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REVIEW
Kelly E Hall, Claire Tucker, Julie A Dunn, Tracy Webb, Sarah A Watts, Emrys Kirkman, Julien Guillaumin, Guillaume L Hoareau, Heather F Pidcoke
Trauma is a common cause of morbidity and mortality in humans and companion animals. Recent efforts in procedural development, training, quality systems, data collection, and research have positively impacted patient outcomes; however, significant unmet need still exists. Coordinated efforts by collaborative, translational, multidisciplinary teams to advance trauma care and improve outcomes have the potential to benefit both human and veterinary patient populations. Strategic use of veterinary clinical trials informed by expertise along the research spectrum (i...
2024: Journal of Clinical and Translational Science
#2
JOURNAL ARTICLE
Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati
BACKGROUND: Microparticles (MPs) have been implicated in thrombosis and endothelial dysfunction. Their involvement in early coagulopathy and in worsening of outcomes in isolated severe traumatic brain injury (sTBI) patients remains ill defined. OBJECTIVE: We sought to quantify the circulatory MP subtypes derived from platelets (PMPs; CD42), endothelial cells (EMPs; CD62E), and those bearing tissue factor (TFMP; CD142) and analyze their correlation with early coagulopathy, thrombin generation, and in-hospital mortality...
March 1, 2024: Neurology India
#3
JOURNAL ARTICLE
Mikael Levy, Esther Arfi Levy, Neelan J Marianayagama, Vladimir Frolov, Shimon Maimon, Ophira Salomon
OBJECTIVE: To determine the role of platelet counts in the context of the decision to treat patients with non-compounded, non-surgically-treated blunt traumatic brain injury (NCNS-bTBI) with anticoagulants/antiaggregants. METHODS: A retrospective analysis of 141 anticoagulants/antiaggregants-naïve patients with NCNS-bTBI. Changes in PT-INR and prolonged aPTT were examined and correlated with Marshall and Rotterdam scores, clinical and neuroradiological outcomes...
April 28, 2024: Brain Injury
#4
Ali M Hassan, Chad W Donley, Praveen Venkatachalam
BACKGROUND: Epistaxis is a frequent presenting complaint in the Emergency Department (ED). Roughly 60% of the population will suffer from epistaxis in their lifetime. The most common causes of epistaxis include nose picking, facial trauma, foreign bodies, and coagulopathies. There are other causes that are much less common, such as intracranial pseudoaneurysms. There are multiple causes that precipitate intracranial pseudoaneurysm formation, with head trauma accounting for less than 1% of inciting events...
2024: Open Access Emergency Medicine: OAEM
#5
JOURNAL ARTICLE
Asanthi M Ratnasekera, Sirivan S Seng, Daniel Kim, Wenyan Ji, Christina L Jacovides, Elinore J Kaufman, Hannah M Sadek, Lindsey L Perea, Christina Monaco Poloni, Ilya Shnaydman, Alexandra Jeongyoon Lee, Victoria Sharp, Angela Miciura, Eric Trevizo, Martin G Rosenthal, Lawrence Lottenberg, William Zhao, Alicia Keininger, Michele Hunt, John Cull, Chassidy Balentine, Tanya Egodage, Aleem T Mohamed, Michelle Kincaid, Stephanie Doris, Robert Cotterman, Sara Seegert, Lewis E Jacobson, Jamie Williams, Melissa Moncrief, Brandi Palmer, Caleb Mentzer, Nichole Tackett, Tjasa Hranjec, Thomas Dougherty, Shawna Morrissey, Lauren Donatelli-Seyler, Amy Rushing, Leah C Tatebe, Tiffany J Nevill, Michel B Aboutanos, David Hamilton, Diane Redmond, Daniel C Cullinane, Carolyne Falank, Mark McMellen, Chris Duran, Jennifer Daniels, Shana Ballow, Kevin M Schuster, Paula Ferrada
BACKGROUND: In patients with severe traumatic brain injury (TBI), clinicians must balance preventing venous thromboembolism (VTE) with the risk of intracranial hemorrhagic expansion (ICHE). We hypothesized that low molecular weight heparin (LMWH) would not increase risk of ICHE or VTE as compared to unfractionated heparin (UH) in patients with severe TBI. METHODS: Patients ≥ 18 years of age with isolated severe TBI (AIS ≥ 3), admitted to 24 level I and II trauma centers between January 1, 2014 to December 31, 2020 and who received subcutaneous UH and LMWH injections for chemical venous thromboembolism prophylaxis (VTEP) were included...
