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https://www.readbyqxmd.com/read/28533934/mortality-outcomes-in-trauma-patients-undergoing-prehospital-red-blood-cell-transfusion-a-systematic-literature-review
#1
REVIEW
Gregory S Huang, C Michael Dunham
The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. Eligible studies were combined for meta-analysis when tests for heterogeneity were insignificant. The synthesized mortality was 35.6% for systolic blood pressure ≤ 90 mmHg; 51.1% for ≤ 80 mmHg; and 63...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28529983/role-of-leukoreduction-of-packed-red-blood-cell-units-in-trauma-patients-a-review
#2
Young Kim, Brent T Xia, Alex L Chang, Timothy A Pritts
Hemorrhagic shock is a leading cause of mortality within the trauma population, and blood transfusion is the standard of care. Leukoreduction filters remove donor leukocytes prior to transfusion of blood products. While the benefits of leukocyte depletion are well documented in scientific literature, these benefits do not translate directly to the clinical setting. This review summarizes current research regarding leukoreduction in the clinical arena, as well as studies performed exclusively in the trauma population...
June 2016: International Journal of Hematology Research
https://www.readbyqxmd.com/read/28526897/the-impact-of-pre-injury-direct-oral-anticoagulants-compared-to-warfarin-in-geriatric-g-60-trauma-patients
#3
J F Barletta, S Hall, J F Sucher, J K Dzandu, M Haley, A J Mangram
PURPOSE: Pre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin. METHODS: All trauma patients, age ≥60 who were admitted to the hospital and taking an oral anticoagulant pre-injury were retrospectively identified. Patients were excluded if their reason for admission was a suicide attempt or penetrating extremity injury...
May 19, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28522144/viscoelastic-tissue-plasminogen-activator-challenge-predicts-massive-transfusion-in-15-minutes
#4
Hunter B Moore, Ernest E Moore, Michael P Chapman, Benjamin R Huebner, Peter M Einersen, Solimon Oushy, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Coagulopathy is associated with massive transfusion in trauma, yet most clinical scores to predict this end point do not incorporate coagulation assays. Previous work has identified that shock increases circulating tissue plasminogen activator (tPA). When tPA levels saturate endogenous inhibitors, systemic hyperfibrinolysis can occur. Therefore, the addition of tPA to a patient's blood sample could stratify a patients underlying degree of shock and early coagulation changes to predict progression to massive transfusion...
April 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#5
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#6
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28497100/does-tranexamic-acid-reduce-bleeding-during-femoral-fracture-operation
#7
Mohammad Haghighi, Hossein Ettehad, Mohsen Mardani-Kivi, Ahmadreza Mirbolook, Bahram Naderi Nabi, Roya Moghaddam, Abbas Sedighinejad, Gita Khanjanian
BACKGROUND: Proximal Femoral shaft fractures are commonly associated with marked blood loss which can lead to postoperative acute anemia and some other complications. Tranexamic acid (TA) is an antifibrinolytic medication that reduces intra-and postoperative blood loss and transfusion requirements during some elective surgeries. The aim of this study is to evaluate the effect of intravenous Tranexamic acid (TA) on intraoperative blood loss and a subsequent need for transfusion in patients who were undergoing surgery for femoral shaft fractures in trauma setting...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#8
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#9
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28484665/retrospective-review-of-pediatric-blunt-renal-trauma-a-single-institution-s-five-year-experience
#10
Carly R Richards, Margaret E Clark, Ronald S Sutherland, Russell K Woo
Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i...
May 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28481839/high-ratio-plasma-resuscitation-does-not-improve-survival-in-pediatric-trauma-patients
#11
Jeremy W Cannon, Michael A Johnson, Robert C Caskey, Matthew A Borgman, Lucas P Neff
BACKGROUND: Damage control resuscitation (DCR) including balanced resuscitation with high ratios of plasma (PLAS) and platelets (PLT) to packed red blood cells (PRBC) improves survival in adult patients. We sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric trauma patients (<18 years)...
