Tesi sul tema "Trauma hemorrhagic shock"
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Talving, Peep. "Aspects of hepatoduodenal trauma and fluid therapy in hemorrhagic shock /". Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-740-5/.
Testo completoAlexander, Geoffrey C. "The Effect of Adding Drag-Reducing Polymers to Resuscitation Fluid During Hemorrhagic Shock on Skeletal Muscle Microcirculation". VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/1522.
Testo completoLabruto, Fausto. "Modifications of cardiovascular response to ischemia and trauma /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-379-5/.
Testo completoJi, Soo-Yeon. "COMPUTER-AIDED TRAUMA DECISION MAKING USING MACHINE LEARNING AND SIGNAL PROCESSING". VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1628.
Testo completoLundin, Sandra, e Jonas Molin. "Räddar liv eller slösar tid? : prehospital vätskebehandlings effekter på patienter i hemorragisk chock". Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3742.
Testo completoTrauma is the leading cause of death in Sweden for people between the age of 15 and 44 years and a large proportion of people die because of bleeding that occurs at the time of the injury. Bleeding also continues to be the leading cause of trauma-related death that could have been preventable both in a civilian and military setting. Trauma care is complex, often time-critical, and the ambulance nurses are often the first to care for these patients on the scene and therefore the first assessment and care of these patients is of great importance. Fluid resuscitation for critically injured trauma patients in hemorrhagic shock or threatening hemorrhagic shock is a debated topic and Sweden lacks national guidelines for trauma care and treatment prehospital. The regional guidelines sometimes for some manner differ between the counties in Sweden. The aim of this study was to determine the impact of fluid resuscitation for patients with hemorrhagic shock after trauma. As a method, a literature review was carried out, which included a total of 15 studies published between 2009 and 2019. The result revealed two main themes - the impact of fluid resuscitation on mortality and the impact of fluid resuscitation on coagulation. All four studies that examined how coagulation ability is affected by crystalloid hypertonic and/or isotonic fluid resuscitation in patients at risk of hemorrhagic shock after trauma, the severity seems to be dependent on the amount of fluid infused, the more fluid the more severe coagulation abnormalities. The result showed unclear evidence of the effect of fluid resuscitation in mortality for trauma patients in hemorrhagic shock. However, none of the studies showed it decreased in mortality. In conclusion, the majority of articles show that large amount of fluid given in prehospital care have no impact or did have a negative impact on survival of critically injured trauma patients in hemorrhagic shock. Many factors come into play and it is difficult to draw any conclusions based on the results and more research are needed.
Dufour-Gaume, Frédérique. "Enjeux, préparation et évaluation de produits sanguins labiles innovants adaptés aux blessés de guerre". Electronic Thesis or Diss., université Paris-Saclay, 2023. http://www.theses.fr/2023UPASQ076.
Testo completoWar casualties associate multiple injuries with shock hemorrhage. Despite the therapeutic progress of recent years, hemorrhage is the leading cause of preventable deaths and secondary multiple organ failure can lead to vital and functional prognosis. Management of war-injured patients based on damage control resuscitation and massive transfusion of whole blood reduced considerably the number of deaths. Nevertheless, during foreign operations whole blood is sometimes lacking because of logistic limitations and massive casualties. Modified blood products that are free from constraints could help war-injured patients to survive. To achieve this objective, we developed two French hyper-concentrated lyophilized plasmas with (FLYP-H/LP) or not (FLYP-H) lyophilized platelets. The production of these products is of a high quality. FLYP-H and FLYP-H/LP are high protein products, especially albumin, which confer them a hyperosmolarity twice that of plasma. In FLYP-H/LP, platelets were lysed during the manufacturing process and liberated high quantities of coagulation factors, such as fibrinogen. The therapeutic effects of FLYP-H and FLYP-H/LP were evaluated thanks to our war-injured porcin model. Statistical analysis highlighted the beneficial effects of FLYP-H and FLYP-H/LP on cardiovascular function and hemostasis. These results open the door to more analysis but on human FLYP-H and FLYP-H/LP
Prunet, Bertrand. "Contusion pulmonaire : aspects physiopathologiques et conséquences thérapeutiques". Thesis, Aix-Marseille, 2015. http://www.theses.fr/2015AIXM5001.
