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TBI coagulopathy

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https://www.readbyqxmd.com/read/27906868/individual-clotting-factor-contributions-to-mortality-following-trauma
#1
Ryan C Kunitake, Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mitchell J Cohen, Rachael A Callcut
BACKGROUND: Acute traumatic coagulopathy (ATC) afflicts 20-30% of trauma patients, but the extensive collinearity of the coagulation cascade complicates attempts to clarify global clotting factor dysfunction. This study aims to characterize phenotypes of clotting factor dysfunction and their contributions to mortality after major trauma. METHODS: This prospective cohort study examines all adult trauma patients of the highest activation level presenting to San Francisco General Hospital between 2/2005 and 2/2015...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27852408/-study-on-the-difference-of-blood-coagulation-function-in-patients-with-traumatic-brain-injury-in-plain-and-plateau-area
#2
J Sun, Y Tian, R C Jiang, X L Dong, Y Wang, W B Wu, K X Wu, J N Zhang
Objective: In this study, we tested platelet count (PC), prothrombin time (PT), activated partial thromboplastin time (APTT), and other indicators of coagulation function, and revealed their difference in patients with traumatic brain injury (TBI) between plain and plateau area. Base on the results, we may provide research basis for the therapy of TBI associated coagulopathy in different areas. Methods: 151 TBI patients from Tianjin Medical University General Hospital, and 74 from People's Hospital of Tibet Autonomous Region in the period from Dec 2013 to Dec 2015 were enrolled...
October 25, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27621012/relationship-between-tissue-perfusion-and-coagulopathy-in-traumatic-brain-injury
#3
Simone E Dekker, Anne Duvekot, Hielke-Martijn de Vries, Leo M G Geeraedts, Saskia M Peerdeman, Monique C de Waard, Christa Boer, Patrick Schober
BACKGROUND: Traumatic brain injury (TBI)-related coagulopathy appears to be most prevalent in patients with tissue hypoperfusion, but evidence for this association is scarce. This study investigated the relationship between tissue perfusion and hemostatic derangements in TBI patients. MATERIALS AND METHODS: Coagulation parameters were measured on emergency department admission in patients with TBI (head abbreviated injury scale ≥ 3). The level of hypoperfusion was simultaneously assessed by near-infrared spectroscopy (NIRS) at the forehead and arm, and by base excess and lactate...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27424129/prognostic-factors-of-early-outcome-and-discharge-status-in-patients-undergoing-surgical-intervention-following-traumatic-intracranial-hemorrhage
#4
Tatsuhiro Fujii, Gabriela Moriel, Daniel R Kramer, Frank Attenello, Gabriel Zada
Over the past several decades, the rate of traumatic brain injury (TBI)-related emergency room visits in the United States has steadily increased, yet mortality in these patients has decreased. This improvement in outcome is largely due to advances in prehospital care, intensive care unit management, and the effectiveness of neurosurgical procedures, such as decompressive craniectomies. It is imperative to identify clinical factors predictive of patients who benefit from early mobilization of resources and operative treatment...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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
#5
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/27381903/advances-in-the-understanding-of-trauma-induced-coagulopathy
#6
REVIEW
Ronald Chang, Jessica C Cardenas, Charles E Wade, John B Holcomb
Ten percent of deaths worldwide are due to trauma, and it is the third most common cause of death in the United States. Despite a profound upregulation in procoagulant mechanisms, one-quarter of trauma patients present with laboratory-based evidence of trauma-induced coagulopathy (TIC), which is associated with poorer outcomes including increased mortality. The most common causes of death after trauma are hemorrhage and traumatic brain injury (TBI). The management of TIC has significant implications in both because many hemorrhagic deaths could be preventable, and TIC is associated with progression of intracranial injury after TBI...
