Over the past 13 years, the military health care system has made improvements that are associated with an unprecedented survival rate for severely injured casualties. Monitoring for indications of deterioration as the critically injured patient moves across the continuum of care is difficult given the limitations of routinely used vital signs. Research by both military and civilian researchers is revolutionizing monitoring, with an increased focus on noninvasive, continuous, dynamic measurements to provide earlier, more sensitive indications of the patient's perfusion status.
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http://dx.doi.org/10.1016/j.cnc.2015.02.003 | DOI Listing |
Burns Trauma
January 2025
Australian and New Zealand Intensive Care-Research Centre, Monash University School of Public Health and Preventive Medicine, 553 St Kilda Road, Melbourne VIC 3004, Australia.
Septic shock is a significant challenge in the management of patients with burns and traumatic injuries when complicated by infection, necessitating prompt and effective haemodynamic support. This review provides a comprehensive overview of current strategies for vasopressor and fluid management in septic shock, with the aim to optimize patient outcomes. With regard to vasopressor management, we elaborate on the pharmacologic profiles and clinical applications of catecholamines, vasopressin derivatives, angiotensin II, and other vasoactive agents.
View Article and Find Full Text PDFObstet Gynecol Surv
January 2025
Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC.
Importance: To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.
Objectives: The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.
Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.
BMC Emerg Med
January 2025
Department of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, University of Health Sciences, Istanbul, Turkey.
Background: In the 21st century, disasters (particularly earthquakes, which remain the leading cause of death) continue to be among the foremost issues requiring global emergency response. While the impact of advancing technologies on the environmental and human damage caused by earthquakes is still a subject of debate, search and rescue (SAR) teams and emergency departments (ED), specifically emergency physicians (EPs), play a crucial role in the most acute management of the effects of these earthquakes on human life. This study aims to examine the injury dynamics of two catastrophic earthquakes that occurred in Turkey 24 years apart from the perspective of EPs, utilizing archival records from the SAR teams in which EPs served.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Kore University, Enna, Italy and Centro Cuore GB Morgagni, Catania, Italy.
Objectives: The benefit of combining multiple mechanical circulatory support (MCS) systems in patients with cardiogenic shock (CS) is debated. This review examines patient characteristics across studies to identify differences and assesses if patients with a higher-risk clinical profile receive Impella unloading.
Design: A systematic review and meta-analysis was conducted to examine if there were significant differences in baseline clinical parameters among patients receiving MCS in addition to venoarterial extracorporeal membrane oxygenation (VA ECMO).
Rev Col Bras Cir
January 2025
- School of Medical Sciences Orebro university, Department of Surgery - Orebro - OR - Suécia.
Introduction: Hemorrhage is the leading cause of preventable deaths in trauma patients, resulting in 1.5 million deaths annually worldwide. Traditional trauma assessment follows the ABC (airway, breathing, circulation) sequence; evidence suggests the CAB (circulation, airway, breathing) approach to maintain perfusion and prevent hypotension.
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