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Review Article
Trauma
Damage control strategy in bleeding trauma patients
Maru Kim, Hangjoo Cho
Acute Crit Care. 2020;35(4):237-241.   Published online November 30, 2020
DOI: https://doi.org/10.4266/acc.2020.00941
  • 5,762 View
  • 363 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Hemorrhagic shock is a main cause of death in severe trauma patients. Bleeding trauma patients have coagulopathy on admission, which may even be aggravated by incorrectly directed resuscitation. The damage control strategy is a very urgent and essential aspect of management considering the acute coagulopathy of trauma and the physiological status of bleeding trauma patients. This strategy has gained popularity over the past several years. Patients in extremis cannot withstand prolonged definitive surgical repair. Therefore, an abbreviated operation, referred to as damage control surgery (DCS), is needed. In addition to DCS, the likelihood of survival should be maximized for patients in extremis by providing appropriate critical care, including permissive hypotension, hemostatic resuscitation, minimization of crystalloid use, early use of tranexamic acid, and avoidance of hypothermia and hypocalcemia. This review presents an overview of the evolving strategy of damage control in bleeding trauma patients.

Citations

Citations to this article as recorded by  
  • Current Approaches to the Treatment of Traumatic Shock (Review)
    D. A. Ostapchenko, A. I. Gutnikov, L. A. Davydova
    General Reanimatology.2021; 17(4): 65.     CrossRef
Original Articles
Trauma
The association between the initial lactate level and need for massive transfusion in severe trauma patients with and without traumatic brain injury
Young Hoon Park, Dong Hyun Ryu, Byung Kook Lee, Dong Hun Lee
Acute Crit Care. 2019;34(4):255-262.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00640
  • 5,039 View
  • 134 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Exsanguination is a major cause of death in severe trauma patients. The purpose of this study was to analyze the prognostic impact of the initial lactate level for massive transfusion (MT) in severe trauma. We divided patients according to subgroups of traumatic brain injury (TBI) and non-TBI.
Methods
This single-institution retrospective study was conducted on patients who were admitted to hospital for severe trauma between January 2016 and December 2017. TBI was defined by a head Abbreviated Injury Scale ≥3. Receiver operating characteristic analysis was used to analyze the prognostic impact of the lactate level. Multivariate analyses were performed to evaluate the relationship between the MT and lactate level. The primary outcome was MT.
Results
Of the 553 patients, MT was performed in 62 patients (11.2%). The area under the curve (AUC) for the lactate level for predicting MT was 0.779 (95% confidence interval [CI], 0.742 to 0.813). The AUCs for lactate level in the TBI and non-TBI patients were 0.690 (95% CI, 0.627 to 0.747) and 0.842 (95% CI, 0.796 to 0.881), respectively. In multivariate analyses, the lactate level was independently associated with the MT (odds ratio [OR], 1.179; 95% CI, 1.070 to 1.299). The lactate level was independently associated with MT in non-TBI patients (OR, 1.469; 95% CI, 1.262 to 1.710), but not in TBI patients.
Conclusions
The initial lactate level may be a possible prognostic factor for MT in severe trauma. In TBI patients, however, the initial lactate level was not suitable for predicting MT.

Citations

Citations to this article as recorded by  
  • Association of initial lactate levels and red blood cell transfusion strategy with outcomes after severe trauma: a post hoc analysis of the RESTRIC trial
    Yoshinori Kosaki, Takashi Hongo, Mineji Hayakawa, Daisuke Kudo, Shigeki Kushimoto, Takashi Tagami, Hiromichi Naito, Atsunori Nakao, Tetsuya Yumoto
    World Journal of Emergency Surgery.2024;[Epub]     CrossRef
Trauma
Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study
Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin
Acute Crit Care. 2019;34(4):269-275.   Published online November 18, 2019
DOI: https://doi.org/10.4266/acc.2019.00591
Correction in: Acute Crit Care 2020;35(1):56
  • 5,275 View
  • 159 Download
  • 8 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
Snakebite can cause various complications, including coagulopathy. The clinical features of snakebite-associated coagulopathy differ from those of disseminated intravascular coagulation (DIC) caused by other diseases and its treatment is controversial.
Methods
We retrospectively reviewed the medical records of patients hospitalized for snakebite between January 2006 and September 2018.
Results
A total of 226 patients were hospitalized due to snakebite. Their median hospital stay was 4.0 days (interquartile range, 2.0 to 7.0 days). Five patients arrived at hospital with shock and one patient died. Twenty-one patients had overt DIC according to the International Society of Thrombosis and Hemostasis scoring system. Two patients developed major bleeding complications. Initial lower cholesterol level at presentation was associated with the development of overt DIC. International normalization ratio (INR) exceeding the laboratory’s measurement limit was recorded as late as 4 to 5 days after the bite. Higher antivenom doses (≥18,000 units) and transfusion of fresh frozen plasma (FFP) or cryoprecipitate did not affect prolonged INR duration or hospital stay in the overt DIC patients without bleeding.
Conclusions
Initial lower cholesterol level may be a risk factor for overt DIC following snakebite. Although patients lack apparent symptoms, the risk of coagulopathy should be assessed for at least 4 to 5 days following snakebite. Higher antivenom doses and transfusion of FFP or cryoprecipitate may be unbeneficial for coagulopathic patients without bleeding.