May 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28468146/microsurgical-replantation-of-total-avulsed-scalp-extending-the-limits
#12
Yunbo Jin, Chen Hua, Xiaojie Hu, Hui Chen, Gang Ma, Yun Zou, Bin Chen, Dongze Lyu, Mathias Tremp, Xiaoxi Lin
BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#13
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28461988/endoscopic-extraperitoneal-radical-prostatectomy-an-initial-report-following-the-first-30-cases
#14
Bartłomiej Jakóbczyk, Marek Wrona, Marta Wrona-Lis, Elżbieta Oszukowska, Piotr Lipiński, Mariusz Szewczyk, Marek Lipiński, Waldemar Różański
INTRODUCTION: To present initial observations after the first 30 cases of endoscopic extraperitoneal radical prostatectomy carried out at our department, which so far has had no experience with this surgical procedure. MATERIAL AND METHODS: In the period of 15 months a group of 30 patients with organ confined prostate cancer, underwent endoscopic extraperitoneal radical prostatectomy using Montsouris technique. All procedures were performed by the same team of two urologists and one resident...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28459796/splenic-artery-embolization-versus-splenectomy-analysis-for-early-in-hospital-infectious-complications-and-outcomes
#15
Alberto Aiolfi, Kenji Inaba, Aaron Strumwasser, Kazuhide Matsushima, Daniel Grabo, Elizabeth R Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Splenic artery embolization has gained increasing acceptance as an important adjunct in the treatment of splenic injuries. Residual immunologic function of the spleen after embolization and its consequences on early infectious complications still remain intensely debated. The purpose of this study was to compare splenic artery embolization and splenectomy in terms of early in-hospital infectious complications and outcomes. METHODS: Two year retrospective Trauma Quality Improvement Program (TQIP) database prognostic study...
April 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28458065/outcomes-of-lumbopelvic-fixation-in-the-treatment-of-complex-sacral-fractures-using-minimally-invasive-surgical-techniques
#16
Ehsan Jazini, Tristan Weir, Emeka Nwodim, Oliver Tannous, Comron Saifi, Nicholas Caffes, Timothy Costales, Eugene Koh, Kelley Banagan, Daniel Gelb, Steven C Ludwig
BACKGROUND CONTEXT: Complex sacral fractures with vertical and anterior pelvic ring instability treated with traditional fixation methods are associated with high rates of failure and poor clinical outcomes. Supplemental lumbopelvic fixation (LPF) has been applied for additional stability to help with fracture union. PURPOSE: To determine whether minimally invasive LPF provides reliable fracture stability and acceptable complication rates in cases of complex sacral fractures...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28452886/platelet-transfusions-reduce-fibrinolysis-but-do-not-restore-platelet-function-during-trauma-hemorrhage
#17
Paul Vulliamy, Scarlett Gillespie, Lewis S Gall, Laura Green, Karim Brohi, Ross A Davenport
INTRODUCTION: Platelets play a critical role in hemostasis with aberrant function implicated in trauma-induced coagulopathy. However, the impact of massive transfusion protocols on platelet function during trauma hemorrhage is unknown. The aim of this study was to characterize the effects of platelet transfusion on platelet aggregation and fibrinolytic markers during hemostatic resuscitation. METHODS: Trauma patients enrolled into the prospective Activation of Coagulation and Inflammation in Trauma (ACIT) study between January 2008 and November 2015 who received at least four units of packed red blood cells (PRBCs) were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452877/incompatible-type-a-plasma-transfusion-in-patients-requiring-massive-transfusion-protocol-outcomes-of-an-east-multicenter-study
#18
W Tait Stevens, Bryan C Morse, Andrew Bernard, Dan Davenport, Valerie G Sams, Michael Goodman, Russell Dumire, Matt Carrick, Patrick McCarthy, James R Stubbs, Timothy Pritts, Christopher J Dente, Xian Luo-Owen, Jason Gregory, David Turay, Dina Gomaa, Juan C Quispe, Caitlin A Fitzgerald, Nadeem Haddad, Asad Choudhry, Jose Quesada, Martin D Zielinski
With a relative shortage of type AB plasma, many centers have converted to type A plasma for resuscitation of patients whose blood type is unknown. The goal of this study is to determine outcomes for trauma patients who received incompatible plasma transfusions as part of a massive transfusion protocol (MTP). METHODS: As part of an EAST multi-institutional trial, registry and blood bank data were collected from 8 trauma centers for trauma patients (age ≥ 15 years) receiving emergency release plasma transfusions as part of MTPs from January 2012 - August 2016...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28445186/the-hip-fracture-patient-on-warfarin-evaluating-blood-loss-and-time-to-surgery
#19
Matthew R Cohn, Ashley E Levack, Nikunj N Trivedi, Jordan C Villa, David S Wellman, John P Lyden, Dean G Lorich, Joseph M Lane
OBJECTIVES: To compare blood loss, delay of surgery, and short term adverse events in (1) patients admitted on warfarin versus non-anticoagulated controls and (2) warfarin patients with day of surgery (DOS) INR of 1.5 or greater versus below 1.5. DESIGN: Retrospective cohort. SETTING: Academic level I trauma center. PATIENTS/PARTICIPANTS: One hundred twenty four patients treated surgically for hip fractures including patients presenting on warfarin (n=62) and matched controls (n=62)...
April 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#20
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
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