keyword
https://read.qxmd.com/read/38464129/identifying-trigger-cues-for-hospital-blood-transfusions-based-on-ensemble-learning-methods
#21
Eva V Zadorozny, Tyler Weigel, Samuel M Galvagno, Joshua B Brown, Francis X Guyette
Background Traumatic shock is the leading cause of preventable death with most patients dying within the first 6 hours. This underscores the importance of prehospital interventions, and growing evidence suggests prehospital transfusion improves survival. Optimizing transfusion triggers in the prehospital setting is key to improving outcomes for patients in hemorrhagic shock. Our objective was to identify factors associated with early in-hospital transfusion requirements available to prehospital clinicians in the field to develop a simple algorithm for prehospital transfusion, particularly for patients with occult shock...
February 20, 2024: Research Square
https://read.qxmd.com/read/38453304/the-role-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#22
REVIEW
Megan Brenner
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized by trauma surgeons at the bedside for over a decade in both civilian and military settings. Both translational and clinical research suggest it is superior to resuscitative thoracotomy for specific patient populations. Technological advancements in recent years have significantly enhanced the safety profile of REBOA. Resuscitative balloon occlusion of the aorta has also swiftly found implementation in patients in shock from non-traumatic hemorrhage...
April 2024: Surgical Clinics of North America
https://read.qxmd.com/read/38449336/early-beta-blocker-utilization-in-critically-ill-patients-with-moderate-severe-traumatic-brain-injury-a-retrospective-cohort-study
#23
JOURNAL ARTICLE
Margot Kelly-Hedrick, Sunny Yang Liu, Jordan Komisarow, Jordan Hatfield, Tetsu Ohnuma, Miriam M Treggiari, Katharine Colton, Evangeline Arulraja, Monica S Vavilala, Daniel T Laskowitz, Joseph P Mathew, Adrian Hernandez, Michael L James, Karthik Raghunathan, Vijay Krishnamoorthy
BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice are lacking. OBJECTIVE: The present study uses a large, national hospital claims-based dataset to examine early beta-blocker utilization patterns and its association with clinical outcomes among critically ill patients with moderate-severe TBI...
March 6, 2024: Journal of Intensive Care Medicine
https://read.qxmd.com/read/38436361/the-active-place-avoidance-apa-test-an-effective-versatile-and-repeatable-spatial-learning-task-for-mice
#24
JOURNAL ARTICLE
Asad A Ali, Tara L Walker, Daniel G Blackmore
Hippocampus-dependent spatial learning in rodents has been tested using a variety of methods. These include the Morris water maze (MWM), Y-maze, and novel object location (NOL) tasks. More recently, the active place avoidance (APA) task has been developed as an alternative to these more traditional approaches. In the APA task, mice must use spatial cues placed around a rotating arena to avoid a stationary shock zone. Due to the multiple parameters that can be adjusted, the APA task has been demonstrated to be a very versatile approach...
February 16, 2024: Journal of Visualized Experiments: JoVE
https://read.qxmd.com/read/38436287/crystalloid-fluid-management-of-non-traumatic-hypotension-by-new-south-wales-ambulance
#25
JOURNAL ARTICLE
Pieter Francsois Fouche, Martin Nichols, Justin Scott, Jack Richardson, Jason Bendall
IntroductionShock is circulatory insufficiency, inadequate oxygen delivery, and cellular hypoxia. Intravenous fluids are essential for shock management. Despite treatment, patients can face persistent shock with ongoing hypotension, contributing to higher mortality. This analysis aims to quantify hypotensive non-traumatic cases in an Australian ambulance service, determine persistent hypotension prevalence, and assess paramedic-administered intravascular fluids' impact on blood pressure changes.MethodsThis study is a retrospective analysis of prehospital fluid resuscitation by New South Wales Ambulance paramedics during 2022...
