The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: Comparative effectiveness of a time-varying treatment with competing risks
John B. Holcomb,Deborah J. del Junco,Erin E. Fox,Charles E. Wade,Mitchell J. Cohen,Martin A. Schreiber,Louis H. Alarcon,Yu Bai,Karen J. Brasel,Eileen M. Bulger,Bryan A. Cotton,Nena Matijevic,Peter Muskat,John G. Myers,Herb A. Phelan,Christopher E. White,Jiajie Zhang,Mohammad H. Rahbar +17 more
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Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission, and among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or Platelet ratios.Abstract:
Objective To relate in-hospital mortality to early transfusion of plasma and/or platelets and to time-varying plasma:red blood cell (RBC) and platelet:RBC ratios. Design Prospective cohort study documenting the timing of transfusions during active resuscitation and patient outcomes. Data were analyzed using time-dependent proportional hazards models. Setting Ten US level I trauma centers. Patients Adult trauma patients surviving for 30 minutes after admission who received a transfusion of at least 1 unit of RBCs within 6 hours of admission (n = 1245, the original study group) and at least 3 total units (of RBCs, plasma, or platelets) within 24 hours (n = 905, the analysis group). Main Outcome Measure In-hospital mortality. Results Plasma:RBC and platelet:RBC ratios were not constant during the first 24 hours (P Conclusions Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission. Among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or platelet ratios.read more
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Severe Trauma-Induced Coagulopathy: Molecular Mechanisms Underlying Critical Illness
Christian Zanza,T. Romenskaya,Fabrizio Racca,Eduardo Rocca,Fabio Piccolella,Andrea Piccioni,Angela Saviano,Gabriele Savioli,Francesco Franceschi,Yaroslava Longhitano +9 more
TL;DR: In this paper , the authors report the pathophysiology, early diagnosis and treatment of Trauma-Induced Coagulopathy (TIC), a biochemical response involving dysregulated coagulation, altered fibrinolysis, systemic endothelial dysfunction, platelet dysfunction, and inflammatory responses due to trauma.
Journal ArticleDOI
Evaluation of A plasma for incompatible patients.
Gregory Olsen,Michael Passwater,Monique Huggins,Faisal Mukhtar,Faisal Mukhtar,Peter Pelletier,Peter Pelletier +6 more
TL;DR: As this practice becomes widely adopted it is important to evaluate safety, because Hemolytic transfusions reactions are underreported, and hemolysis may be subclinical.
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Evolution of Resuscitation: What Is Damage Control Resuscitation?
Kyle J. Kalkwarf,John B. Holcomb +1 more
TL;DR: The current treatment for massively bleeding patients is nearly identical to practices developed by physicians caring for thousands of injured combatants during World War I and II, with a focus on limiting crystalloid, whole blood, or balance blood component transfusions to achieve permissive hypotension.
Journal ArticleDOI
Simplified treatment algorithm for the management of trauma-induced hemorrhage without viscoelastic testing.
TL;DR: In this paper, a concise and pragmatic algorithm was developed to guide treatment of bleeding trauma patients without the use of point-of-care viscoelastic testing, based on published guidelines and research, including recommendations regarding treatment and dosing, and is simple and clear enough for even an inexperienced physician to follow.
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Modelo sintético de baixo custo para treinamento do uso de torniquete
Daniel Souza Lima,Yuri Augusto da Silva Almeida,Danielle Maria Camelo Cid,Lucas Candeira Cardoso,Camila Soldon Braga,Francisco George de Lima Regis +5 more
TL;DR: A low-cost model for bleeding control training with the use of a tournique had excellent acceptability, was considered viable for educational purposes of tourniquet use, and had low cost.
References
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The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies
Erik von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
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Erik von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
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The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies
E von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The STROBE Statement is a checklist of items that should be addressed in articles reporting on the 3 main study designs of analytical epidemiology: cohort, casecontrol, and cross-sectional studies; these recommendations are not prescriptions for designing or conducting studies.
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