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Damage control resuscitation

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https://www.readbyqxmd.com/read/29318344/severe-casualties-from-bastille-day-attack-in-nice-france
#1
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29283977/divergent-effects-of-hypertonic-fluid-resuscitation-on-renal-pathophysiological-and-structural-parameters-in-rat-model-of-lower-body-ischemia-reperfusion-induced-sterile-inflammation
#2
Bulent Ergin, Coert J Zuurbier, Aysegul Kapucu, Can Ince
The pathogenesis of acute kidney injury (AKI) is characterized by the deterioration of tissue perfusion and oxygenation and enhanced inflammation. The purpose of this study was to investigate whether or not the hemodynamic and inflammatory effects of hypertonic saline (HS) protect the kidney by promoting renal microcirculatory oxygenation and possible deleterious effects of HS due to its high sodium content on renal functional and structural injury following ischemia/reperfusion. Mechanically ventilated and anesthetized rats were randomly divided into four groups (n = 6 per group): a sham-operated control group; a group subjected to renal ischemia for 45 min by supra-aortic occlusion followed by 2 h of reperfusion (I/R); and I/R group treated with a continuous i...
December 27, 2017: Shock
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#3
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#4
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#5
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29220129/damage-control-resuscitation
#6
William Selde
No abstract text is available yet for this article.
April 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29207113/spontaneous-hypothermia-ameliorated-inflammation-and-neurologic-deficit-in-rat-cardiac-arrest-models-following-resuscitation
#7
Minggen Zhou, Peng Wang, Zhengfei Yang, Haidong Wu, Zitong Huan
Cardiac arrest (CA) is a leading cause of mortality worldwide. The majority of the associated mortalities are caused by post‑CA syndrome, which includes symptoms, such as neurologic damage, myocardial dysfunction and systemic inflammation. Following CA, return of spontaneous circulation (ROSC) leads to a brain reperfusion injury, which subsequently causes adverse neurologic outcomes or mortality. Therefore, investigating the underlying mechanisms of ROSC‑induced neurologic deficits and establishing potential treatments is critical to prevent and treat post‑CA syndrome...
November 20, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#8
Richard L Purcell, Michael A Donohue, Sameer K Saxena, Wade T Gordon, Louis L Lewandowski
INTRODUCTION: Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29156155/leukotriene-b4-indicates-lung-injury-and-on-going-inflammatory-changes-after-severe-trauma-in-a-porcine-long-term-model
#9
Philipp Störmann, Birgit Auner, Lukas Schimunek, Rafael Serve, Klemens Horst, Tim-P Simon, Roman Pfeifer, Kernt Köhler, Frank Hildebrand, Sebastian Wutzler, Hans-Christoph Pape, Ingo Marzi, Borna Relja
BACKGROUND: Recognizing patients at risk for pulmonary complications (PC) is of high clinical relevance. Migration of polymorphonuclear leukocytes (PMN) to inflammatory sites plays an important role in PC, and is tightly regulated by specific chemokines including interleukin (IL)-8 and other mediators such as leukotriene (LT)B4. Previously, we have reported that LTB4 indicated early patients at risk for PC after trauma. Here, the relevance of LTB4 to indicating lung integrity in a newly established long-term porcine severe trauma model (polytrauma, PT) was explored...
December 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29132584/damage-control-advances-in-trauma-resuscitation
#10
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132576/management-of-major-vascular-injuries-neck-extremities-and-other-things-that-bleed
#11
REVIEW
Chris Evans, Tim Chaplin, David Zelt
Vascular injuries represent a significant burden of mortality and disability. Blunt injuries to the neck vessels can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiography and managed with either antiplatelet medications or anticoagulation. In contrast, patients with penetrating injuries to the neck vessels require airway management, hemorrhage control, and damage control resuscitation before surgical repair. The keys to diagnosis and management of peripheral vascular injury include early recognition of the injury; hemorrhage control with direct pressure, packing, or tourniquets; and urgent surgical consultation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132575/acute-management-of-the-traumatically-injured-pelvis
#12
REVIEW
Steven Skitch, Paul T Engels
Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists)...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132511/resuscitation-for-hypovolemic-shock
#13
REVIEW
Kyle J Kalkwarf, Bryan A Cotton
Hemorrhage is the leading cause of preventable deaths in trauma patients. After presenting a brief history of hemorrhagic shock resuscitation, this article discusses damage control resuscitation and its adjuncts. Massively bleeding patients in hypovolemic shock should be treated with damage control resuscitation principles including limited crystalloid, whole blood or balance blood component transfusion to permissive hypotension, preventing hypothermia, and stopping bleeding as quickly as possible.
