Tag: hemorrhage
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
Hyperchloremia Is Associated With AKI in Patients With Subarachnoid Hemorrhage
Critically ill patients with subarachnoid hemorrhage show a strong association between hyperchloremia and acute kidney injury as well as acute kidney injury and mortality. Of 1,267 patients included in this cohort, 16.7%... read more
Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock
Use of vasopressor for traumatic hemorrhagic shock was associated with mortality after controlling for biases (trauma severity; volume of fluid resuscitation). Among 236,698 trauma patients, 3,551 were included in the... read more
First Portable MRI Scanner for Neuro ICU
Health technology incubator Hyperfine Research and the Yale School of Medicine are testing out a first-of-its-kind, portable MRI scanner in the neuro intensive care unit (ICU). The point-of-care system, designed by Hyperfine,... read more
Reversal of Oral Anticoagulation in Patients with Acute Intracerebral Hemorrhage
In light of an aging population with increased cardiovascular comorbidity, the use of oral anticoagulation (OAC) is steadily expanding. A variety of pharmacological alternatives to vitamin K antagonists (VKA) have emerged... read more
Outcomes and Costs of Patients Admitted to the ICU Due to Spontaneous Intracranial Hemorrhage
Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little... read more
Is Pre-hospital Coagulation Management in Trauma Feasible?
Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more
Catheter-Directed Therapy for PE Built on Fallacy
Tissue plasminogen activator has a notoriously checkered past within emergency medicine, and its controversial use continues with the advent of targeted therapy for pulmonary embolism. Catheter-directed administration of... read more
Mortality of civilian patients with suspected traumatic hemorrhage receiving pre-hospital transfusion of packed red blood cells compared to pre-hospital crystalloid
In a single centre UK HEMS study, in patients with suspected traumatic hemorrhage who received a PRBC transfusion there was an observed, but non-significant, reduction in mortality at 6 h and 28 days, also reflected in... read more
Blood test may obviate need for head CTs in brain trauma evaluation
A biomarker test based on the presence of two proteins in the blood appears to be suitable for ruling out significant intracranial injuries in patients with a history of mild traumatic brain injury (TBI) without the need... read more