August 25, 2016: Blood
https://www.readbyqxmd.com/read/27206278/sympathoadrenal-activation-is-associated-with-acute-traumatic-coagulopathy-and-endotheliopathy-in-isolated-brain-injury
#7
Alex P Di Battista, Sandro B Rizoli, Brandon Lejnieks, Arimie Min, Maria Y Shiu, Henry T Peng, Andrew J Baker, Michael G Hutchison, Nathan Churchill, Kenji Inaba, Bartolomeu B Nascimento, Airton Leonardo de Oliveira Manoel, Andrew Beckett, Shawn G Rhind
BACKGROUND: Acute coagulopathy after traumatic brain injury (TBI) involves a complex multifactorial hemostatic response that is poorly characterized. OBJECTIVES: To examine early posttraumatic alterations in coagulofibrinolytic, endothelial, and inflammatory blood biomarkers in relation to sympathetic nervous system (SNS) activation and 6-month patient outcomes, using multivariate partial least-squares (PLS) analysis. PATIENTS AND METHODS: A multicenter observational study of 159 adult isolated TBI patients admitted to the emergency department at an urban level I trauma center, was performed...
September 2016: Shock
https://www.readbyqxmd.com/read/27190065/early-coagulation-events-induce-acute-lung-injury-in-a-rat-model-of-blunt-traumatic-brain-injury
#8
Hideki Yasui, Deborah L Donahue, Mark Walsh, Francis J Castellino, Victoria A Ploplis
Acute lung injury (ALI) and systemic coagulopathy are serious complications of traumatic brain injury (TBI) that frequently lead to poor clinical outcomes. Although the release of tissue factor (TF), a potent initiator of the extrinsic pathway of coagulation, from the injured brain is thought to play a key role in coagulopathy after TBI, its function in ALI following TBI remains unclear. In this study, we investigated whether the systemic appearance of TF correlated with the ensuing coagulopathy that follows TBI in ALI using an anesthetized rat blunt trauma TBI model...
July 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27172161/%C3%AE-blockade-use-for-traumatic-injuries-and-immunomodulation-a-review-of-proposed-mechanisms-and-clinical-evidence
#9
Tyler J Loftus, Philip A Efron, Lyle L Moldawer, Alicia M Mohr
Sympathetic nervous system activation and catecholamine release are important events following injury and infection. The nature and timing of different pathophysiologic insults have significant effects on adrenergic pathways, inflammatory mediators, and the host response. Beta adrenergic receptor blockers (β-blockers) are commonly used for treatment of cardiovascular disease, and recent data suggests that the metabolic and immunomodulatory effects of β-blockers can expand their use. β-blocker therapy can reduce sympathetic activation and hypermetabolism as well as modify glucose homeostasis and cytokine expression...
October 2016: Shock
https://www.readbyqxmd.com/read/27155585/the-prognostic-value-of-plasma-nesfatin-1-concentrations-in-patients-with-traumatic-brain-injury
#10
Gang-Qun Wu, Xiao-Min Chou, Wen-Jian Ji, Xiao-Gang Yang, Luo-Xin Lan, Yan-Jun Sheng, Yang-Fang Shen, Jian-Rong Li, Guo-Zhong Huang, Wen-Hua Yu, Xiao-Qiao Dong, Quan Du, Ding-Bo Yang, Zu-Yong Zhang, Hao Wang, Yong-Feng Shen, Li Jiang
BACKGROUND: Nesfatin-1 is related to inflammation. Its increased circulating concentrations are associated with the severity and prognosis of subarachnoid hemorrhage. In-hospital major adverse events (IMAEs), including acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction, are correlated with mortality after traumatic brain injury (TBI). The present study was designed to investigate the changes of plasma nesfatin-1 concentrations and further assess its association with inflammation, trauma severity, in-hospital mortality and IMAEs following TBI...
