Initial Experience of US Marine Corps Forward Resuscitative Surgical System During Operation Iraqi Freedom

doi:10.1001/archsurg.140.1.26

Cited by 111 publications

(5 citation statements)

References 20 publications

(20 reference statements)

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“…Hemorrhage is the leading cause of death in combat, including those killed instantly (killed in action) and those who died after transport to a medical facility (died of wounds). 131 Chambers and colleagues 132 reported that 90% of patients treated by the United States Marine Forward Resuscitation Surgical System (FRSS) during Operation Iraqi Freedom sustained penetrating injuries and, therefore, some degree of hemorrhage. More than 80% of the most critically ill patients treated by the FRSS presented in class three or four hemorrhagic shock, and 40% of patients who required treatment during transport to higher echelons of care were treated for systemic arterial hypotension.…”

Section: Discussionmentioning

confidence: 99%

“…More than 80% of the most critically ill patients treated by the FRSS presented in class three or four hemorrhagic shock, and 40% of patients who required treatment during transport to higher echelons of care were treated for systemic arterial hypotension. 132 Nelson and colleagues 133 observed that 100% of blast-injured patients with persistent arterial hypotension (systolic blood pressure <90) died, whereas all of those without hypotension survived their injuries. Although the results of Nelson and colleagues 133 suggest that hemorrhagic hypotension after blast injury is associated with higher mortality, it was a small study ( n = 14,) and it is possible that mortality was high in the patients with hypotension because they were more seriously injured.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Mild Blast Traumatic Brain Injury on Cerebral Vascular, Histopathological, and Behavioral Outcomes in Rats

Rodriguez

Zeng

Deyo

et al. 2018

Journal of Neurotrauma

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To determine the effects of mild blast-induced traumatic brain injury (bTBI), several groups of rats were subjected to blast injury or sham injury in a compressed air-driven shock tube. The effects of bTBI on relative cerebral perfusion (laser Doppler flowmetry [LDF]), and mean arterial blood pressure (MAP) cerebral vascular resistance were measured for 2 h post-bTBI. Dilator responses to reduced intravascular pressure were measured in isolated middle cerebral arterial (MCA) segments, ex vivo, 30 and 60 min post-bTBI. Neuronal injury was assessed (Fluoro-Jade C [FJC]) 24 and 48 h post-bTBI. Neurological outcomes (beam balance and walking tests) and working memory (Morris water maze [MWM]) were assessed 2 weeks post-bTBI. Because impact TBI (i.e., non-blast TBI) is often associated with reduced cerebral perfusion and impaired cerebrovascular function in part because of the generation of reactive oxygen and nitrogen species such as peroxynitrite (ONOO−), the effects of the administration of the ONOO− scavenger, penicillamine methyl ester (PenME), on cerebral perfusion and cerebral vascular resistance were measured for 2 h post-bTBI. Mild bTBI resulted in reduced relative cerebral perfusion and MCA dilator responses to reduced intravascular pressure, increases in cerebral vascular resistance and in the numbers of FJC-positive cells in the brain, and significantly impaired working memory. PenME administration resulted in significant reductions in cerebral vascular resistance and a trend toward increased cerebral perfusion, suggesting that ONOO− may contribute to blast-induced cerebral vascular dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of Mild Blast Traumatic Brain Injury on Cerebral Vascular, Histopathological, and Behavioral Outcomes in Rats

Rodriguez

Zeng

Deyo

et al. 2018

Journal of Neurotrauma

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“…Reports from Iraq demonstrate that most shunts are placed at level II forward surgical units before transport to level III hospitals, where shunts are removed and repair completed 7–10. In this setting, total warm ischemia time of the extremity begins at the time of injury, which is typically 30 minutes to 60 minutes from initial surgical evaluation 20. In separate reports from different US Navy Forward Resuscitative Surgical Suites, Chambers, and more recently Taller et al9,10 documented time from initial injury to presentation to be about an hour (61 and 46 minutes, respectively).…”

Section: Discussionmentioning

confidence: 99%

Early Versus Delayed Restoration of Flow With Temporary Vascular Shunt Reduces Circulating Markers of Injury in a Porcine Model

Gifford

Eliason²,

Clouse

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…In the civilian setting, over 26% of trauma patients with a severe brain injury also experience hemorrhagic shock [ 1 ]. In the military setting, the incidence rate of warfighters that sustained brain injuries plus concurrent hemorrhagic shock is closer to 80% [ 1 , 2 , 3 ]. Together, these injuries comprise a major focus that necessitates improved therapeutics from the point of injury through prolonged field care to enhance the repair and recovery of damaged organs and tissues.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Thera-101 as a Low-Volume Resuscitation Fluid in a Model of Polytrauma

Shah

Macaitis

Lundquist

et al. 2022

IJMS

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Traumatic brain injury (TBI) and hemorrhage remain challenging to treat in austere conditions. Developing a therapeutic to mitigate the associated pathophysiology is critical to meet this treatment gap, especially as these injuries and associated high mortality are possibly preventable. Here, Thera-101 (T-101) was evaluated as low-volume resuscitative fluid in a rat model of TBI and hemorrhage. The therapeutic, T-101, is uniquely situated as a TBI and hemorrhage intervention. It contains a cocktail of proteins and microvesicles from the secretome of adipose-derived mesenchymal stromal cells that can act on repair and regenerative mechanisms associated with poly-trauma. T-101 efficacy was determined at 4, 24, 48, and 72 h post-injury by evaluating blood chemistry, inflammatory chemo/cytokines, histology, and diffusion tensor imaging. Blood chemistry indicated that T-101 reduced the markers of liver damage to Sham levels while the levels remained elevated with the control (saline) resuscitative fluid. Histology supports the potential protective effects of T-101 on the kidneys. Diffusion tensor imaging showed that the injury caused the most damage to the corpus callosum and the fimbria. Immunohistochemistry suggests that T-101 may mitigate astrocyte activation at 72 h. Together, these data suggest that T-101 may serve as a potential field deployable low-volume resuscitation therapeutic.

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Initial Experience of US Marine Corps Forward Resuscitative Surgical System During Operation Iraqi Freedom

Cited by 111 publications

References 20 publications

Effects of Mild Blast Traumatic Brain Injury on Cerebral Vascular, Histopathological, and Behavioral Outcomes in Rats

Effects of Mild Blast Traumatic Brain Injury on Cerebral Vascular, Histopathological, and Behavioral Outcomes in Rats

Early Versus Delayed Restoration of Flow With Temporary Vascular Shunt Reduces Circulating Markers of Injury in a Porcine Model

Evaluating Thera-101 as a Low-Volume Resuscitation Fluid in a Model of Polytrauma

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