Battlefield resuscitation

Dawes, Rob; Thomas, GO Rhys

doi:10.1097/mcc.0b013e32833190c3

Cited by 51 publications

(35 citation statements)

References 94 publications

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“…Figure 4 presents the results of a meta-analysis of studies comparing intravenous vs inhalational anaesthesia. The first study listed is 'Cai 2012' [2], a high-powered (n = 2000) and apparently high-quality, block-randomised, blinded controlled trial, showing a strong and statistically highly significant benefit in favour of intravenous anaesthesia. This study has been assigned a weighting of 0% in the meta-analysis, and is not represented on the adjacent Forest plot; no explanation is given for this weighting in either the figure or the text.…”

Section: Reducing Postoperative Deliriummentioning

confidence: 99%

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Pooled platelet ratio in damage control resuscitation

Lowes

2014

Anaesthesia

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Section: Reducing Postoperative Deliriummentioning

confidence: 99%

“…The one pooled unit to five PRBC/FFP ratio may have been taken from the paper by Dawes and Thomas [2], which stated: "Using platelet apheresis in theatre. .…”

mentioning

confidence: 99%

Pooled platelet ratio in damage control resuscitation

Lowes

2014

Anaesthesia

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“…This drop can be exacerbated in the prebuspital setting by environmental factors. prolonged extrication or scene time, intoxication, and convective heat losses (for example, open helicopter door during flight) as well as injudicious administration of cold resuscitation fluids and blood [4,14].…”

Section: Fluid Space Dynamicsmentioning

confidence: 99%

“…Results of randomized controlled prospective clinical studies suggest that limiting the sodium and chloride input and optimal use of colloids. which are well retained in the vascular space, can reduce the inflammatory response to injury and improve organ function [4,5,14]. Datta shock.…”

Section: Fluid Space Dynamicsmentioning

confidence: 99%

Fluid Therapy in Trauma

Datta

Chaturvedi

2010

Medical Journal Armed Forces India

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Advances in shock resuscitation have occnrred as a result of various military conflicts. Primary ohjective of trauma care is to minimize or reverse shock, avoiding the lethal triad of hypothermia, acidosis, and coagulopathy. The concept of Damage Control Resuscitation has evolved aloug with "damage control surgery" which includes hypotensive and haemostatic resuscitation, where small aliquots of fluid are infused, with hypovotaemia and hypotension tolerated as a necessary evil until definitive haemorrhage control can be achieved. In the initial stages of trauma resuscitation the precise fluid, crystalloid or coDoid, used is probably not important as long as an appropriate volume is given. Haem08tatic resuscitation includes early use of fresh frozen plasma in a 1:1 ratio with packed red ceUs with emphasis on whole hlood, frequent cryo precipitates and platelets and the use of recombinant Factor VU for control of bleeding.

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“…Finally, blood product therapy should be used as a supplement to other evidencebased "damage control" measures, such as low-volume resuscitation and permissive hypotension until surgical hemostasis is achieved, as well as the prevention or correction of acidosis and hypothermia. 16 One of the more promising developments has been the safe and effective use of the antifibrinolytic drug tranexemic acid in trauma patients to reduce transfusion requirements and improve survival in a recent prospective randomized trial. 17 …”

mentioning

confidence: 99%

Trauma Blood Management: Avoiding the Collateral Damage of Trauma Resuscitation Protocols

Hannon

2010

Hematology

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The use of high ratios of red blood cells to platelets and plasma in trauma resuscitation protocols is quickly gaining favor in civilian trauma centers. The use of higher ratios of coagulation factors to red blood cells has been shown to improve outcomes in both military and civilian centers, but does the evidence support the use of a 1:1:1 ratio, as has been suggested? There is growing evidence that the use of such high ratios may be excessive and potentially harmful, and there has not been enough emphasis on the other components of evidence-based "damage control" resuscitation.Transfusion therapy has come full cycle in Iraq and Afghanistan as fresh whole blood use has again found a place in the resuscitation of military casualties. The use of equal ratios of packed red blood cells, plasma, and platelets (so called 1:1:1 therapy) to effectively reconstitute whole blood is gaining ground in civilian trauma centers to attempt to replicate the approach of military trauma teams. Although this is an exciting and potential livesaving therapy, have we considered the "collateral damage" of these trauma resuscitation protocols and does the current evidence support this approach? A cautionary note to begin the discussion was best phrased by Dr. Stephen Cohen: "As mortality rates range from one-third to one-half of these massively transfused individuals, heroic new measures are aggressively sought after and easily embraced." 1

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Battlefield resuscitation

Cited by 51 publications

References 94 publications

Pooled platelet ratio in damage control resuscitation

Pooled platelet ratio in damage control resuscitation

Fluid Therapy in Trauma

Trauma Blood Management: Avoiding the Collateral Damage of Trauma Resuscitation Protocols

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