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Resuscitative thoracotomy

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https://www.readbyqxmd.com/read/29319648/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-hemorrhage-control-in-trauma-patients-an-evidence-based-review
#1
Molly Sambor
Traditionally, resuscitative efforts for uncontrolled noncompressible torso hemorrhage are achieved by cross-clamping the proximal aorta via thoracotomy to deliver temporary hemodynamic stability during injury repair. A less commonly used method of promoting early resuscitation and hemorrhagic control in trauma patients is resuscitative endovascular balloon occlusion of the aorta (REBOA). The focus of this literature review is to examine the effectiveness of REBOA in the management of noncompressible pelvic hemorrhage when compared with traditional methods of hemorrhage control in trauma patients...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29300281/the-ios-have-it-a-prospective-observational-study-of-vascular-access-success-rates-in-patients-in-extremis-using-video-review
#2
Kristen M Chreiman, Ryan P Dumas, Mark J Seamon, Patrick K Kim, Patrick M Reilly, Lewis J Kaplan, Jason D Christie, Daniel N Holena
BACKGROUND: Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral IVs (PIVs) or central venous catheters (CVCs). METHODS: High-definition video recordings of resuscitations for all patients undergoing Emergency Department Thoracotomy (EDT) from 4/2016-7/2017 were reviewed as part of a quality improvement initiative...
January 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29280925/ontemporary-utilization-of-resuscitative-thoracotomy-results-from-the-aast-aortic-occlusion-for-resuscitation-in-trauma-and-acute-care-surgery-aorta-multicenter-registry
#3
Joseph DuBose, Timothy Fabian, Tiffany Bee, Laura J Moore, John B Holcomb, Megan Brenner, David Skarupa, Kenji Inaba, Todd E Rasmussen, David Turay, Thomas M Scalea
INTRODUCTION: Several reviews of Resuscitative thoracotomy (RT) use over the last 5 decades have been conducted, most recently the evidence-based practice management guideline (PMG) of the Eastern Association for the Surgery of Trauma (EAST). The present study was designed to examine contemporary RT utilization and outcomes compared to historical data (n = 10,238) from the EAST PMG review from published series 1974 - 2013. METHODS: The AAST AORTA registry was utilized to identify patients undergoing RT in the ED from Nov 2013 to Dec 2016...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29237544/cardiac-tamponade-due-to-internal-mammary-artery-injury-after-cardiopulmonary-resuscitation-a-case-report
#4
Keon Kim, Eun Kim, Duk Hee Lee
Vascular injuries caused by cardiopulmonary resuscitation (CPR) can be associated with major complications. If patients who have received CPR have sudden abnormal hemodynamic findings, it is necessary to consider the possibility of these injuries. We report a 73-year-old man who had cardiac tamponade due to an injury to the internal mammary artery following manual chest compression. This very rare injury was detected by computed tomography and was treated by thoracotomy and hematoma evacuation.
December 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29237485/resuscitative-endovascular-balloon-occlusion-of-the-aorta-may-increase-the-bleeding-of-minor-thoracic-injury-in-severe-multiple-trauma-patients-a-case-report
#5
Takaaki Maruhashi, Hiroaki Minehara, Ichiro Takeuchi, Yuichi Kataoka, Yasushi Asari
BACKGROUND: The resuscitative endovascular balloon occlusion of the aorta, because of its efficacy and feasibility, has been widely used in treating patients with severe torso trauma. However, complications developing around the site proximal to the occlusion by resuscitative endovascular balloon occlusion of the aorta have almost never been studied. CASE PRESENTATION: A 50-year-old Japanese woman fell from a height of approximately 10 m. At initial arrival, her respiratory rate was 24 breaths/minute, her blood oxygen saturation was 95% under 10 L/minute oxygenation, her pulse rate was 90 beats per minute, and her blood pressure was 180/120 mmHg...
