QS371. Effects of a Hypotensive Resusciation Strategy on Peripheral Leukocyte Apoptosis in Trauma Patients With Hemorrhagic Shock

Background To compare the main outcomes of trauma patients with and without traumatic brain injury (TBI), hemorrhagic shock, and the combination of both using data from the Spanish trauma intensive care unit (ICU) registry (RETRAUCI). Methods Patients admitted to the participating ICUs from March 2015 to May 2019 were included in the study. The main outcomes were analyzed according to the presence of TBI, hemorrhagic shock, and/or both. Comparison of groups with quantitative variables was performed using the Kruskal-Wallis test, and differences between groups with categorical variables were compared using the Chi-square test or Fisher’s exact test as appropriate. A P value <.05 was considered significant. Results Overall, 310 patients (3.98%) were presented with TBI and hemorrhagic shock. Patients with TBI and hemorrhagic shock received more red blood cell (RBC) concentrates, fresh frozen plasma (FFP), a higher ratio FFP/RBC, and had a higher incidence of trauma-induced coagulopathy (60%) ( P < .001). These patients had higher mortality ( P < .001). Intracranial hypertension was the leading cause of death (50.4%). Conclusions Concomitant TBI and hemorrhagic shock occur in nearly 4% of trauma ICU patients. These patients required a higher amount of RBC concentrates and FFP and had an increased mortality.

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Association of Prehospital Plasma Transfusion With Survival in Trauma Patients With Hemorrhagic Shock When Transport Times Are Longer Than 20 Minutes

JAMA Surgery ◽

10.1001/jamasurg.2019.5085 ◽

2020 ◽

Vol 155 (2) ◽

pp. e195085 ◽

Cited By ~ 13

Author(s):

Anthony E. Pusateri ◽

Ernest E. Moore ◽

Hunter B. Moore ◽

Tuan D. Le ◽

Francis X. Guyette ◽

...

Keyword(s):

Hemorrhagic Shock ◽

Trauma Patients ◽

Plasma Transfusion

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Preoperative fluid restriction for trauma patients with hemorrhagic shock decreases ventilator days

Acute Medicine & Surgery ◽

10.1002/ams2.328 ◽

2018 ◽

Vol 5 (2) ◽

pp. 154-159 ◽

Cited By ~ 1

Author(s):

Shigenari Matsuyama ◽

Ryusuke Miki ◽

Hirotada Kittaka ◽

Haruki Nakayama ◽

Shota Kikuta ◽

...

Keyword(s):

Hemorrhagic Shock ◽

Fluid Restriction ◽

Trauma Patients

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Peripheral Leukocyte Apoptosis in Patients with Parkinsonism: Correlation with Clinical Characteristics and Neuroimaging Findings

BioMed Research International ◽

10.1155/2014/635923 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Wei-Che Lin ◽

Nai-Wen Tsai ◽

Yung-Cheng Huang ◽

Kuei-Yueh Cheng ◽

Hsiu-Ling Chen ◽

...

Keyword(s):

Neurodegenerative Disease ◽

Functional Status ◽

Peripheral Blood ◽

Clinical Characteristics ◽

Peripheral Blood Leukocyte ◽

Leukocyte Apoptosis ◽

Peripheral Leukocyte ◽

Treatment And Prevention ◽

Duration Of Disease ◽

Blood Leukocyte

Apoptosis of both brain neurons and peripheral blood leukocyte is believed to be an important biomarker for evaluating the functional status of Parkinson’s disease (PD). However, their correlation remains unknown. A better understanding of the pathophysiology of neurodegeneration is essential for the treatment and prevention of PD. The present study demonstrated that leukocyte apoptosis is significantly higher in PD patients and is associated with central dopamine neuron loss by usingTc99m-TRODAT-1 SPECT. The leukocyte apoptosis and striatal dopamine transporter uptake ratios were further associated with increased severity and longer duration of disease. The interaction between brain and systemic inflammation may be responsible for the neurodegenerative disease progression.

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Emergency Department Crowding and the Performance of Damage Control Resuscitation in Major Trauma Patients With Hemorrhagic Shock

Academic Emergency Medicine ◽

10.1111/acem.12726 ◽

2015 ◽

Vol 22 (8) ◽

pp. 915-921 ◽

Cited By ~ 15

Author(s):

Dingqian Wu ◽

Xiaoxia Zhou ◽

Ligang Ye ◽

Jianxin Gan ◽

Mao Zhang

Keyword(s):

Emergency Department ◽

Hemorrhagic Shock ◽

Major Trauma ◽

Damage Control ◽

Trauma Patients ◽

Damage Control Resuscitation ◽

Emergency Department Crowding

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Increased Neutrophil Adenosine A3 Receptor Expression Is Associated With Hemorrhagic Shock and Injury Severity in Trauma Patients

Shock ◽

10.1097/shk.0b013e318231ee2e ◽

2011 ◽

Vol 36 (5) ◽

pp. 435-439 ◽

Cited By ~ 14

Author(s):

Eileen M. Bulger ◽

Cindy M. Tower ◽

Keir J. Warner ◽

Tara Garland ◽

Joseph Cuschieri ◽

...