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29123911/perimortem-cesarean-delivery-and-subsequent-emergency-hysterectomy-new-strategy-for-maternal-cardiac-arrest
#14
Mayako Goto, Hiroaki Watanabe, Kazuhide Ogita, Tetsuya Matsuoka
Cases: Perimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant women in cardiac arrest, and has been found to increase maternal resuscitation rate by increasing circulating plasma volume. However, many obstetricians have not experienced a case of PMCD, as situations requiring it are rare. We report our strategy for cases of maternal cardiac arrest, on the basis of a review of published work, and present two case reports from our medical center. Outcomes: In case 1, PMCD led to death by massive bleeding...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123853/high-grade-traumatic-torso-visceral-injury-with-hemodynamic-instability-effectiveness-of-transarterial-embolization-using-n-butyl-cyanoacrylate
#15
REVIEW
Junya Tsurukiri, Shoichi Ohta, Akira Hoshiai, Hidefumi Sano, Eitaro Okumura, Nobuhiko Tsubouchi, Hiroyuki Konishi, Tetsuo Yukioka
Trauma patients with uncontrolled hemorrhage encountering coagulopathy are often associated with poor outcome. Recently, the concept of damage control interventional radiology, which focuses on "speedy stoppage of bleeding" by interventional radiology among trauma patients with hemodynamic instability and acute traumatic coagulopathy, was proposed as an alternative to damage control surgery. N-butyl cyanoacrylate (NBCA) has been used as a liquid embolic agent in various non-traumatic situations, where it has been shown to have a high technical success rate and low recurrent bleeding rate, especially in patients with coagulopathy...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122112/prehospital-transfusion-for-gastrointestinal-bleeding
#16
Maile E Parker, Mohammad A Khasawneh, Cornelius A Thiels, Kathleen S Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
OBJECTIVE: Gastrointestinal (GI) bleeding is a common medical emergency with significant morbidity and mortality. Many patients are coagulopathic, which may perpetuate bleeding. Remote damage control resuscitation, including early correction of coagulopathy and anemia, may benefit exsanguinating patients with GI bleeding. METHODS: We conducted a retrospective review of patients with acute GI bleeding who received packed red blood cells (pRBC) and/or plasma during transportation to our institution between 2010 and 2014...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29115207/self-evaluated-competence-in-trauma-reception
#17
Kristin Julia Steinthorsdottir, Peter Svenningsen, Rasmus Fabricius, Lars Bo Svendsen, Jens Hillingsø, Martin Sillesen
INTRODUCTION: No formal training requirements exist for trauma teams in Denmark. The aim of this study was to investigate the point prevalence level of training and the self-evaluated competence of doctors involved in trauma care. METHODS: On two nights, all doctors on call at departments involved in trauma care were interviewed and answered a structured questionnaire pertaining to their level of training and self-evaluated level of competence in relevant skills...
November 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29099239/physician-approaches-to-conflict-with-families-surrounding-end-of-life-decision-making-in-the-icu-a-qualitative-study
#18
Hashim M Mehter, Jessica B McCannon, Jack A Clark, Renda Soylemez Wiener
RATIONALE: Families of critically ill patients are often asked to make difficult decisions to pursue, withhold or withdraw aggressive care or resuscitative measures, exercising "substituted judgment" from the imagined standpoint of the patient. Conflict may arise between intensive care unit (ICU) physicians and family members regarding the optimal course of care. OBJECTIVES: To characterize how ICU physicians approach and manage conflict with surrogates regarding end-of-life decision-making...
November 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29097176/how-shall-we-transfuse-hippolyta
#19
Brendan C Graham, Lindsey J Graham, Carl H Rose, Jeffrey L Winters
The US Department of Defense recently made the decision to open direct ground combat roles to women. Blood product transfusion is an essential component of the US Military guidelines for tactical combat casualty care and damage control resuscitation, but blood transfusion carries with it the specific side effect of alloimmunization-a uniquely significant side effect for young women who may desire subsequent pregnancies. Presently to be considered are the changes that may need to be made to blood transfusion in the setting of battlefield medicine to optimally care for combat-injured women, as a majority of the existing data regarding the risks of transfusion in the trauma setting involve predominantly men...
October 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#20
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
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