December 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29190256/time-to-aortic-occlusion-it-s-all-about-access
#6
Anna Romagnoli, William Teeter, Jason Pasley, Peter Hu, Melanie Hoehn, Deborah Stein, Thomas Scalea, Megan Brenner
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less invasive method of proximal aortic occlusion compared with resuscitative thoracotomy with aortic cross-clamping (RTACC). This study compared time to aortic occlusion with REBOA and RTACC, both including and excluding time required for common femoral artery (CFA) cannulation. METHODS: This was a retrospective, single-institution review of REBOA or RTACC performed between February 2013 and January 2016...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29170346/49%C3%A2-paediatric-traumatic-cardiac-arrest-the-development-of-a-treatment-algorithm
#7
James Vassallo, Tim Nutbeam, Annette Rickard, Mark Lyttle, Jason Smith
INTRODUCTION: Paediatric Traumatic Cardiac Arrest (TCA) is a high acuity, low frequency event with fewer than 15 cases reported per year to the Trauma Audit Research Network (TARN). Traditionally survival from TCA has been reported as low, with some believing resuscitation is futile. Within the adult population there is growing evidence to suggest that with early and aggressive correction of reversible causes, survival from TCA may be comparable to that seen from medical out-of-hospital cardiac arrests...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29157684/resuscitation-thoracotomy-technical-aspects
#8
H De Lesquen, F Beranger, C Natale, G Boddaert, J-P Avaro
No abstract text is available yet for this article.
November 17, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29150491/hypothermia-modulates-arrhythmia-substrates-during-different-phases-of-resuscitation-from-ischemic-cardiac-arrest
#9
Joseph S Piktel, Aurelia Cheng, Matthew McCauley, Zack Dale, Michelle Nassal, Danielle Maleski, Gary Pawlowski, Kenneth R Laurita, Lance D Wilson
BACKGROUND: We designed an innovative porcine model of ischemia-induced arrest to determine dynamic arrhythmia substrates during focal infarct, global ischemia from ventricular tachycardia or fibrillation (VT/VF) and then reperfusion to determine the effect of therapeutic hypothermia (TH) on dynamic arrhythmia substrates and resuscitation outcomes. METHODS AND RESULTS: Anesthetized adult pigs underwent thoracotomy and regional plunge electrode placement in the left ventricle...
November 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29150222/retrospective-study-of-thoracotomy-performed-in-a-french-level-1-trauma-center
#10
A Mancini, A Bonne, A Pirvu, P Porcu, P Bouzat, J Abba, C Arvieux
OBJECTIVE: Resuscitative thoracotomy, a potentially life-saving procedure, is used exceptionally, and essentially for penetrating trauma. Most of the available literature is American while reports from Europe are sparse. We report our experience in a French level 1-trauma center. MATERIAL AND METHODS: Patient records (patient age, gender, mechanism of injury, indication for emergency thoracotomy, anatomic injuries, interventions and survival) for all patients who underwent emergency thoracotomy between January 2005 and December 2015 were analyzed...
November 14, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#11
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#12
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29126457/chest-compression-related-fatal-internal-mammary-artery-injuries-manifesting-after-venoarterial-extracorporeal-membrane-oxygenation-a-case-series
#13
Toshinobu Yamagishi, Masahiro Kashiura, Kazuhiro Sugiyama, Kazuha Nakamura, Takuto Ishida, Takahiro Yukawa, Kazuki Miyazaki, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: Cardiopulmonary resuscitation-related bleeding, especially internal mammary artery injuries, can become life-threatening complications after initiating venoarterial extracorporeal membrane oxygenation owing to the frequent involvement of concomitant anticoagulant treatment, antiplatelet treatment, targeted temperature management, and bleeding coagulopathy. We report the cases of five patients who experienced this complication and discuss their management. CASE PRESENTATION: We retrospectively evaluated five patients with cardiopulmonary resuscitation-related internal mammary artery injuries who were treated between February 2011 and February 2016 at our institution...
November 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29111081/timing-of-mortality-in-pediatric-trauma-patients-a-national-trauma-data-bank-analysis
#14
Cory McLaughlin, Jessica A Zagory, Michael Fenlon, Caron Park, Christianne J Lane, Daniella Meeker, Randall S Burd, Henri R Ford, Jeffrey S Upperman, Aaron R Jensen
BACKGROUND/PURPOSE: The classic "trimodal" distribution of death has been described in adult patients, but the timing of mortality in injured children is not well understood. The purpose of this study was to define the temporal distribution of mortality in pediatric trauma patients. METHODS: A retrospective cohort of patients with mortality from the National Trauma Data Bank (2007-2014) was analyzed. Categorical comparison of 'dead on arrival', 'death in the emergency department', and early (≤24h) or late (>24h) inpatient death was performed...