Keyword(s):

Hemorrhagic Shock ◽

Injury Severity ◽

Receptor Expression ◽

Trauma Patients ◽

Adenosine A3 Receptor

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Are Aorta Artery Diameter and Inferior Vena Cava Diameter a Reliable Predictor index in Traumatic Patients with Hemorrhagic Shock?

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2021.014 ◽

2021 ◽

Vol 9 (1) ◽

pp. 14-14

Author(s):

Kavous Shahsavarinia ◽

Peyman Habibi ◽

Ali Taghizadieh ◽

Payman Moharamzadeh ◽

Farzad Rahmani ◽

...

Keyword(s):

Inferior Vena Cava ◽

Hemorrhagic Shock ◽

Inferior Vena ◽

Vena Cava ◽

Cross Sectional Study ◽

Trauma Patients ◽

Odds Ratios ◽

Cross Sectional ◽

Unit Increase ◽

Ordinal Regression Model

Background: Intravascular volume is the most important factor in determining patients' hemodynamic status. This present study aimed to assay the predictive value of aorta artery diameter and inferior vena cava (IVC) diameter in trauma patients with hemorrhagic shock. Materials and Methods: This was a cross-sectional study conducted on 69 trauma patients who referred to Imam Reza Hospital in Tabriz. Inclusion criteria were all trauma patients with hemorrhagic shock. Patients with diseases such as liver disease,cardiovascular,coronary heart disease and concurrent dehydration were excluded. Odds ratios and Adjusted odds ratios for the risk of events were obtained using cumulative logit ordinal regression model with version 15 of Stata software. Results: There were 58 men (84/1%) and 11 women (15/9%) with an average age of 36.4±12.4 year. Findings showed that for one unit increase in the diameter of the aorta by controlling the effect of other variables, the odds of mortality decreased for 2% compared with hospitalization in ward or intensive care unit (ICU). The reduction was also statistically significant (P=0.037). Furthermore, by modifying the effect of other variables, one unit increase in the diameter of IVC during inhale and exhale, increases the odds of hospitalization in ward or ICU. Conclusion: This study showed that the diameter of the aorta and also the diameter of IVC during inhale and exhale can be used to predict the outcome of trauma patients with hemorrhagic shock and eventually to take steps for emergent and effective treatment.

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Is the Whole Greater than the Sum of Its Parts? The Implementation and Outcomes of a Whole Blood Program in Ecuador

10.21203/rs.3.rs-66244/v2 ◽

2021 ◽

Author(s):

Amber Nicole Himmler ◽

Monica Eulalia Galarza Armijos ◽

Jeovanni Reinoso Naranjo ◽

Sandra Gioconda Peña Patiño ◽

Doris Sarmiento Altamirano ◽

...

Keyword(s):

Latin America ◽

Hemorrhagic Shock ◽

Whole Blood ◽

Vital Signs ◽

Human Albumin ◽

Acute Care Surgery ◽

Trauma Patients ◽

Transfusion Reaction ◽

Shock Index ◽

Care Surgery

Abstract Background: Hemorrhagic shock is a major cause of mortality in low-and-middle-income countries (LMICs). Many institutions in LMICs lack the resources to adequately prescribe balanced resuscitation. This study aims to describe the implementation of a whole blood program in Latin America and to discuss the outcomes of the patients that received whole blood (WB).Methods: We conducted a retrospective review of patients resuscitated with WB from 2013-2019. Five units of O+ WB were made available on a consistent basis for patients presenting in hemorrhagic shock. Variables collected included: gender, age, service treating the patient, units of WB administered, units of components administered, admission vital signs, admission hemoglobin, Shock Index, Revised Trauma Score (RTS) in trauma patients, intraoperative crystalloid (lactated ringers or normal saline) and colloid (5% human albumin) administration, symptoms of transfusion reaction, length-of-stay and in-hospital mortality.Results: The sample includes a total of 101 patients, 57 of whom were trauma and acute care surgery (TACS) patients and 44 of whom were obstetrics and gynecology patients. No patients developed symptoms consistent with a transfusion reaction. Average shock index was 1.16 (±0.55). On average, patients received 1.66 (±0.80) units of whole blood. Overall mortality was 14/101 (13.86%) in the first 24 hours and 6/101 (5.94%) after 24 hours.Conclusion: Implementing a WB protocol is achievable in LMICs. Whole blood allows for more efficient delivery of hemostatic resuscitation and is ideal for resource-restrained settings. To our knowledge, this is the first description of a whole blood program implemented in a civilian hospital in Latin America.

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