A5102893032- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Abdominal Trauma and Injuries
- Blood transfusion and management
- Cardiac Arrest and Resuscitation
- Pelvic and Acetabular Injuries
- Venous Thromboembolism Diagnosis and Management
- Sepsis Diagnosis and Treatment
- Trauma Management and Diagnosis
- Pregnancy-related medical research
- Cardiac, Anesthesia and Surgical Outcomes
- Ultrasound in Clinical Applications
- Blood donation and transfusion practices
- Traumatic Brain Injury and Neurovascular Disturbances
- Acute Ischemic Stroke Management
- Abdominal Surgery and Complications
- Acute Myocardial Infarction Research
- Urological Disorders and Treatments
- Hemodynamic Monitoring and Therapy
- Appendicitis Diagnosis and Management
- Immune Response and Inflammation
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Cardiac Structural Anomalies and Repair
- Antimicrobial Resistance in Staphylococcus
- Maternal and fetal healthcare
University of Pittsburgh
2016-2025
Délégation Paris 6
2024
Kuwait Petroleum Corporation (Kuwait)
2024
Hochschule Düsseldorf University of Applied Sciences
2024
The Bronx Defenders
2024
University of Pittsburgh Medical Center
2008-2022
University of Maryland, Baltimore
2018-2022
Oregon Health & Science University
2022
University of Southern California
2017-2022
Orthopaedic Trauma Association
2022
A cornerstone of modern biomedical research is the use mouse models to explore basic pathophysiological mechanisms, evaluate new therapeutic approaches, and make go or no-go decisions carry drug candidates forward into clinical trials. Systematic studies evaluating how well murine mimic human inflammatory diseases are nonexistent. Here, we show that, although acute stresses from different etiologies result in highly similar genomic responses humans, corresponding correlate poorly with...
Background: Blood transfusion is known to be an independent risk factor for mortality, multiple organ failure (MOF), acute respiratory distress syndrome (ARDS), and nosocomial infection after injury. Less about the risks associated with plasma-rich components including fresh frozen plasma (FFP), platelets (PLTS), cryoprecipitate (CRYO) We hypothesized that would independently a lower of mortality but result in greater morbid complications. Methods: Data were obtained from multicenter...
In the past three decades, there has been a significant clinical shift in performance of resuscitative thoracotomy (RT), from nearly obligatory procedure before declaring any trauma patient deceased to more selective application RT. We have sought formulate an evidence-based guideline for current indications RT after injury patient.The Western Trauma Association Critical Decisions Committee queried literature studies defining appropriate role patient. When good data were not available,...
BACKGROUND There is no consensus as to the optimal treatment paradigm for patients presenting with hemorrhage from severe pelvic fracture. This study was established determine methods of control currently being used in clinical practice. METHODS prospective, observational multi-center enrolled fracture blunt trauma. Demographic data, admission vital signs, presence shock on (systolic blood pressure < 90 mm Hg or heart rate > 120 beats per minute base deficit −5), method control, transfusion...
This is a recommended evaluation and management algorithm from the Western Trauma Association (WTA) Algorithms Committee focused on of pharmacologic prophylaxis for venous thromboembolism (VTE) prevention in trauma patients. Because there are few related published prospective, randomized clinical trials that have generated class I data this topic population, these recommendations based primarily prospective retrospective cohort studies, expert opinion WTA members. The final result an...
Tranexamic acid (TXA) is used as a hemostatic adjunct for hemorrhage control in the injured patient and reduces early preventable death. However, risk of venous thromboembolism (VTE) has been incompletely explored. Previous studies investigating effect TXA on VTE vary their findings. We performed propensity matched analysis to investigate association between following trauma, hypothesizing that an independent factor VTE.This retrospective study queried trauma patients presenting single Level...
Objective: Recent evidence suggests that overly aggressive crystalloid resuscitation is associated with poor outcome. This has led to a renewed interest in the use of vasopressors for hemodynamic support during after injury. We sought characterize early vasopressor (EV) and (ECR) their association mortality severely injured patients. Methods: Data were obtained from multicenter, prospective, cohort study designed evaluate outcome blunt adults hemorrhagic shock. Early deaths (<48 hours)...
To describe the incidence of postinjury multiple organ failure and its relationship to nosocomial infection mortality in trauma centers using evidence-based standard operating procedures.Prospective cohort study wherein procedures were developed implemented optimize care.Seven U.S. level I centers.Severely injured patients (older than age 16 yrs) with a blunt mechanism, systolic hypotension (<90 mm Hg), and/or base deficit (≥6 mEq/L), need for blood transfusion within first 12 hrs, an...
This is a recommended algorithm of the Western Trauma Association for acute management penetrating chest injury. Because paucity recent prospective randomized trials on evaluation and injury, current algorithms recommendations are based available published cohort, observational retrospective studies, expert opinion members. The two should be reviewed in following sequence: Figure 1 damage-control strategies unstable patient 2 definitive repair stable patient. will discuss techniques; focus...