July 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27032006/the-impact-of-acute-coagulopathy-on-mortality-in-pediatric-trauma-patients
#11
Aaron Strumwasser, Allison L Speer, Kenji Inaba, Bernardino C Branco, Jeffrey S Upperman, Henri R Ford, Lydia Lam, Peep Talving, Ira Shulman, Demetrios Demetriades
BACKGROUND: Traumatic coagulopathy (TC) occurs in 24% to 38% of adults and is associated with up to a six-fold increase in mortality. This study's purpose was to determine the incidence of pediatric TC and its impact on mortality. METHODS: A retrospective review (2004-2009) of all trauma patients from our Level I trauma center was performed. Coagulopathy was defined as an international normalized ratio of 1.5 or higher or activated partial thromboplastin time of more than 36 seconds or platelets less than 100,000/mm...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26914721/the-impact-of-pre-hospital-administration-of-lactated-ringer-s-solution-versus-normal-saline-in-patients-with-traumatic-brain-injury
#12
Susan E Rowell, Kelly A Fair, Ronald R Barbosa, Jennifer M Watters, Eileen M Bulger, John B Holcomb, Mitchell J Cohen, Mohammad H Rahbar, Erin E Fox, Martin A Schreiber
Lactated Ringer's (LR) and normal saline (NS) are both used for resuscitation of injured patients. NS has been associated with increased resuscitation volume, blood loss, acidosis, and coagulopathy compared with LR. We sought to determine if pre-hospital LR is associated with improved outcome compared with NS in patients with and without traumatic brain injury (TBI). We included patients receiving pre-hospital LR or NS from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study. Patients with TBI (Abbreviated Injury Scale [AIS] head ≥3) and without TBI (AIS head ≤2) were compared...
June 1, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/26850305/coagulopathy-in-traumatic-brain-injury-and-its-correlation-with-progressive-hemorrhagic-injury-a-systematic-review-and-meta-analysis
#13
Qiang Yuan, Yi-Rui Sun, Xing Wu, Jian Yu, Zhi-Qi Li, Zhuo-Ying Du, Xue-Hai Wu, Liang-Fu Zhou, Jin Hu
The association between coagulopathy and either isolated traumatic brain injury (TBI) or progressive hemorrhagic injury (PHI) remains controversial. The aims of this study were to evaluate whether isolated TBI induces pronounced coagulopathy, in comparison with non-TBI or TBI in conjunction with other injuries (TBI + other injuries), and to examine whether there is any evidence of a relationship between coagulopathy and PHI in patients who have experienced TBI. The MEDLINE(®) and Embase databases, and the Cochrane Central Register of Controlled Trials (Central), were trawled for relevant studies...
July 15, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/26666545/thromboelastography-after-murine-tbi-and-implications-of-beta-adrenergic-receptor-knockout
#14
Douglas Z Liou, Ara Ko, Oksana Volod, Galinos Barmparas, Megan Y Harada, Matthew J Martin, Ali Salim, Navpreet Dhillon, Gretchen M Thomsen, Eric J Ley
BACKGROUND: The source of coagulopathy in traumatic brain injury (TBI) is multifactorial and may include adrenergic stimulation. The aim of this study was to assess coagulopathy after TBI using thromboelastography (TEG), and to investigate the implications of β-adrenergic receptor knockout. METHODS: Adult male wild type c57/bl6 (WT) and β1/β2-adrenergic receptor knockout (BKO) mice were assigned to either TBI (WT-TBI, BKO-TBI) or sham injury (WT-sham, BKO-sham)...
August 2016: Neurocritical Care
https://www.readbyqxmd.com/read/26539924/traumatic-brain-injury-advancements
#15
REVIEW
Bellal Joseph, Ansab Haider, Peter Rhee
PURPOSE OF REVIEW: Traumatic brain injury (TBI) remains the leading cause of morbidity and mortality in the United States. Over the last decade, several advancements have been made in the field of TBI all aimed at improving outcomes. RECENT FINDINGS: Advancements in the management of TBI have been made possible through improved understanding of basic pathophysiology associated with this condition. The aim of this review is to briefly highlight the underlying pathophysiology of TBI and the most recent advancements and novel strategies being used in its treatment...
