A5104978237- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac Arrest and Resuscitation
- Gut microbiota and health
- Immune Response and Inflammation
- Abdominal Trauma and Injuries
- Burn Injury Management and Outcomes
- Wound Healing and Treatments
- Sepsis Diagnosis and Treatment
- Injury Epidemiology and Prevention
- Clostridium difficile and Clostridium perfringens research
- Heme Oxygenase-1 and Carbon Monoxide
- Hemodynamic Monitoring and Therapy
- Trauma Management and Diagnosis
- Blood transfusion and management
- Enhanced Recovery After Surgery
- Respiratory Support and Mechanisms
- Pleural and Pulmonary Diseases
- Blood donation and transfusion practices
- T-cell and B-cell Immunology
- Bariatric Surgery and Outcomes
- Disaster Response and Management
- Dietary Effects on Health
- Emergency and Acute Care Studies
- Thermal Regulation in Medicine
The University of Texas Health Science Center at San Antonio
2016-2025
The University of Texas at San Antonio
2021-2025
The University of Texas Health Science Center at Houston
2019-2024
Society of Critical Care Medicine
2021
United States Army Institute of Surgical Research
2019-2020
Cleveland Clinic
2020
Uniformed Services University of the Health Sciences
2020
American College of Surgeons
2020
Louisiana State University
2019
Audie L. Murphy Memorial VA Hospital
2015
Abstract Introduction The use of low titer O whole blood (LTOWB) has expanded although it remains unclear how many civilian trauma centers are using LTOWB. Methods We analyzed data on LTOWB recipients in the American College Surgeons Trauma Quality Improvement Program (TQIP) database 2020–2021. Unique facility keys were used to determine number that period. Results A total 16,603 patients received TQIP between 2020 and 2021; 6600 2020, 10,003 2021. facilities reported went from 287/779 (37%)...
The microbiome is defined as the collective genomes of microbes (composed bacteria, bacteriophage, fungi, protozoa, and viruses) that colonize human body, alterations have been associated with a number disease states. Changes in gut commensals can influence neurologic system via brain-gut axis, systemic insults such trauma or traumatic brain injury (TBI) may alter microbiome. objective this study was to evaluate preclinical TBI cortical impact model. Male rats underwent craniotomy randomized...
The mortality from hemorrhage in trauma patients remains high. Early balanced resuscitation improves survival. These truths, with the availability of local resources and our goals for positive regional impact, were foundation development prehospital whole blood initiative-using low-titer cold-stored O RhD-positive blood. main concern use is potential isoimmunization RhD-negative patients. We used retrospective massive transfusion protocol (MTP) data to analyze anticipated risk this change...
BACKGROUND Despite countless advancements in trauma care a survivability gap still exists the prehospital setting. Military studies clearly identify hemorrhage as leading cause of potentially survivable death. Shifting resuscitation from hospital to point injury has shown great promise decreasing mortality among severely injured. MATERIALS AND METHODS Our regional network (Southwest Texas Regional Advisory Council) developed and implemented multiphased approach toward facilitating remote...
Abstract Background Low titer O+ whole blood (LTOWB) is being increasingly used for resuscitation of hemorrhagic shock in military and civilian settings. The objective this study was to identify the impact prehospital LTOWB on survival patients receiving transfusion. Study design methods A single institutional trauma registry queried undergoing transfusion between 2015 2019. Patients were stratified based (PHT) or no (NT). Outcomes measured included emergency department (ED), 6‐h hospital...
Mass casualty incidents and massive transfusion requirements continue to plague the USA with hemorrhage remaining number one cause of death in trauma. The unfortunate reality numerous mass shootings Southwest Texas has led need for a way which provide blood during these events as rapidly it is required. Multiple agencies within system have united help this life-saving people when they most. This effort began development safe, efficient, now widespread use whole region. After demonstrating...
ABSTRACT Human aging presents an evolutionary paradox: while rates remain constant, healthspan and lifespan vary widely. We address this conundrum via salutogenesis—the active production of health—through immune resilience (IR), the capacity to resist disease despite inflammation. Analyzing ~17,500 individuals across stages inflammatory challenges, we identified a core salutogenic mechanism: IR centered on TCF7 , conserved transcription factor maintaining T‐cell stemness regenerative...
BACKGROUND Whole blood (WB) use has become increasingly common in trauma centers across the United States for both in-hospital and prehospital resuscitation. We hypothesize that WB (pWB) patients with suspected hemorrhage will result improved hemodynamic status reduced product requirements. METHODS The institutional registries of two academic level I were queried all from 2015–2019 who underwent transfusion upon arrival to bay. Patients dead on or had isolated head injuries excluded....
ABSTRACT Introduction: Hemorrhage is one of the most substantial causes death after traumatic injury. Standard measures, including systolic blood pressure (SBP), are poor surrogate indicators physiologic compromise until compensatory mechanisms have been overwhelmed. Compensatory Reserve Index (CRI) a novel monitoring technology with ability to assess reserve. We hypothesized CRI would be better predictor secondary hemorrhage than traditional vital signs. Methods: A prospective observational...
BACKGROUND Hemorrhage is the most common cause of preventable death in trauma patients. These mortalities might be prevented with prehospital transfusion. We sought to characterize injured patients requiring massive transfusion determine potential impact a whole blood program. The primary goal this analysis was method identify at risk environment. Many existing predictive models require laboratory values and/or sonographic evaluation patient after arrival hospital. Development an algorithm...
Traumatic injury can lead to a compromised intestinal epithelial barrier, decreased gut perfusion, and inflammation. While recent studies indicate that the microbiome (GM) is altered early following traumatic injury, impact of GM changes on clinical outcomes remains unknown. Our objective this follow-up study was determine if associated with in critically injured patients.
Abstract Background Studies of the gut microbiome are becoming increasingly important. Such studies require stool collections that can be processed or frozen in a timely manner so as not to alter microbial content. Due logistical difficulties home-based collection, there has been challenge selecting appropriate sample collection technique and comparing results from different studies. Thus, we compared two alternative clinic-based fecal techniques, including newer glove-based method. Results...
INTRODUCTION With the emergence of whole blood (WB) in trauma resuscitation, cost-related comparisons are significant importance to providers, banks, and hospital systems throughout country. The objective this study was determine if there is a transfusion-related cost difference between patients who received low titer O+ (LTO+WB) component therapy (CT). METHODS A retrospective review adult pediatric either LTO+WB or CT from time injury within 4 hours arrival performed. Annual mean per unit...
BACKGROUND Traumatic injury can lead to a compromised intestinal epithelial barrier and inflammation. While alterations in the gut microbiome of critically injured patients may influence clinical outcomes, impact trauma on microbial composition is unknown. Our objective was determine if altered severely begin characterize changes due time therapeutic intervention. METHODS We conducted prospective, observational study adult (n = 72) sustaining severe admitted Level I Trauma Center. Healthy...
BACKGROUND During traumatic hemorrhage, the ability to identify shock and intervene before decompensation is paramount survival. Lactate extremely sensitive shock, its clearance has been demonstrated a useful gauge of resuscitation status. Though lactate can be measured in field, logistical constraints render it impractical certain environments. The compensatory reserve represents new clinical measurement reflecting remaining capacity compensate for hypoperfusion. We hypothesized index (CRI)...