To determine the feasibility, efficacy, and safety of early cold stored platelet transfusion compared with standard care resuscitation in patients hemorrhagic shock.
Importance While national guidelines recommend avoidance of hypoxia, hypotension, and hypocarbia in the prehospital care traumatic brain injury (TBI), limited data validate association these adverse physiologic events with TBI outcomes. Objective To associations outcomes a US trauma network. Design, Setting, Participants This cohort study examined from 8 level I centers their affiliated ground air emergency medical services (EMS) agencies Linking Investigations Trauma Emergency Services...
Background: Critically ill patients often require invasive monitoring to evaluate and optimize cardiac function preload. With questionable outcomes associated with pulmonary artery catheters (PACs), some have evaluated the role of less monitors. We hypothesized that Bedside Echocardiographic Assessment in Trauma (BEAT) examination would generate index (CI) central venous pressure (CVP) estimates correlate a PAC. Methods: BEAT was performed on all SICU PAC place. Prospective data included...
Background: Advances in computed tomography capabilities have enabled trauma surgeons to screen for and diagnose the severity of blunt cervical vascular injury (BCVI) using tomographic angiography (CTA) alone. We hypothesized that use CTA-alone screening diagnostic methods would reduce time interval from admission diagnosis and, hence, also stroke rates associated with these injuries. Methods: All patients admitted a level I center after December 1999 at risk BCVI were screened. Until March...
Objective: To characterize the gender dimorphism after injury with specific reference to reproductive age of women (young, <48 yrs age, vs. old, >52 age) in a cohort severely injured trauma patients for which significant variation postinjury care is minimized. Design: Secondary data analysis an ongoing prospective multicenter study. Setting: Academic, level I and intensive unit centers. Patients: Blunt-injured adults hemorrhagic shock. Interventions: None. Measurements Main Results: Separate...
Necrotizing soft-tissue infections (NSTI) have high morbidity and mortality rates despite aggressive surgical debridement antibiotic therapy. AB103 is a peptide mimetic of the T-lymphocyte receptor, CD28. We hypothesized that will limit inflammatory responses to bacterial toxins decrease incidence organ failure. To establish safety in patients with NSTI evaluate potential effects on clinically meaningful parameters related disease. A prospective, randomized, placebo-controlled,...
Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques used for definitive repair or control of these anatomically challenging injuries. The aim this study was determine the relative roles in management subclavian comparing hospital outcomes, long-term limb viability.A multicenter, retrospective review patients with from January 1, 2004, December 31, 2014, completed at 11 participating Western Trauma Association institutions....
Early identification of patients with pelvic fractures at risk severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that fracture patterns predict the need for hemorrhage control intervention.This prospective, observational, multicenter enrolled due blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, ability review imaging). Demographic...
Screening for blunt cerebrovascular injuries (BCVIs) in asymptomatic high-risk patients has become routine. To date, the length of this period not been defined. Determining time to stroke could impact therapy including earlier initiation antithrombotics multiply injured patients. The purpose study was determine with a BCVI-related stroke. We hypothesized that majority suffer between 24 hours and 72 after injury.Patients from January 2007 2017 37 trauma centers were reviewed.During 10-year...
The staged laparotomy in the operative management of emergency general surgery (EGS) patients is an extension trauma surgeons operating on this population. Indications for its application, however, are not well defined, and currently based lethal triad used physiologically-decompensated patients. This study sought to determine acute indications staged, rapid source control (RSCL) EGS patients.All undergoing emergent RSCL non-RSCL over 3 years were studied. Demographics, physiologic...
Objective: An important and persistent laboratory finding has been that males females respond differently after traumatic injury hemorrhagic shock. We have previously presented clinical data showing male gender is independently associated with a 40% higher rate of multiple organ failure (MOF) 25% nosocomial infection (NI) injury; however, the mechanism responsible for this dimorphic response not adequately characterized clinically. Methods: Data were obtained from multicenter prospective...
Background: Endovascular management of blunt aortic injury has dramatically reduced the morbidity and mortality associated with this specific injury. There remains a paucity evidence quantifying beneficial effects endovascular (ENDO) techniques for other vascular types little information regarding impact ENDO have had on traumatic injuries over time. Methods: We performed retrospective analysis data from National Trauma Data Bank 2002 to 2006 2008 time periods (NTDB 7.2 RDS 2008). Injured...
BACKGROUND A subset of trauma patients with critical injury present coagulopathy, portending markedly worse outcomes. Clinical practice is evolving to treat the classical risk factors hypothermia, hemodilution, and acidosis; however, coagulopathy persists even in absence these factors. We sought determine relative importance injury- shock-specific compared resuscitation-associated after trauma. METHODS Comprehensive demographic data, laboratory outcomes data were prospectively collected from...