October 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28973104/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-proximal-aortic-control-in-patients-with-severe-hemorrhage-and-arrest
#15
Megan Brenner, William Teeter, Melanie Hoehn, Jason Pasley, Peter Hu, Shiming Yang, Anna Romagnoli, Jose Diaz, Deborah Stein, Thomas Scalea
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis, often instead of emergency department thoracotomy. The ability to perform aortic occlusion (AO) with an intravascular device allows focused occlusion at the most distal level to perfuse proximal regions while slowing hemorrhage to injured areas. Objective: To describe what is to date the largest single-institution experience with REBOA in the United States...
September 27, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28958368/assessment-and-resuscitation-in-trauma-management
#16
REVIEW
Stephen Gondek, Mary E Schroeder, Babak Sarani
The golden hour of trauma represents a crucial period in the management of acute injury. In an efficient trauma resuscitation, the primary survey is viewed as more than simple ABCs with multiple processes running in parallel. Resuscitation efforts should be goal oriented with defined endpoints for airway management, access, and hemodynamic parameters. In tandem with resuscitation, early identification of life-threatening injuries is critical for determining the disposition of patients when they leave the trauma bay...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28955248/aicar-administration-attenuates-hemorrhagic-hyperglycemia-and-lowers-oxygen-debt-in-anesthetized-male-rabbits
#17
Yi Huang, Paul H Ratz, Amy S Miner, Victoria A Locke, Grace Chen, Yang Chen, Robert W Barbee
Background: Many strategies have been utilized to treat traumatic shock via improved oxygen delivery (DO2), while fewer have been used to in an attempt to reduce oxygen demand (VO2). The cellular energy sensor 5' adenosine monophosphate-activated protein kinase (AMPK) has the potential to modulate both whole-body DO2 and VO2. Therefore, we determined the effect of the AMPK activator AICAR (5-aminoimidazole-4-carboxamide 1-β-D-ribonucleoside) given acutely or chronically on key metabolites, hemodynamics, and oxygen consumption/delivery before and during hemorrhage in anesthetized male rabbits...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28941568/resuscitation-thoracotomy
#18
G Boddaert, E Hornez, H De Lesquen, A Avramenko, B Grand, T MacBride, J-P Avaro
Resuscitation thoracotomy is a rarely performed procedure whose use, in France, remains marginal. It has five specific goals that correspond point-by-point to the causes of traumatic cardiac arrest: decompression of pericardial tamponade, control of cardiac hemorrhage, performance of internal cardiac massage, cross-clamping of the descending thoracic aorta, and control of lung injuries and other intra-thoracic hemorrhage. This approach is part of an overall Damage Control strategy, with a targeted operating time of less than 60minutes...
September 20, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28860179/fewer-reboa-complications-with-smaller-devices-and-partial-occlusion-evidence-from-a-multicentre-registry-in-japan
#19
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tokiya Ishida, Yuri Kon, Keisuke Tomita, Kenichiro Ishida, Tomoya Hirose, Kensuke Umakoshi, Tomohiro Funabiki
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) performed by emergency physicians has been gaining acceptance as a less invasive technique than resuscitative thoracotomy. OBJECTIVE: To evaluate access-related complications and duration of occlusions during REBOA. METHODS: Patients with haemorrhagic shock requiring REBOA, from 18 hospitals in Japan, included in the DIRECT-IABO Registry were studied. REBOA-related characteristics were compared between non-survivors and survivors at 24 hours...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28831501/non-traumatic-hemorrhage-is-controlled-with-reboa-in-acute-phase-then-mortality-increases-gradually-by-non-hemorrhagic-causes-direct-iabo-registry-in-japan
#20
Y Matsumura, J Matsumoto, K Idoguchi, H Kondo, T Ishida, Y Kon, K Tomita, K Ishida, T Hirose, K Umakoshi, T Funabiki
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is now a feasible and less invasive resuscitation procedure. This study aimed to compare the clinical course of trauma and non-trauma patients undergoing REBOA. METHODS: Patient demographics, etiology, bleeding sites, hemodynamic response, length of critical care, and cause of death were recorded. Characteristics and outcomes were compared between non-trauma and trauma patients. Kaplan-Meier survival analysis was then conducted...
August 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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