Abstract Introduction Recently, it has been shown in several experimental settings that the noble gases xenon and helium have neuroprotective properties. In this study we tested hypothesis gas argon a potential as well. Since traumatic brain injury stroke are widespread generate an enormous economic social burden, investigated possible effect vitro models of cerebral ischemia. Methods Organotypic hippocampal slice cultures from mice pups were subjected to either oxygen-glucose deprivation or...

New oral anticoagulants are effective alternatives to warfarin. However, no specific reversal agents available for life-threatening bleeding or emergency surgery. Using a porcine model of trauma, this study assessed the ability prothrombin complex concentrate (PCC), activated PCC (aPCC), recombinant FVIIa (rFVIIa) and antidote dabigatran (aDabi-Fab) reverse anticoagulant effects dabigatran.Dabigatran etexilate (DE) was given orally 3 days (30 mg/kg bid) intravenously on day 4 achieve...

BACKGROUND Anticoagulation is essential for the treatment and prevention of thromboembolic events. Current guidelines recommend direct oral anticoagulants (DOACs) over vitamin K antagonists in DOAC-eligible patients. The major complication anticoagulation serious or life-threatening haemorrhage, which may necessitate prompt haemostatic intervention. Reversal DOACs also be required patients need urgent invasive procedures. This guideline from European Society Anaesthesiology Intensive Care...

After severe trauma, but also perioperatively, massive bleeding is associated with increased morbidity and mortality. In severely injured patients, hemorrhagic shock remains to be the main cause of death in addition traumatic brain hemorrhage. non-cardiac surgery, a surgical complication increases perioperative (intensive care length stay, acute renal failure, infections, thromboembolic complications) by factor three four mortality six. cardiac postoperative requiring revision 50% increase...

Summary Urgent surgery or life-threatening bleeding requires prompt reversal of the anticoagulant effects dabigatran. This study assessed ability three- and four-factor prothrombin complex concentrate (PCC) idarucizumab (specific antidote for dabigatran) to reverse dabigatran in a porcine model trauma. Twelve animals were given etexilate (DE) orally intravenously, before infliction Six received tranexamic acid plus fibrinogen 12 minutes post-injury. PCCs (each 30 60 U/kg) (30 mg/kg) added...

Traumatic brain injury (TBI) is the leading cause of death among trauma patients. Patients under antithrombotic therapy (ATT) carry an increased risk for intracranial haematoma (ICH) formation. There a paucity data about role direct oral anticoagulants (DOACs) TBI patients.In this retrospective study, we investigated all patients ≥60-years-old who were admitted to intensive care unit (ICU) from January 2014 until May 2017. grouped into those receiving vitamin K antagonists (VKA), platelet...

In emergency medicine, the benefits of high-fidelity simulation (SIM) are widely accepted and standardized patients (SP) known to mimic real accurately. However, only limited data available concerning physicians' stress markers within these training environments. The aim this pilot study was investigate repetitive among healthcare professionals in simulated pre-hospital scenarios using either SIM or SPs. Teams with one medical services (EMS) physician two paramedics completed three SP...

In urgent clinical situations, such as trauma, surgery or before thrombolysis, rapid quantification of direct oral anticoagulant plasma drug levels is warranted. Using the ClotPro® analyser, we assessed two novel viscoelastic tests for detection clinically-relevant in trauma patients. The ecarin clotting time was used to assess concentration dabigatran and Russell´s viper venom determine factor Xa inhibitors. parallel, concentrations were analysed using plasma-based chromogenic assays. A...

Severe peripartum hemorrhage (PPH) contributes to maternal morbidity and mortality is one of the most frequent emergencies in obstetrics, occurring at a prevalence 0.5–5.0%. Detection antepartum risk factors essential order implement preventive measures. Proper training obstetric staff publication recommendations guidelines can effectively reduce frequency PPH its resulting mortality. Therefore, an interdisciplinary expert committee was formed, with members from Germany, Austria,...

The early application of fibrinogen could potentially reverse haemodilution-induced coagulopathy, although the impact varying concentrations to dilutional coagulopathy has not been studied in vivo. We postulated that concentration is correlated with blood loss a pig model blunt liver injury.Coagulopathy was induced 18 anaesthetized pigs (32 +/- 1.6 kg body weight) by replacing 80% volume hydroxyethylstarch 130/0.4 and Ringer's lactated solution, re-transfusion erythrocytes. Animals were...

Objective: To assess the impact of direct oral anticoagulant (DOAC) intake compared with Coumadin (COU) in patients suffering hip fractures (HFs). Design: Retrospective cohort analysis. Setting: Level 1 Trauma Center. Intervention: Timing surgical fixation. Patients: Three-hundred twenty 65 years age or older isolated HF were enrolled into study: 207 (64.7%) without any antithrombotic therapy (no-ATT), 59 (18.4%) on COU, and 54 (16.9%) DOACs. Main Outcome Measurements: Time to surgery, blood...

BACKGROUND Viscoelastic coagulation testing is increasingly used to diagnose trauma-induced coagulopathy. Two fully automated analysers, TEG 6s and ROTEM Sigma, were launched recently. No previous studies have compared these devices in trauma paients. OBJECTIVE The aim of this study was evaluate whether both automatic deliver comparable results. DESIGN Prospective observational study. SETTING Level one centre from August 2017 September 2018. PATIENTS A total 105 blood samples 67 patients...

Background The use of PCC for the treatment trauma-induced coagulopathy potentially increase risk thromboembolism and disseminated intravascular coagulation, which is addressed to an imbalance both pro- anticoagulants. As PCCs differ in composition, we used vitro dilutional approach assess overall thrombin generation five different through various laboratory assays. Methods vitamin K-dependent coagulation factors, heparin, antithrombin were assessed commercially available PCCs. procoagulant...

In the event of trauma, emergency reversal anticoagulation therapy may be required. However, no specific agents are routinely available for direct oral anticoagulants such as dabigatran. The authors investigated four-factor prothrombin complex concentrate (PCC) treating dabigatran-induced in a porcine polytrauma model.Dabigatran etexilate was given orally 3 days and intravenously on day 4 to 32 pigs. Animals were randomized 1:1:1:1 PCC (25, 50, or 100 U/kg) saline. Study medication...