March 4, 2024: Prehospital Emergency Care
https://read.qxmd.com/read/38435957/anesthesia-approach-to-managing-severe-hemorrhagic-shock-and-anemia-with-non-transfusion-alternatives-in-a-practicing-jehovah-s-witness-a-case-report
#26
Colin Kirsch, Romain Rabany, Matthew Pon, Julia Shabanian, Anand Narayanappa
Traumatic hemorrhagic shock is a common yet life-threatening occurrence across the United States and is typically managed with blood transfusions as the standard of care. However, providers caring for a Jehovah's Witness patient who refuses transfusions due to religious reasons face unique ethical challenges in upholding evidence-based shock resuscitation protocols while respecting the patient's autonomy and faith-based stance that strictly prohibits blood products. We present a complex clinical case of a 46-year-old Jehovah's Witness who developed severe hemorrhagic shock, partial amputation, and critical anemia after a traumatic 40-mile-per-hour motorcycle collision resulting in comminuted fractures and arterial disruption...
January 2024: Curēus
https://read.qxmd.com/read/38435379/effects-of-biventricular-pacing-locations-on-anti-tachycardia-pacing-success-in-a-patient-specific-model
#27
JOURNAL ARTICLE
Eric N Paccione, Matthias Lange, Benjamin A Orkild, Jake A Bergquist, Eugene Kwan, Bram Hunt, Derek Dosdall, Rob S Macleod, Ravi Ranjan
Patients with drug-refractory ventricular tachycardia (VT) often undergo implantation of a cardiac defibrillator (ICD). While life-saving, shock from an ICD can be traumatic. To combat the need for defibrillation, ICDs come equipped with low-energy pacing protocols. These anti-tachycardia pacing (ATP) methods are conventionally delivered from a lead inserted at the apex of the right ventricle (RV) with limited success. Recent studies have shown the promise of biventricular leads placed in the left ventricle (LV) for ATP delivery...
October 2023: Computing in Cardiology
https://read.qxmd.com/read/38435160/voices-of-women-with-emergency-cesarean-section-experience-a-qualitative-approach
#28
JOURNAL ARTICLE
Eirini Orovou, Evangelia Antoniou
The midwifery psychoeducation, relationship with the midwives, feelings from the surgery, and delivery expectations are major factors that affect the birth experiences of mothers following an emergency cesarean section. This study aimed to give voice to mothers to express the feelings they had before, during, and after an emergency cesarean section and primarily to express whether their expectations were met after the surgery. The research was conducted on mothers who gave birth through an emergency cesarean section in a public hospital by completing specific questionnaires...
February 2024: Curēus
https://read.qxmd.com/read/38429202/measurement-of-cerebral-metabolism-under-non-chronic-hemodynamic-conditions
#29
JOURNAL ARTICLE
Oliver D Kripfgans, Stephen Z Pinter, Brendan M McCracken, Carmen I Colmenero Mahmood, Venkatakrishna Krishna Rajajee, Hakam Tiba, Jonathan M Rubin
BACKGROUND: Blood flow to the brain is a critical physiological function and is useful to monitor in critical care settings. Despite that, a surrogate is most likely measured instead of actual blood flow. Such surrogates include velocity measurements in the carotid artery and systemic blood pressure, even though true blood flow can actually be obtained using MRI and other modalities. Ultrasound is regularly used to measure blood flow and is, under certain conditions, able to provide quantitative volumetric blood flow in milliliters per minute...
February 29, 2024: Ultrasound in Medicine & Biology
https://read.qxmd.com/read/38420102/understanding-phantom-shocks-in-implantable-cardioverter-defibrillator-recipients
#30
Jason Galo, Rafey Feroze, Talal Almas, Julianna Morera, Jayakumar Sahadevan
Phantom shocks in implantable cardioverter-defibrillator (ICD) recipients create a complex nexus between cardiac treatment and psychological distress. These sensations, mimicking therapeutic shocks without device activation, deeply affect patients' functionality and well-being. Heightened anxiety, depression, and hopelessness predispose individuals to these occurrences, posing significant challenges. This article delves into the intricate nature of phantom shocks, highlighting subtle clinical cues to differentiate them from genuine therapy shocks...
January 2024: Curēus
https://read.qxmd.com/read/38419729/assessment-of-brain-response-in-operators-subject-to-recoil-force-from-firing-long-range-rifles
#31
JOURNAL ARTICLE
Tanvi Seeburrun, Michael C Bustamante, Devon C Hartlen, Austin Azar, Simon Ouellet, Duane S Cronin
Mild traumatic brain injury (mTBI) may be caused by occupational hazards military personnel encounter, such as falls, shocks, exposure to blast overpressure events, and recoil from weapon firing. While it is important to protect against injurious head impacts, the repeated exposure of Canadian Armed Forces (CAF) service members to sub-concussive events during the course of their service may lead to a significant reduction in quality of life. Symptoms may include headaches, difficulty concentrating, and noise sensitivity, impacting how personnel complete their duties and causing chronic health issues...