April 9, 2024: Injury
#6
Nicholas Dietz, Meghan Blank, William Asaka, Brent G Oxford, Dale Ding, Emily Sieg, Heidi M Koenig
Hypothermia in a trauma patient has been associated with increased morbidity and mortality and is more frequently seen in those sustaining traumatic brain injuries (TBIs). Acidosis is an important consequence of hypothermia that leads to derangements across the spectrum of the coagulation cascade. Here, we present a case of a 31-year-old male presented after suffering a right parietal penetrating ballistic injury with an associated subdural hematoma and 7 mm midline shift requiring decompressive craniectomy and external ventricular drain (EVD) placement in the setting of severe hypothermia (28°C) and acidosis (pH 7...
March 2024: Curēus
#7
JOURNAL ARTICLE
Eric Lee, Daniel Hart, Andrea Ruggiero, Oonagh Dowling, Gavriel Ausubel, Jonathan Preminger, Chad Vitiello, Linda Shore-Lesserson
OBJECTIVES: To understand if red blood cell (RBC) transfusions are independently associated with a risk of mortality, prolonged intubation, or infectious, cardiac, or renal morbid outcomes. DESIGN: A retrospective review. SETTING: A single-institution university hospital. PARTICIPANTS: A total of 2,458 patients undergoing coronary bypass artery graft and/or valvular surgery from July 2014 through January 2018. INTERVENTIONS: No interventions were done...
March 8, 2024: Journal of Cardiothoracic and Vascular Anesthesia
#8
JOURNAL ARTICLE
Mats L Moskopp, Dag Moskopp, Lennart W Sannwald
INTRODUCTION: Initial management of traumatic brain injury (TBI) without immediate need for surgical therapy varies across centers. The additional value of routine repeat cranial computerized tomography (CT) to neurological monitoring is controversial. This retrospective study investigates the impact of routine follow-up CT after 6 h (CT6h) in initially conservatively managed TBI on surgical decision making. Furthermore, the impact of coagulopathy on lesion size and progression was examined...
March 26, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
#9
JOURNAL ARTICLE
Geoffrey P Dobson, Jodie L Morris, Hayley L Letson
Severe burn injury elicits a profound stress response with the potential for high morbidity and mortality. If polytrauma is present, patient outcomes appear to be worse. Sex-based comparisons indicate females have worse outcomes than males. There are few effective drug therapies to treat burn shock and secondary injury progression. The lack of effective drugs appears to arise from the current treat-as-you-go approach rather than a more integrated systems approach. In this review, we present a brief history of burns research and discuss its pathophysiology from a systems' perspective...
March 22, 2024: Journal of Burn Care & Research: Official Publication of the American Burn Association
#10
REVIEW
Jessie W Ho, Zaiba Shafik Dawood, Meredith E Taylor, Marjorie R Liggett, Guang Jin, Dinesh Jaishankar, Satish N Nadig, Ankit Bharat, Hasan B Alam
Severe traumatic brain injury (TBI) often initiates a systemic inflammatory response syndrome, which can potentially culminate into multiorgan dysfunction. A central player in this cascade is endotheliopathy, caused by perturbations in homeostatic mechanisms governed by endothelial cells due to injury-induced coagulopathy, heightened sympathoadrenal response, complement activation, and proinflammatory cytokine release. Unique to TBI is the potential disruption of the blood-brain barrier, which may expose neuronal antigens to the peripheral immune system and permit neuroinflammatory mediators to enter systemic circulation, propagating endotheliopathy systemically...
March 1, 2024: Shock
#11
JOURNAL ARTICLE
Chun-Yu Lin, Ming-Chang Kao, Hsin-Fu Lee, Meng-Yu Wu, Chi-Nan Tseng
BACKGROUND: Acute type A aortic intramural hematoma (ATAIMH) is a variant of acute type A aortic dissection (ATAAD), exhibiting an increased risk of hemopericardium and cardiac tamponade. It can be life-threatening without emergency treatment. However, comprehensive studies of the clinical features and surgical outcomes of preoperative hemopericardium in patients with ATAIMH remain scarce. This retrospective study aims to investigate the clinical features and early and late outcomes of patients who underwent aortic repair surgery for ATAIMH complicated with preoperative hemopericardium...
March 13, 2024: Journal of Cardiothoracic Surgery
#12
REVIEW
Monica Christine Ciorba, Marc Maegele
BACKGROUND: Inadequate clinical experience still causes uncertainty in the acute diagnostic evaluation and treatment of polytrauma in children (with or without coagulopathy). This review deals with the main aspects of the acute care of severely injured children in the light of current guidelines and other relevant literature, in particular airway control, volume and coagulation management, acute diagnostic imaging, and blood coagulation studies in the shock room. METHODS: This review is based on literature retrieved by a selective search in PubMed, Medline (OVIDSP), the Cochrane Central Register of Controlled Trials, and Epistemonikos covering the period January 2001 to August 2023...
