Tag: hemorrhage
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
The Contemporary Timing of Trauma Deaths
In this study, the distribution of trauma deaths no longer appears to be trimodal. This may reflect advances in trauma and ICU care, and the widespread adaption of damage control principles. Early deaths, however, remains... read more
Haemostatic Resuscitation in Trauma: The Next Generation
The next generation of haemostatic resuscitation aims at applying a ratio 1:1:1 driven strategy while using antifibrinolytics, haemostatic monitoring and avoiding critical fibrinogen deficiency by substitution. Mortality... read more
Scavenging Circulating Mitochondrial DNA as a Potential Therapeutic Option for Multiple Organ Dysfunction in Trauma Hemorrhage
Trauma is a leading cause of death worldwide with 5.8 million deaths occurring yearly. Almost 40% of trauma deaths are due to bleeding and occur in the first few hours after injury. Of the remaining severely injured patients... read more
Novel Oral Anticoagulants and Trauma
The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants... read more
Emergency Management of Intracerebral Hemorrhage – The Golden Hour
There is a kind of self-fulfilling prognostic pessimism when it comes to Intracerebral Hemorrhage. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome... read more
Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage
This guideline provides timely, evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage. Utilizing the GRADE methodology, the committee developed... read more
Hemorrhagic Shock: Pearls and Pitfalls for the Resuscitation Room
Hemorrhagic shock is a state of systemic hypoperfusion secondary to acute blood loss which may have either traumatic or atraumatic etiologies. While gastrointestinal and traumatic etiologies are some of the most common causes... read more
Early Hemorrhage Control and Management of Trauma-induced Coagulopathy
Trauma resuscitation should focus on early goal-directed therapy with use of viscoelastic hemostatic assays while initially applying a ratio 1:1:1 driven transfusion therapy (with red blood cells, plasma and platelets) in... read more
Cerebral Autoregulation in the Prediction of Delayed Cerebral Ischemia and Clinical Outcome in Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients
High initial pressure reactivity index, presumably reflecting early brain injury, but not oxygen reactivity index, was associated with delayed cerebral ischemia and worse clinical outcome in poor-grade subarachnoid hemorrhage... read more
Treating Acid–Base Abnormalities in the ICU
Acidemia has both harmful and beneficial biological effects. Sodium bicarbonate is generally ineffective in raising pH when ventilation is limited, as in patients with ARDS. Even when alkalinizing agents can correct the pH,... read more
Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe hemorrhage
Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. We obtained data for 40,138 patients from two randomised... read more
Clinical Experience With IV Angiotensin II Administration
Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. This is a systematic review of the safety of IV angiotensin II. Adverse events associated with angiotensin II were infrequent; however, exacerbation... read more
Protocol-based Invasive Intracranial Pressure Monitoring in Acute Liver Failure
Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial... read more
Low-volume Resuscitation with Normal Saline is Associated with Microvascular Endothelial Dysfunction After Hemorrhage
Low-volume resuscitation with normal saline is associated with microvascular endothelial dysfunction after hemorrhage in rats, compared to colloids and balanced crystalloids. Resuscitation with NS failed to inhibit syndecan-1... read more
Mechanical Thrombectomy for Acute Ischemic Stroke
Coutinho et al have performed a timely post hoc analysis consisting of a patient population from 2 large, prospective, core laboratory–adjudicated trials: Solitaire With the Intention for Thrombectomy (SWIFT) and Solitaire... read more
Risk of hemorrhage with statins and stroke prevention drug combination
Two commonly used statins can increase the risk of hemorrhage when combined with dabigatran etexilate, a drug often used for preventing stroke in patients with atrial fibrillation.... read more