2024: Frontiers in Bioengineering and Biotechnology
https://read.qxmd.com/read/38407818/resuscitative-endovascular-balloon-occlusion-of-the-aorta-zone-1-reperfusion-induced-coagulopathy
#32
JOURNAL ARTICLE
Alexis L Cralley, Ernest E Moore, Ian LaCroix, T J Schaid, Otto Thielen, William Hallas, Patrick Hom, Sanchayita Mitra, Marguerite Kelher, Kirk Hansen, Mitchell Cohen, Christopher Silliman, Angela Sauaia, Charles J Fox
Objective: We sought to identify potential drivers behind resuscitative endovascular balloon occlusion of the aorta (REBOA) induced reperfusion coagulopathy using novel proteomic methods. Background: Coagulopathy associated with REBOA is poorly defined. The REBOA Zone 1 provokes hepatic and intestinal ischemia that may alter coagulation factor production and lead to molecular pathway alterations that compromises hemostasis. We hypothesized that REBOA Zone 1 would lead to reperfusion coagulopathy driven by mediators of fibrinolysis, loss of coagulation factors, and potential endothelial dysfunction...
February 1, 2024: Shock
https://read.qxmd.com/read/38396902/brain-plasticity-in-patients-with-spinal-cord-injuries-a-systematic-review
#33
REVIEW
Andrea Calderone, Davide Cardile, Rosaria De Luca, Angelo Quartarone, Francesco Corallo, Rocco Salvatore Calabrò
A spinal cord injury (SCI) causes changes in brain structure and brain function due to the direct effects of nerve damage, secondary mechanisms, and long-term effects of the injury, such as paralysis and neuropathic pain (NP). Recovery takes place over weeks to months, which is a time frame well beyond the duration of spinal shock and is the phase in which the spinal cord remains unstimulated below the level of injury and is associated with adaptations occurring throughout the nervous system, often referred to as neuronal plasticity...
February 13, 2024: International Journal of Molecular Sciences
https://read.qxmd.com/read/38394296/fibrinolysis-resistance-after-injury-is-a-risk-factor-for-a-hospital-acquired-pneumonia-like-disease-pattern
#34
JOURNAL ARTICLE
Ivan E Rodriguez, Jessica L Saben, Ernest E Moore, M Margaret Knudson, Peter K Moore, Fredric Pieracci, Angela Sauaia, Hunter B Moore
Background: Pneumonia is associated with increased morbidity and costs in the intensive care unit (ICU). Its early identification is key for optimal outcomes, but early biomarkers are lacking. Studies suggest that fibrinolysis resistance (FR) after major abdominal surgery is linked to an increased risk of infection. Patients and Methods: Patients in a randomized controlled trial for hemorrhagic shock were evaluated for FR. Fibrinolysis resistance was quantified by thrombelastography with exogenous tissue plasminogen activator (tPA-TEG) at 24- and 48-hours post-injury and measuring LY30 (%)...
February 23, 2024: Surgical Infections
https://read.qxmd.com/read/38390985/massive-transfusion-in-trauma
#35
JOURNAL ARTICLE
Heiko Lier, Björn Hossfeld
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of currently recommended treatment approaches for traumatic hemorrhage shock, with a special focus on massive transfusion. RECENT FINDINGS: Severe trauma patients require massive transfusion, but consensual international definitions for traumatic hemorrhage shock and massive transfusion are missing. Current literature defines a massive transfusion as transfusion of a minimum of 3-4 packed red blood cells within 1 h...
January 22, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38390911/dosing-of-tranexamic-acid-in-trauma
#36
REVIEW
David Faraoni, Christian Fenger-Eriksen
PURPOSE OF REVIEW: Tranexamic acid is routinely used as part of the management of traumatic bleeding. The dose recommendation in trauma was extrapolated from other clinical settings and the results of pragmatic randomized trials rather than pharmaco-kinetic and -dynamic evaluations. The review addresses current evidence on dosing of tranexamic acid in traumatized patients with a focus on efficacy, safety and risk-benefit profile. RECENT FINDINGS: A majority, but not all, of existing randomized clinical trials reports a reduction in mortality and/or blood loss with tranexamic acid administration...