Citations

Citations to this article as recorded by  
  • EXPERIMENTAL MODEL OF DIC SYNDROME
    Olena Boiarchuk
    Grail of Science.2024; (38): 138.     CrossRef
  • A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study
    Maya Gopalakrishnan, Suman Saurabh, Pramod Sagar, Chanaveerappa Bammigatti, Tarun Kumar Dutta, Nicholas R. Casewell
    PLOS Neglected Tropical Diseases.2022; 16(2): e0010183.     CrossRef
  • Attempt for a Recombinant Thrombomodulin Alpha Treatment in a Rat Disseminated Intravascular Coagulation Model Using Yamakagashi (Rhabdophis tigrinus) Venom
    Akihiko Yamamoto, Takashi Ito, Toru Hifumi
    Toxins.2022; 14(5): 322.     CrossRef
  • Coagulopathy following Crotaliπae snakebites in northeast Florida
    Satish Maharaj, Karan Seegobin, Simone Chang
    Blood Coagulation & Fibrinolysis.2022; 33(4): 220.     CrossRef
  • Unmasking the ties of snake bite poisoning and COVID-19
    Anjuman Chander, Tanvir Samra, Sekar Loganathan, Varun Mahajan
    Ain-Shams Journal of Anesthesiology.2022;[Epub]     CrossRef
  • Venom induced consumption coagulopathy and performance of 20-min whole blood clotting test for its detection in viperid envenomation
    Bayye Rajkumar, Kolar Vishwanath Vinod, Rakhee Kar, Premkumar Ramasubramani
    Journal of the Royal College of Physicians of Edinburgh.2022; 52(3): 232.     CrossRef
  • The effect of myocardial injury on the clinical course of snake envenomation in South Korea
    J. M. Moon, Y. J. Koo, B. J. Chun, K. H. Park, Y. S. Cho, J. C. Kim, S. D. Lee, Y. R. Min, H. S. Park
    Clinical Toxicology.2021; 59(4): 286.     CrossRef
Review
Cardiology
Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation
Hyoung Soo Kim, Sunghoon Park
Korean J Crit Care Med. 2017;32(1):22-28.   Published online February 28, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00983
  • 20,506 View
  • 702 Download
  • 19 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Extracorporeal membrane oxygenation (ECMO) is frequently associated with bleeding and coagulopathy complications, which may lead to the need for transfusion of multiple blood products. However, blood transfusions are known to increase morbidity and mortality, as well as hospital cost, in critically ill patients. In current practice, patients on ECMO receive a transfusion, on average, of 1-5 packed red blood cells (RBCs)/day, with platelet transfusion accounting for the largest portion of transfusion volume. Generally, adult patients require more transfusions than neonates or children, and patients receiving venovenous ECMO for respiratory failure tend to need smaller transfusion volumes compared to those receiving venoarterial ECMO for cardiac failure. Observation studies have reported that a higher transfusion volume was associated with increased mortality. To date, the evidence for transfusion in patients undergoing ECMO is limited; most knowledge on transfusion strategies was extrapolated from studies in critically ill patients. However, current data support a restrictive blood transfusion strategy for ECMO patients, and a low transfusion trigger seems to be safe and reasonable.

