A5048738726- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Abdominal Trauma and Injuries
- Blood transfusion and management
- Pelvic and Acetabular Injuries
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac Arrest and Resuscitation
- Sepsis Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Emergency and Acute Care Studies
- Vascular Procedures and Complications
- Muscle and Compartmental Disorders
- Trauma Management and Diagnosis
- Hip and Femur Fractures
- Blood donation and transfusion practices
- Disaster Response and Management
- Hemostasis and retained surgical items
- Aortic Disease and Treatment Approaches
- Diverticular Disease and Complications
- Mechanical Circulatory Support Devices
- Traumatic Ocular and Foreign Body Injuries
- Aortic aneurysm repair treatments
- Gun Ownership and Violence Research
- Colorectal Cancer Surgical Treatments
- Venous Thromboembolism Diagnosis and Management
Queen Mary University of London
2016-2025
Barts Health NHS Trust
2015-2025
National Health Service
2021-2025
Royal London Hospital
2010-2025
University of Edinburgh
2024
European Society of Intensive Care Medicine
2022
Novem (Netherlands)
2021
William Harvey Research Institute
2011-2016
University of Sheffield
1979-2015
Accident Compensation Corporation
2015
Objective: To identify an appropriate diagnostic tool for the early diagnosis of acute traumatic coagulopathy and validate this modality through prediction transfusion requirements in trauma hemorrhage. Design: Prospective observational cohort study. Setting: Level 1 center. Patients: Adult patients who met local criteria full team activation. Exclusion included emergency department arrival >2 hrs after injury, >2000 mL intravenous fluid before arrival, or transfer from another hospital....
Contemporary trauma resuscitation prioritizes control of bleeding and uses major haemorrhage protocols (MHPs) to prevent treat coagulopathy. We aimed determine whether augmenting MHPs with Viscoelastic Haemostatic Assays (VHA) would improve outcomes compared Conventional Coagulation Tests (CCTs).This was a multi-centre, randomized controlled trial comparing in patients who received empiric MHPs, augmented by either VHA or CCT-guided interventions. Primary outcome the proportion subjects who,...
Major haemorrhage is an important cause of morbidity and mortality, affecting up to 40% all trauma patients (Stanworth et al, 2016) 10% cardiac surgery (Serraino & Murphy, 2017). Blood loss one the main causes following liver transplantation (Gurusamy 2011) most common death worldwide in women at time delivery (Say 2014). Diagnosis major bleeding difficult often made using clinical measures (e.g. rising heart rate, falling blood pressure) but these can be insensitive, particularly younger...
Importance Critical bleeding is associated with a high mortality rate in patients trauma. Hemorrhage exacerbated by complex derangement of coagulation, including an acute fibrinogen deficiency. Management replacement cryoprecipitate transfusions or concentrate, usually administered relatively late during hemorrhage. Objective To assess whether survival could be improved administering early and empirical dose to all trauma that required activation major hemorrhage protocol. Design, Setting,...
The Trauma Hemostasis and Oxygenation Research Network held its third annual Remote Damage Control Resuscitation Symposium in June 2013 Bergen, Norway. is a multidisciplinary group of investigators with common interest improving outcomes safety patients severe traumatic injury. network's mission to reduce the risk morbidity mortality from hemorrhagic shock, prehospital phase resuscitation through research, education, training. concept remote damage control infancy, there significant amount...
A cute traumatic coagulopathy ( ATC ) is an early endogenous process, driven by the combination of tissue injury and shock that associated with increased mortality worse outcomes in polytrauma patient. This review summarizes our current understanding pathophysiology role rapid diagnostics management severe trauma hemorrhage. In particular we consider diagnostic therapeutic strategies for bleeding patients short versus long prehospital times concept remote damage control resuscitation....
BACKGROUND Trauma hemorrhage continues to carry a high mortality rate despite changes in modern practice. Traditional approaches the massively bleeding patient have been shown result persistent coagulopathy, bleeding, and poor outcomes. Hemostatic (or damage control) resuscitation developed from discovery of acute traumatic coagulopathy increased recognition negative consequences dilutional coagulopathy. These strategies concentrate on early delivery coagulation therapy combined with...
To characterize the relationship between tranexamic acid (TXA) use and patient outcomes in a severely injured civilian cohort, to determine any differential effect patients who presented with without shock.TXA has demonstrated survival benefits trauma an international randomized control trial military setting. The uptake of TXA into major hemorrhage protocols (MHPs) been variable. evidence gap mature systems is limiting widespread its potential on survival.Prospective cohort study adult...
Major trauma is a leading cause of morbidity and mortality worldwide with hemorrhage accounting for 40% deaths. Acute traumatic coagulopathy exacerbates bleeding, but controversy remains over the degree to which inhibition procoagulant pathways (anticoagulation), fibrinogen loss, fibrinolysis drive pathologic process. Through combination experimental study in murine model human observation, authors' objective was determine predominant pathophysiology acute coagulopathy.First, prospective...
Background: Damage control resuscitation targets acute traumatic coagulopathy with the early administration of high-dose fresh frozen plasma (FFP). FFP is administered empirically and as a ratio number packed red blood cells (PRBC). There controversy over optimal FFP:PRBC respect to outcomes, their hemostatic effects have not been studied. We report preliminary findings on different ratios coagulation. Methods: This prospective observational cohort study trauma patients requiring >4 U PRBCs....
There has been an increased interest in the use of viscoelastic testing to guide blood product replacement during acute resuscitation injured patient. Currently, no uniformly accepted guidelines exist for how this technology should be integrated into clinical care. In September 2014, international multidisciplinary group leaders field trauma coagulopathy and was assembled a 2-day consensus conference Philadelphia, Pennsylvania. This panel included surgeons, hematologists, bank specialists,...
Abstract Background The aim of this study was to describe the prevalence, patterns blood use and outcomes major haemorrhage in trauma. Methods This a prospective observational from 22 hospitals UK, including both trauma centres smaller units. Eligible patients received at least 4 units packed red cells (PRBCs) first 24 h admission with activation massive protocol. Case notes, transfusion charts, bank records copies prescription/theatre charts were accessed reviewed centrally. Study were:...
The aim of this study was to identify the effects recent innovations in trauma major hemorrhage management on outcome and transfusion practice, determine contemporary timings patterns death.
To determine the characteristics of trauma patients with low levels fibrinolysis as detected by viscoelastic hemostatic assay (VHA) and explore underlying mechanisms this subtype.Hyperfibrinolysis is a central component acute traumatic coagulopathy but group present VHA-detected fibrinolysis. There concern that these may be at risk thrombosis if empirically administered an antifibrinolytic agent.A prospective multicenter observational cohort study was conducted 5 European major centers....
There is increasing interest in the timely administration of concentrated sources fibrinogen to patients with major traumatic bleeding. Following evaluation early cryoprecipitate CRYOSTAT 1 trial, we explored use concentrate, which may have advantages more rapid acute haemorrhage. The aims this pragmatic study were assess feasibility concentrate within 45 minutes hospital admission and quantify efficacy maintaining levels ≥ 2 g/L during active We conducted a blinded, randomised,...
Abstract Background In-hospital acute resuscitation in trauma has evolved toward early and balanced transfusion with red blood cells (RBC) plasma being transfused equal ratios. Being able to deliver this ratio prehospital environments is a challenge. A combined component, like leukocyte-depleted cell (RCP), could facilitate RBC plasma, while at the same time improving logistics for team. However, there limited evidence on clinical benefits of RCP. Objective To compare RCP versus alone or...