Testo completoPulmonary contusion is often associated with hemorrhagic shock, constituting a challenge in trauma care. For patients who have sustained lung contusions, fluid resuscitation should be carefully performed, because injured lungs are particularly vulnerable to massive fluid infusions with an increased risk of pulmonary edema and compliance impairment. Fluid administration should be included in an optimized and goal directed resuscitation, based on blood pressure objectives and hemodynamical monitoring. The use of fluids with high volume-expanding capacities (hypertonic saline, colloids) is probably interesting, as well as early introduction of vasopressors. Hemodynamic monitoring will allow to conduct resuscitation on blood pressure objectives, on preload parameters and on extravascular lung water measurement.Our work, based on experimental and clinical studies, objective to characterize the current modalities of ventilatory and hemodynamical aspect of pulmonary contusion care
Morrison, C. Anne Horwitz Irwin Hwang Lu-Yu. "Hypotensive resuscitation versus standard fluid resuscitation for the management of trauma patients in hemorrhagic shock : the safety phase of a randomized controlled trial". 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1465583.
Testo completoFraga, Caroline Anne Pires. "The use of Tranexamic acid in trauma patients with hemorrhagic shock - a retrospective study in a tertiary care hospital". Master's thesis, 2020. https://hdl.handle.net/10216/128787.
Testo completoIntroduction - Hemorrhagic shock is the major complication and cause of morbi-mortality in trauma patients. We aimed to study the impact of tranexamic acid in trauma patients with hemorrhagic shock in a tertiary hospital. Material and methods - Our study, performed at Centro Hospitalar e Universitário São João, included adult trauma patients with hemorrhagic shock admitted to the Intensive Care Department. We defined hemorrhagic shock as Systolic Blood Pressure ≤90 mmHg and/or Heat Rate ≥110 bpm. In the absence of these, the clinical judgment of the attending physician prevailed. We did patients cohort with and without tranexamic acid use: we assessed global mortality, invasive mechanical ventilation duration, Intensive Care Unit and hospital length of stay, red blood cells units transfused and vascular occlusive events. Results - 105 patients were included from the 1045 admitted for trauma between January 2017 and December 2018: of those, 38 received tranexamic acid (36,2%) versus 67 without it (63,8%). Tranexamic acid group registered a higher severity (APACHE II p=0,038) and mortality in the Intensive Care Unit either in the global population (p=0,003) or in the stratified Traumatic Brain Injury subgroup (p=0,037). We found no statistically significant differences in the secondary outcomes. Discussion - Trauma patients with hemorrhagic shock admitted in the Intensive Care Department and treated with tranexamic acid had higher mortality, probably explained by the higher severity observed. We didnt find increased vascular occlusive events in tranexamic acid group. Conclusions - It is necessary to complement these findings with more studies and larger cohorts to assess the real benefits of tranexamic acid use in these patients.
Fraga, Caroline Anne Pires. "The use of Tranexamic acid in trauma patients with hemorrhagic shock - a retrospective study in a tertiary care hospital". Dissertação, 2020. https://hdl.handle.net/10216/128787.
Testo completoIntroduction - Hemorrhagic shock is the major complication and cause of morbi-mortality in trauma patients. We aimed to study the impact of tranexamic acid in trauma patients with hemorrhagic shock in a tertiary hospital. Material and methods - Our study, performed at Centro Hospitalar e Universitário São João, included adult trauma patients with hemorrhagic shock admitted to the Intensive Care Department. We defined hemorrhagic shock as Systolic Blood Pressure ≤90 mmHg and/or Heat Rate ≥110 bpm. In the absence of these, the clinical judgment of the attending physician prevailed. We did patients cohort with and without tranexamic acid use: we assessed global mortality, invasive mechanical ventilation duration, Intensive Care Unit and hospital length of stay, red blood cells units transfused and vascular occlusive events. Results - 105 patients were included from the 1045 admitted for trauma between January 2017 and December 2018: of those, 38 received tranexamic acid (36,2%) versus 67 without it (63,8%). Tranexamic acid group registered a higher severity (APACHE II p=0,038) and mortality in the Intensive Care Unit either in the global population (p=0,003) or in the stratified Traumatic Brain Injury subgroup (p=0,037). We found no statistically significant differences in the secondary outcomes. Discussion - Trauma patients with hemorrhagic shock admitted in the Intensive Care Department and treated with tranexamic acid had higher mortality, probably explained by the higher severity observed. We didnt find increased vascular occlusive events in tranexamic acid group. Conclusions - It is necessary to complement these findings with more studies and larger cohorts to assess the real benefits of tranexamic acid use in these patients.
