Tag: hemorrhage
Oral Vitamin K Lowers the International Normalized Ratio More Rapidly
Oral vitamin K lowers INR more rapidly than subcutaneous vitamin K in asymptomatic patients who have supratherapeutic INR values while receiving warfarin. Warfarin therapy was withheld, and 1 mg of vitamin K was given... read more
Clinical and Pathophysiologic Aspects of ECMO-associated Hemorrhagic Complications
Extracorporeal membrane oxygenation (ECMO) is increasingly used to treat severe cases of acute respiratory or cardiac failure. Hemorrhagic complications represent one of the most common complications during ECMO, and can... read more
Viscoelastic Hemostatic Assay Augmented Protocols for Major Trauma Hemorrhage
Our international randomized trial has evaluated the role of VHAs to individualize care and augment empiric hemostatic resuscitation in the challenging and time-critical environment of trauma care. Empiric haemostatic therapy... read more
TEG for Hypocoagulable Patients with Non-Traumatic Bleeding
Thromboelastogram (TEG) has been extensively studied in trauma and surgical patients, but has not been well studied in nontraumatic bleeding, nor has its use been well evaluated in the emergency department. This study... read more
Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding
In patients with high risk upper GI bleeding, who were treated with pre-endoscopy PPI and were not in persistent shock, an endoscopy performed at a median of 10 hours vs. a median of 25 hours post presentation did not reduce... read more
Acute on Chronic Liver Failure in the ICU
Liver Failure may constitute one of the least favorite disease processes for anyone routinely taking care of critically ill patients. Intensivist and hepatology circles have begun to describe a specific population known as... read more
Intracerebral Hemorrhage (ICH)
For most patients, the best treatment seems to be high-quality supportive care. Aggressive interventions (e.g., causing dramatic drops in blood pressure and "prophylactic" hypertonic saline) may cause more harm than good. Cerebellar... read more
Hydrocortisone Prevents Immunosuppression by interleukin-10+ Natural Killer Cells After Trauma-Hemorrhage
These data demonstrate that trauma-induced immunosuppression is characterized by an interleukin-10-dependent elimination of dendritic cell by natural killer cells and that hydrocortisone improves outcome by limiting this... read more
The Misunderstood Coagulopathy of Liver Disease
In patients with abnormal coagulation testing results in the setting of liver disease, INR and PT may be best used to provide the practitioner with information about the synthetic function of the liver but not to assess hemorrhagic... read more
eFAST Performance with a Novel vs. Conventional Transducers
Point-of-injury extended focused assessment with sonography in trauma (eFAST) may identify life-threatening torso hemorrhage and expedite casualty evacuation. The purpose of this study was to compare combat medic eFAST performance... read more
Glucose Variability as Measured by Inter-measurement Percentage Change is Predictive of In-patient Mortality in Aneurysmal Subarachnoid Hemorrhage
Reduced glucose variability is highly correlated with in-patient survival and long-term mortality in subarachnoid hemorrhage (aSAH) patients. This finding was observed in the non-diabetic and well-controlled diabetic patients,... read more
Tranexamic Acid Has Nominal Benefit for TBI
Studies examining the use of tranexamic acid (TXA) inescapably seem to pit our rigorous methodological demons against our practical clinical angels. The CRASH-2 trial randomized 20,211 adult trauma patients presenting... read more
Fixing Hypernatremia: Acting Fast or Acting Slow?
This is the largest adult cohort study focusing on the neurologic complications and mortality after hypernatremia correction in critically ill adults. There wasn't any evidence that rapid correction of hypernatremia was... read more
Prognostic Value of Spreading Depolarizations in Patients With Severe TBI
In this cohort study of patients with acute brain trauma, spreading depolarizations were predominant but heterogeneous and independently associated with poor neurologic recovery. Monitoring the occurrence of spreading depolarizations... read more
Quantitative EEG for Detection of Brain Ischemia
Electroencephalography (EEG) is a very promising tool for monitoring brain function in real-time in the ICU. There are characteristic changes that occur on EEG in response to brain ischemia, correlating with CBF and brain... read more
Vasopressin for Acute Hemorrhage?
Vasoactive medications are one of the pillars of management of shock in Emergency Departments. Inopressors, namely Norepinephrine and Epinephrine, are the two most commonly used pressors in US Emergency Departments, used... read more
Modeling Cardiac Dysfunction Following Traumatic Hemorrhage Injury
Cardiac dysfunction (CD) importantly contributes to mortality in trauma patients, who survive their initial injuries following successful hemostatic resuscitation. This poor outcome has been correlated with elevated biomarkers... read more