May 17, 2024: Deutsches Ärzteblatt International
#13
JOURNAL ARTICLE
Omid Yousefi, Amirmohammad Farrokhi, Reza Taheri, Hadis Ghasemi, Sina Zoghi, Asma Eslami, Amin Niakan, Hosseinali Khalili
In patients affected by traumatic brain injury (TBI), hypofibrinogenemia within the initial hours of trauma can be expected due to vascular and inflammatory changes. In this study, we aimed to evaluate the effect of hypofibrinogenemia on the in-hospital mortality and 6-month functional outcomes of TBI patients, admitted to Rajaee Hospital, a referral trauma center in Shiraz, Iran. This study included all TBI patients admitted to our center who had no prior history of coagulopathy or any systemic disease, were alive on arrival, and had not received any blood product before admission...
February 28, 2024: Neurosurgical Review
#14
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
#15
JOURNAL ARTICLE
Bahadar S Srichawla, Kendall Presti, Vincent Kipkorir, Idanis Berrios Morales
RATIONALE: Hodgkin lymphoma, a lymphatic system cancer, is treated by chemotherapy, radiation therapy, and hematopoietic stem cell transplantation. Posterior reversible encephalopathy syndrome (PRES) is a rare neurotoxic effect associated with several drugs and systemic conditions. This case study emphasizes the potential risks of intensive chemotherapy regimens and postulates the impact of the circle of Willis variants on the heterogeneity of hemispheric lesions in PRES. PATIENT CONCERNS: A 42-year-old woman diagnosed with stage IIA nodular sclerosing Hodgkin lymphoma and chronic thrombocytopenia presented after 6 years of initial diagnosis and 4 years post-haploidentical transplant...
February 23, 2024: Medicine (Baltimore)
#16
JOURNAL ARTICLE
Fanjian Li, Lei Li, Ruilong Peng, Chuan Liu, Xiao Liu, Yafan Liu, Cong Wang, Jianye Xu, Qiaoling Zhang, Guili Yang, Ying Li, FangLian Chen, Shenghui Li, Weiyun Cui, Li Liu, Xin Xu, Shu Zhang, Zilong Zhao, Jianning Zhang
Traumatic brain injury (TBI) can induce systemic coagulopathy and inflammation, thereby increasing the risk of mortality and disability. However, the mechanism causing systemic coagulopathy and inflammation following TBI remains unclear. In prior research, we discovered that brain-derived extracellular vesicles (BDEVs), originating from the injured brain, can activate the coagulation cascade and inflammatory cells. In this study, we primarily investigated how BDEVs affect systemic coagulopathy and inflammation in peripheral circulation...
February 21, 2024: International Immunopharmacology
#17
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
#18
JOURNAL ARTICLE
Arianexys Aquino López, Clay T Cohen, Amanda Small, Fong Wilson Lam, Angela N Bachim
For infants that present with intracranial hemorrhage in the setting of suspected abusive head trauma (AHT), the standard recommendation is to perform an evaluation for a bleeding disorder. Factor XIII (FXIII) deficiency is a rare congenital bleeding disorder associated with intracranial hemorrhages in infancy, though testing for FXIII is not commonly included in the initial hemostatic evaluation. The current pediatric literature recognizes that trauma, especially traumatic brain injury, may induce coagulopathy in children, though FXIII is often overlooked as having a role in pediatric trauma-induced coagulopathy...
February 6, 2024: Child Abuse & Neglect
#19
JOURNAL ARTICLE
Sai Krishna Bhogadi, Adam Nelson, Hamidreza Hosseinpour, Tanya Anand, Omar Hejazi, Christina Colosimo, Audrey L Spencer, Michael Ditillo, Louis J Magnotti, Bellal Joseph
INTRODUCTION: This study aims to evaluate effect of 4-factor PCC on outcomes of severe TBI patients on preinjury anticoagulants undergoing craniotomy/craniectomy. METHODS: In this analysis of 2018-2020 ACS-TQIP, patients with isolated blunt severe TBI (Head-AIS≥3, nonhead-AIS<2) using preinjury anticoagulants who underwent craniotomy/craniectomy were identified and stratified into PCC and No-PCC groups. Outcomes were time to surgery and mortality. Multivariable binary logistic and linear regression analyses were performed...
January 30, 2024: American Journal of Surgery
#20
JOURNAL ARTICLE
Yoonjung Heo, Sung Wook Chang, Seok Won Lee, Dae Sung Ma, Dong Hun Kim
BACKGROUND: Fibrinogen concentrate (FC) can be administered during massive transfusions to manage trauma-induced coagulopathy. However, its effectiveness in survival remains inconclusive due to scarce high-level evidence. This study aimed to investigate the hemostatic effects of FC regarding mortality in massive hemorrhage caused by trauma. METHODS: This retrospective study analyzed 839 patients who received massive transfusions (red blood cells (RBCs) ≥5 units in 4 hours or ≥10 units in 24 hours) at a level I trauma center between 2015 and 2022...
2024: Trauma Surgery & Acute Care Open
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