Powers, Kinga Antonina. "Cellular Mechanisms of the Systemic Inflammatory Response Following Resuscitated Hemorrhagic Shock: The Role of Reactive Oxygen Species and Toll-like Receptor 4". Thesis, 2008. http://hdl.handle.net/1807/11247.
Testo completoLIN, YU-HSIN, e 林郁馨. "The effects of glutamine and multiple vitamin-supplemented resuscitation fluids on inflammatory response and target organ injury in rats with trauma and hemorrhagic shock". Thesis, 2016. http://ndltd.ncl.edu.tw/handle/19844509338706124053.
Testo completo輔仁大學
營養科學系碩士班
105
Hemorrhagic shock patients have huge loss of blood, may lead to energy and oxygen deficit and hypoxia. It shall be given as soon as possible to stop bleeding and fluid resuscitation. However, resuscitation may augment oxidative stress which leads to systemic inflammation, multiple organ failure, and even death. Recent studies indicated that antioxidant vitamins, energy metabolism-associated vitamins, and glutamine may alleviate oxidative stress, elevate energy synthesis, and provide energy for immune cells, respectively. Therefore, the aim of this study was to investigate the effects of single and combined treatment of glutamine and multiple vitamins on inflammatory response and target organ damage in rats with trauma hemorrhagic shock and resuscitation (THR). Male SD rats were divided into 6 groups including a normal control group, an intubation sham-operated group, and 5 groups with 5 cm midline laparotomy and catheterization in the left carotid artery and right jugular vein. The blood was withdrawn from the carotid artery within 10 min until a mean arterial pressure was 30 to 35 mmHg in THR rats. After maintained with low blood pressure for 60 minutes, rats were resuscitated with shed blood and equal volume of lactate Ringer’s solution (LR) without or with L-alanyl-L-glutamine, multiple vitamins or L-alanyl-L-glutamine plus multiple vitamins within 10 min. Sham-operated group and THR rats were infused with continuous, slow rate of LR with or without L-alanyl-L-glutamine and multiple vitamins. Rats were executed after infused with continuous, slow rate of LR solution for 42 hours. The results showed that THR rats significantly increased serum glutamic-pyruvic transaminase and decreased plasma and lung interleukin (IL)-4. In the THR rats, glutamine significantly increased red blood cell sulphydryl group and jejunum interferon (IFN)-γ and decreased liver tumor necrosis factor (TNF)-a. Multiple vitamins significantly increased plasma myeloperoxidase (MPO) activity, lung and jejunum IL-8 and decreased serum albumin and lung IL-10. Glutamine and multiple vitamins significantly increased serum blood urea nitrogen and lung MPO activity and decreased serum cholesterol, liver and kidney IL-8. Glutamine or multiple vitamins significantly increased plasma malondialdehyde, jejunum IL-4 and IL-6. Glutamine with or without multiple vitamins significantly increased jejunum MPO activity and decreased liver IL-4 and jejunum cell apoptosis. Multiple vitamins with or without glutamine significantly increased crypt depth and muscularis thickness and decreased red blood cell malondialdehyde and liver IL-6. Glutamine and/or multiple vitamins significantly decreased plasma IFN- γ, liver protein carbonyl and IL-10, liver and kidney intercellular adhesion molecule. Taken together, limit volume resuscitation and slow rate of infusion may improve hemodynamics unstable in THR rats. Supplementation of glutamine and multiple vitamins in resuscitation solution can alleviate liver oxidative stress, system and kidney inflammation and jejunum apoptosis, further may decrease target organ injury.
WU, YI-CHEN, e 吳怡蓁. "The effects of glutamine and fish oil-supplemented resuscitation fluids on inflammatory response and target organ injury in rats with trauma and hemorrhagic shock". Thesis, 2016. http://ndltd.ncl.edu.tw/handle/10494649989046827730.
