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The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital
Published in Stephen M Cohn, Ara J. Feinstein, 50 Landmark Papers every Trauma Surgeon Should Know, 2019
MA Borgman, PC Spinella, JG Perkins, KW Grathwohl, T Repine, AC Beekley, J Sebesta, D Jenkins, CE Wade, JB. Holcomb, J Trauma
Background Patients with severe traumatic injuries often present with coagulopathy and require massive transfusion. The risk of death from hemorrhagic shock increases in this population. To treat the coagulopathy of trauma, some have suggested early, aggressive correction using a 1:1 ratio of plasma to red blood cell (RBC) units.
Thoracolumbar spine injury
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Monica S. Tandon, Priyanka Khurana
Hemorrhagic shock: Associated injuries, eg, chest injuries; retroperitoneal or intra-abdominal trauma (visceral or vascular); pelvic and/or long bone fractures; external bleeding, eg, laceration of the scalp vessels, vascular injury
Truncal vascular trauma
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
Penetrating injuries to the great vessels are found in approximately 5% of thoracic gunshot wounds and 2% of thoracic stab wounds.8 Many patients arrive to definitive care in hemorrhagic shock requiring rapid treatment and emergent surgery for hemorrhage control. Some patients arrive with stable hemodynamics and often remain stable throughout their workup. Stable patients can undergo imaging studies, such as computed tomography angiography (CTA), to help define the injury and plan an optimal operative strategy for repair. Unstable patients can undergo a sternotomy with supraclavicular or neck extension enabling rapid control of proximal great vessels bilaterally, although many favor a left anterolateral thoracotomy to control the proximal left subclavian artery (SCA). The internal mammary artery should always be inspected to rule out injury as a cause of hemorrhagic shock.9
Tourniquet Application for Bleeding Control in a Rural Trauma System: Outcomes and Implications for Prehospital Providers
Published in Prehospital Emergency Care, 2022
Hala Bedri, Hadeal Ayoub, Jacklyn M. Engelbart, Michele Lilienthal, Colette Galet, Dionne A. Skeete
Uncontrolled major bleeding leading to hemorrhagic shock is one of the leading causes of preventable death in the trauma setting (1). In fact, hemorrhage is responsible for up to 40% of trauma deaths (2–4). Recent military studies show that tourniquet use before the onset of shock is associated with better survival outcomes counteracting historical concerns (5,6). Furthermore, prehospital tourniquet application for hemorrhagic control in limb trauma has been associated with better survival than tourniquets applied in the emergency department (6). As a result, tourniquet use for hemorrhage control in civilians has been increasingly utilized by emergency responders (7,8). The revival of tourniquet use in the civilian population was evaluated by Schroll et al. who analyzed 197 adult patients from nine urban Level 1 trauma centers (9). They found that the mean time from tourniquet placement to emergency department arrival was 48 minutes and concluded that tourniquets were applied safely and effectively in 88.8% of the patients. Similar safety and effectiveness results were observed by Kue et al. (10). Tourniquet use in the civilian population is now broadly accepted in the US and abroad (4,11,12).
Thromboelastometry in trauma care: a place in the 2018 Belgian health care system?
Published in Acta Clinica Belgica, 2018
Martin Lucien Tonglet, Jean-Louis Poplavsky, Laurence Seidel, Jean Marc Minon, Vincenzo D’Orio, Alexandre Ghuysen
Hemorrhagic shock was assessed by the attending physician at the time of hospital admission on the basis of persistent hypotension due to proven active bleeding. The transfusion of more than five Red Blood Cells (RBC) units and more than three fresh frozen plasma (FFP) units within the first hour of care was defined as an emergent transfusion. The global need for transfusion within the first 24 h was also recorded. Surgical or endovascular hemostatic procedures were recorded throughout hospitalization. Patients who died because of a confirmed hemorrhagic shock at the early phase of care in the resuscitation room before being able to benefit from surgery were classified as needing emergent surgical hemostasis and blood product transfusion.
In vitro and in vivo investigation of the novel Dex-bHb as oxygen carriers
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2018
Jun Zhang, Ying Wang, Shan Zhang, Guo-Xing You, Peng-Long Li, Quan Wang, Wei-Li Yu, Tao Hu, Hong Zhou, Lian Zhao
Hemorrhagic shock is a life-threatening condition resulting from decreasing blood volume, which could induce tissue perfusion reducing, cellular hypoxia and organ damage [20]. The biological availability of the novel Dex-bHb, was analysed by the hemorrhage shock model in Syrian golden hamsters. From the results of MAP, the infusion of Dex-bHb showed a positive effect during the hypotensive shock state compared with infusion of NS. It is because that NS could not maintain the MAP for a long duration because of extravascular effusion [15], while the novel Dex-bHb is good at volume expansion. As we know, bleeding impairs the delivery of oxygen to the tissues [21].