April 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38380268/predicting-shock-induced-cavitation-using-machine-learning-implications-for-blast-injury-models
#37
JOURNAL ARTICLE
Jenny L Marsh, Laura Zinnel, Sarah A Bentil
While cavitation has been suspected as a mechanism of blast-induced traumatic brain injury (bTBI) for a number of years, this phenomenon remains difficult to study due to the current inability to measure cavitation in vivo . Therefore, numerical simulations are often implemented to study cavitation in the brain and surrounding fluids after blast exposure. However, these simulations need to be validated with the results from cavitation experiments. Machine learning algorithms have not generally been applied to study blast injury or biological cavitation models...
2024: Frontiers in Bioengineering and Biotechnology
https://read.qxmd.com/read/38375027/missingness-matters-a-secondary-analysis-of-thromboelastography-measurements-from-a-recent-prehospital-randomized-tranexamic-acid-clinical-trial
#38
JOURNAL ARTICLE
Jack K Donohue, Nidhi Iyanna, John M Lorence, Joshua B Brown, Frances X Guyette, Brian J Eastridge, Raminder Nirula, Gary A Vercruysse, Terence O'Keeffe, Bellal Joseph, Matthew D Neal, Jason L Sperry
BACKGROUND: Tranexamic acid (TXA) has been hypothesized to mitigate coagulopathy in patients after traumatic injury. Despite previous prehospital clinical trials demonstrating a TXA survival benefit, none have demonstrated correlated changes in thromboelastography (TEG) parameters. We sought to analyze if missing TEG data contributed to this paucity of findings. METHODS: We performed a secondary analysis of the Study of Tranexamic Acid During Air Medical and Ground Prehospital Transport Trial...
2024: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/38373483/investigating-neuropathological-changes-and-underlying-neurobiological-mechanisms-in-the-early-stages-of-primary-blast-induced-traumatic-brain-injury-insights-from-a-rat-model
#39
JOURNAL ARTICLE
Xiyan Zhu, Xiang Chu, Hao Wang, Zhikang Liao, Hongyi Xiang, Wenbing Zhao, Li Yang, Pengfei Wu, Xing Liu, Diyou Chen, Jingru Xie, Wei Dai, Lei Li, Jianmin Wang, Hui Zhao
The utilization of explosives and chemicals has resulted in a rise in blast-induced traumatic brain injury (bTBI) in recent times. However, there is a dearth of diagnostic biomarkers and therapeutic targets for bTBI due to a limited understanding of biological mechanisms, particularly in the early stages. The objective of this study was to examine the early neuropathological characteristics and underlying biological mechanisms of primary bTBI. A total of 83 Sprague Dawley rats were employed, with their heads subjected to a blast shockwave of peak overpressure ranging from 172 to 421 kPa in the GI, GII, and GIII groups within a closed shock tube, while the body was shielded...
February 17, 2024: Experimental Neurology
https://read.qxmd.com/read/38363038/exploring-grandparents-psychosocial-responses-to-childhood-cancer-a-qualitative-study
#40
JOURNAL ARTICLE
Pauline Holmer, Nadja Muehlebach, Anica Ilic, Cristina Priboi, Katharina Roser, Peter Francis Raguindin, Eva Maria Tinner, Rebecca Baechtold, Marc Ansari, Manuel Diezi, Eléna Lemmel, Freimut Schilling, Ahmed Farrag, Katrin Scheinemann, Gisela Michel
OBJECTIVE: A childhood cancer diagnosis is a traumatic experience for patients and their families. However, little is known about the effect on grandparents. We aimed to investigate the negative psychosocial impact, coping strategies, and positive outcomes of grandparents of childhood cancer patients in Switzerland. METHODS: We collected data using a semi-structured interview guide and applied qualitative content analysis. RESULTS: We conducted 20 interviews with 23 grandparents (57% female; mean age = 66...
February 2024: Psycho-oncology
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