Testo completo輔仁大學
營養科學系碩士班
105
Hemorrhagic shock is an emergent condition that usually caused by trauma, surgery, and parturition. When patients suffer from rapid blood loss, the hypovolemia may result in the decreases in energy and oxygen delivery which cause multiple organ failure (MOF). In clinical practice, patients are administered with resuscitation fluid rapidly to improve blood pressure and oxygen supply. However, resuscitation may elevate the production of reactive oxygen species (ROS) which induce inflammatory response and organ damages. Studies showed that fish oil have the anti-inflammatory activity. When fish oil concentration of the cell membrane is increased, the immune cells have decreased ability to produce pro-inflammatory cytokines. In addition, glutamine has been confirmed to be the main source of energy for immune cells and intestinal cells. Therefore, the aim of the present study was to investigate the effects of single or combination treatment of fish oil- and glutamine-supplemented resuscitation fluids on the THR-induced inflammatory responses and antioxidant activity. Male SD rats were divided into 6 groups, expect the control (NC group) and sham-operated (SM group) groups the other THR groups were suffered with 5 cm midline laparotomy and catheterization in the left carotid artery and right jugular vein. The blood was withdrawn from the left carotid artery to reach a mean arterial pressure 30 to 35 mmHg within 10 min for hemorrhagic shock induction. After 60 minutes of hypovolemia, rats were resuscitated with shed blood and equal volume of lactate Ringer’s solution without (TH group) or with L-alanyl-L-glutamine (GN group), fish oil (FA group) or L-alanyl-L-glutamine plus fish oil (GF group) within 10 minutes and followed by continuouslow infusion rate (~1.4 ml/h) of resuscitation fluids. After 42 h, rats were executed and we expect to demonstrate that glutamine- and fish oil-supplemented resuscitation fluids may attenuate THR-induced inflammatory response and target organ injury in rats. The results show that THR may decreased RBC count, hemoglobin and hematocrit, and the loss of blood albumin and the decrease of antioxidant capacity.Then THR model may lead to decrease plasma, pulmonary and intestinal MPO activity and the pulmonary content of interleukin (IL)-8, the content of IL-4 and IL-8 in the kidney were decreased.The utilization of protein in plasma and lipid peroxidation, SOD and GPx activities in RBC could be increased. THR rats were supplemented with L-alanyl-L-glutamine resuscitation fluid to reduce the plasma pro-inflammatory cytokines, liver protein carbonylation and RBC lipid peroxidation. However, THR rats were supplemented with fish oil resuscitation fluid may decrease the concentration of pro-inflammatory cytokines in plasma, liver, kidney and reduce the pulmonary adhesion factor secretion, but also reduce the lipid peroxidation of RBC. In addition, THR rats were supplemented with L-alanyl-L-glutamine and fish oil resuscitation fluids may significantly reduce the plasma, kidney and pro-inflammatory cytokine secretion and increase the anti-inflammatory in the kidney and jejunum, and may lead to enhance the plasma and RBC antioxidative capacity. In summary, our THR model in this study may reduce the systemic antioxidative capacity and enhance jejunum inflammation. THR rats were supplemented with L-alanyl-L-glutamine and fish oil resuscitation fluids may alleviate inflammatory response and increase the antioxidant effect to reduce the THR-induced inflammatory response and target organ injury.
Khazoom, François. "Rôle de l’acide urique dans la défaillance d’organes suite au choc hémorragique : une avenue thérapeutique?" Thesis, 2020. http://hdl.handle.net/1866/24497.
