress-syndrome
#20
Patrick L Bosarge, Lauren Allen Raff, Gerald McGwin, Shannon L Carroll, Scott C Bellot, Enrique Diaz-Guzman, Jeffrey D Kerby
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in the trauma population has been reported to have a mortality benefit in patients with severe refractory hypoxic respiratory failure. This study compares the early initiation of ECMO for the management of severe adult respiratory distress syndrome (ARDS) versus a historical control immediately preceding the use of ECMO for trauma patients. METHODS: A retrospective study was conducted at a single verified Level I trauma center...
August 2016: Journal of Trauma and Acute Care Surgery
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