December 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26457298/coagulation-parameters-and-risk-of-progressive-hemorrhagic-injury-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#16
REVIEW
Danfeng Zhang, Shun Gong, Hai Jin, Junyu Wang, Ping Sheng, Wei Zou, Yan Dong, Lijun Hou
Intracranial hemorrhage (ICH) after traumatic brain injury (TBI) commonly increases in size and coagulopathy has been implicated in such progression. Our aim is to perform a meta-analysis to assess their relationship. Cochrane library, PubMed, and EMBASE were searched for literatures. Pooled effect sizes and 95% confidential intervals (CIs) were calculated using random-effects model. We included six studies, involving 1700 participants with 540 progressive hemorrhagic injuries (PHIs). Our findings indicate that PT, D-dimer level, and INR value are positively associated with the risk of PHI...
2015: BioMed Research International
https://www.readbyqxmd.com/read/26414158/time-course-of-coagulation-and-fibrinolytic-parameters-in-patients-with-traumatic-brain-injury
#17
Ryuta Nakae, Yasuhiro Takayama, Kentaro Kuwamoto, Yasutaka Naoe, Hidetaka Sato, Hiroyuki Yokota
Traumatic brain injury (TBI) has long been associated with coagulopathy; however, the time course of coagulation/fibrinolytic parameters in the acute phase of TBI remains unclear. The purpose of the study was to analyze the time course of coagulation/fibrinolytic parameters in the acute phase of TBI and to elucidate parameter relationships to prognosis. We retrospectively evaluated 234 patients with severe isolated TBI with initial blood samples obtained no more than 1 h after injury. Platelet count, prothrombin time, activated partial thromboplastin time (aPTT), plasma levels of fibrinogen, and D-dimer were measured on arrival in the emergency department and 3, 6, and 12 h after injury...
April 1, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/26067457/predicting-progressive-hemorrhagic-injury-from-isolated-traumatic-brain-injury-and-coagulation
#18
Lindley E Folkerson, Duncan Sloan, Bryan A Cotton, John B Holcomb, Jeffrey S Tomasek, Charles E Wade
BACKGROUND: Progressive hemorrhagic injury (PHI) in traumatic brain injury (TBI) patients is associated with poor outcomes. Early prediction of PHI is difficult yet vital. We hypothesize that TBI subtype and coagulation would be predictors of PHI. METHODS: This was a retrospective analysis of highest level activation adult trauma patients with evidence of TBI (head Abbreviated Injury Scale ≥3). Coagulopathy was determined using rapid thrombelastography (r-TEG), complete blood counts, and conventional coagulation tests obtained on arrival...
September 2015: Surgery
https://www.readbyqxmd.com/read/25883229/the-traumatic-side-of-fibrinolysis
#19
COMMENT
Robert L Medcalf
In this issue of Blood, Hijazi et al challenge the view that consumptive coagulopathy that accompanies traumatic brain injury (TBI) results in a sequence of events that lead to intracranial hemorrhage (ICH).
April 16, 2015: Blood
https://www.readbyqxmd.com/read/25710435/preinjury-warfarin-but-not-antiplatelet-medications-increases-mortality-in-elderly-traumatic-brain-injury-patients
#20
Ramesh Grandhi, Gillian Harrison, Zoya Voronovich, Joshua Bauer, Stephanie H Chen, Dederia Nicholas, Louis H Alarcon, David O Okonkwo
BACKGROUND: Previous studies of traumatic brain injury (TBI) outcomes in elderly patients on oral antithrombotic (OAT) therapies have yielded conflicting results. Our objective was to examine the effect of premorbid OAT medications on outcomes among elderly TBI patients with intracranial hemorrhage. METHODS: We performed a retrospective analysis of elderly TBI patients (≥65 years) with closed head injury and evidence of brain hemorrhage on computed tomography scan from 2006 to 2010...
March 2015: Journal of Trauma and Acute Care Surgery
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