Testo completoWhile hemorrhagic shock is the first cause of early mortality among severe trauma patients, organ failure leads to late mortality and morbidity in this population. Alarmins, molecules released after ischemia-reperfusion, are able to activate local and systemic inflammatory pathways and potentially represent a therapeutic target to minimize organ failure. Uric acid is a pro-inflammatory and pro-apoptotic molecule released after hemorrhagic shock and its role pertaining to organ failure is incompletely studied. The first part of this thesis presents a proof of concept that uric acid plays a key role in liver and intestinal damage in an animal model of hemorrhagic shock; it will be presented in the format of a submitted article. The second part of this thesis presents preliminary data from a prospective observational clinical study evaluating uric acid kinetics in a cohort of trauma patients. Animal study Hemorrhagic shock was induced with blood withdrawal among Wistar rats for a target mean arterial blood pressure of 30-35 mmHg for 60 minutes. Animals were resuscitated with a 1 :1 mix of Ringer Lactate and drawn blood with or without Uricase, a recombinant enzyme that metabolizes uric acid. Results show a statistically significant decrease in hepatocellular damage (plasma AST and ALT), inflammatory markers (ICAM-1, MPO, TNF-alpha, IL-1, Caspase-1) and apoptotic markers (Caspase-3, -8, Bax/BCL-2, pAKT/AKT) among the Uricase group. The intervention on uric acid also prevented increased intestinal permeability and bacterial product (LPS) translocation. Clinical study Twenty patients sustaining major trauma with hemorrhagic shock were prospectively recruited at Montreal Sacré-Cœur Hospital, in the context of a pilot study funded by the FRSQ trauma consortium. Uric acid concentration was determined serially for 7 days after trauma. Feasibility criteria, notably consent rate (95%), sampling observance rate (90% for first sample, 65% for samples every 4 hours, and 73% for samples every 8 hours) were considered acceptable. Uric acid kinetics were reproducible among the entire cohort (R2 = 0.87). The area under the curve was significantly increased among patients with higher sequential organ failure assessment score at 72h (SOFA³6). Conclusions Although mechanisms remain to be elucidated, these studies show that uric acid is an important mediator for the development of organ damage after hemorrhagic shock. This molecule potentially represents a therapeutic target with the ultimate goal of minimizing organ failure after hemorrhagic shock.
Huang, Fu-Huan, e 黃富煥. "The investigation of trauma-hemorrhage shock induced inflammatory responses and organ damages in rats when arginine-, glutamine-, or amino acid mixture as resuscitation fluids". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/w88utc.
Testo completo中山醫學大學
醫學研究所
106
Objective:Patients with trauma-hemorrhagic shock suffer from extensive blood loss and energy and oxygen deficiency that causes multiple organ failure and even death. To provide large volume of resuscitation fluid to recover blood pressure is the traditional clinical strategy; however, extensive production of free radicals may worsen the clinical outcome. We previously showed that arginine, citrulline, or glutamine may not alter inflammatory response in rats with hemorrhagic shock. Herein, we compared the impacts of arginine-, glutamine-, and amino acid mixture-supplemented resuscitation fluids on inflammatory responses and target organ damages in rats with trauma-hemorrhagic shock and limited-volume of resuscitation fluids. Methods and Materials:Male SD rats were suffered from carotid arterial and jugular vein cannulations with 5 cm midline laparotomy and blood loss to mean arterial pressure at 35 mmHg or sham operation (SHA group). After 60 minutes, rats were resuscitated with shed blood and equal volume of lactate Ringer’s solution without (THR group) or with L-alanine (ALA group), L-arginine plus L-alanine (ARG group), L-alanyl-L-glutamine (GLN group), or L-amino acid mixture plus L-alanine (AMX group) within 10 minutes and followed by continuous infusion for 42 h (~1.3 ml/h). After sacrifice, blood and organs were collected for further analysis about inflammatory response and organ damage. Results:The THR group had significantly decreased plasma IFN-γ and spleen weight, increased circulating platelet and renal nitrate/nitrite (NOx), and significant jejunal atrophy compared to the SHA group. The ALA group had alleviated increases in circulating platelet, renal NOx and jejunal atrophy, decreased circulating hemoglobin, hematocrit, plasma pro-inflammatory mediators, and renal apoptosis, and increased cell proliferation in the lung; the ARG group had increased lung wet-to-dry weight and IL-4 and jejunal apoptosis; the GLN group had increased spleen weight, circulating hemoglobin and hematocrit and renal myeloperoxidase activity and apoptosis and had alleviated jejunal atrophy; and the AMX group had reversed circulating hemoglobin and hematocrit, decreased jejunal atrophy and renal NOx, and increased lung, liver, and renal cell proliferation, renal apoptosis, and lung myeloperoxidase activity. These results suggest that amino acid supplemented-resuscitation fluids have beneficial effects on hematology and have differential effects on organ inflammatory response and damages. Conclusion:Amino acid-supplemented resuscitation fluids may have potentials to be a clinical useful nutrition therapy for patients with trauma-hemorrhagic shock and the use of amino acid supplementation should be organ-dependent.