Citations

Citations to this article as recorded by  
  • Oxygenation During Venoarterial Extracorporeal Membrane Oxygenation: Physiology, Current Evidence, and a Pragmatic Approach to Oxygen Titration
    Lavienraj Premraj, Alastair Brown, John F. Fraser, Vincent Pellegrino, David Pilcher, Aidan Burrell
    Critical Care Medicine.2024; 52(4): 637.     CrossRef
  • A Comprehensive Review of Extra Corporeal Membrane Oxygenation: The Lifeline in Critical Moments
    Sindhu Geetha, Neeta Verma, Vivek Chakole
    Cureus.2024;[Epub]     CrossRef
  • Point of care guided coagulation management in adult patients on ECMO: A systematic review and meta-analysis
    Ayten Saracoglu, Ibrahim Fawzy, Kemal Tolga Saracoglu, Bushra M Abdallah, Mariah Arif, Matthieu Schmidt
    Journal of Critical Care.2024; 83: 154830.     CrossRef
  • Veno-arterial extracorporeal membrane oxygenation without allogeneic blood transfusion: An observational cohort study
    Alison Grazioli, Michael Plazak, Siamak Dahi, Joseph Rabin, Ashley Menne, Mehrdad Ghoreishi, Bradley Taylor, Seth Perelman, Michael Mazzeffi
    Perfusion.2023; 38(7): 1519.     CrossRef
  • A value-based approach to optimize red blood cell transfusion in patients receiving extracorporeal membrane oxygenation
    Yasuhiro Shudo, Nathalie Cheng, Hao He, Corinne Rosenberg, William Hiesinger, Eric Hadhazy, John Shepard, Purnima Krishna, Josh Resnik, Robyn Fong, Charles Hill, Joe L Hsu, Paul M Maggio, Sang-Ick Chang, Jack H Boyd, Y Joseph Woo
    Perfusion.2023; 38(8): 1682.     CrossRef
  • ECMO Retrieval Program: What Have We Learned So Far
    Ihor Krasivskyi, Clara Großmann, Marit Dechow, Ilija Djordjevic, Borko Ivanov, Stephen Gerfer, Walid Bennour, Elmar Kuhn, Anton Sabashnikov, Navid Mader, Kaveh Eghbalzadeh, Thorsten Wahlers
    Life.2023; 13(1): 157.     CrossRef
  • Haematological Trends and Transfusion during Adult Extracorporeal Membrane Oxygenation: A Single Centre Study
    Elliott T. Worku, April M. Win, Dinesh Parmar, Chris Anstey, Kiran Shekar
    Journal of Clinical Medicine.2023; 12(7): 2629.     CrossRef
  • Extracorporeal Membrane Oxygenation Patient Outcomes Following Restrictive Blood Transfusion Protocol
    Jacob A. Braaten, Bridget S. Dillon, Jillian K. Wothe, Conner P. Olson, Elizabeth R. Lusczek, Kristiana J. Sather, Gregory J. Beilman, Melissa E. Brunsvold
    Critical Care Explorations.2023; 5(12): e1020.     CrossRef
  • Neonatal extra corporeal membrane oxygenation
    Suneel Kumar Pooboni
    Indian Journal of Thoracic and Cardiovascular Surgery.2021; 37(4): 411.     CrossRef
  • Point-of-care testing of plasma free hemoglobin and hematocrit for mechanical circulatory support
    Dong Ah Shin, Jung Chan Lee, Heean Shin, Young-Jae Cho, Hee Chan Kim
    Scientific Reports.2021;[Epub]     CrossRef
  • Systematic review and meta-analysis of the clinical effectiveness of point-of-care testing for anticoagulation management during ECMO
    Federica Jiritano, Dario Fina, Roberto Lorusso, Hugo ten Cate, Mariusz Kowalewski, Matteo Matteucci, Raffaele Serra, Pasquale Mastroroberto, Giuseppe Filiberto Serraino
    Journal of Clinical Anesthesia.2021; 73: 110330.     CrossRef
  • Blood transfusion strategies and ECMO during the COVID-19 pandemic
    David Koeckerling, Daniel Pan, N Lakmal Mudalige, Oluwatobiloba Oyefeso, Joseph Barker
    The Lancet Respiratory Medicine.2020; 8(5): e40.     CrossRef
  • Life-threatening antineutrophil cytoplasmic antibody–associated vasculitis after influenza A H1N1 infection requiring veno-venous extracorporeal membrane oxygenation
    Frantzeska G. Frantzeskaki, Stavros Dimopoulos, Dimitrios Konstantonis, Pelagia Katsibri, Kostantinos Kostopanagiotou, Maria Theodorakopoulou, Chrysi Diakaki, Dimitrios Dougenis, Dimitrios Boumpas, Andreas Karabinis, Apostolos Armaganidis, Iraklis Tsangar
    Perfusion.2020; 35(6): 546.     CrossRef
  • Case Report: Successful Use of Extracorporeal Therapies After ECMO Resuscitation in a Pediatric Kidney Transplant Recipient
    Andrey Rybalko, Anna Pytal, Mikhail Kaabak, Nadejda Rappoport, Anuar Bidzhiev, Vasilii Lastovka
    Frontiers in Pediatrics.2020;[Epub]     CrossRef
Case Report
Cardiology/Pediatric
Transfusion Associated Hyperkalemia and Cardiac Arrest in an Infant after Extracorporeal Membrane Oxygenation
Do Wan Kim, Kyeong Ryeol Cheon, Duck Cho, Kyo Seon Lee, Hwa Jin Cho, In Seok Jeong
Korean J Crit Care Med. 2015;30(2):132-134.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.132
  • 7,698 View
  • 96 Download
  • 5 Crossref
AbstractAbstract PDF
Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.

Citations

Citations to this article as recorded by  
  • Transfusion-associated graft-versus-host disease, transfusion-associated hyperkalemia, and potassium filtration: advancing safety and sufficiency of the blood supply
    Kenneth E. Nollet, Alain M. Ngoma, Hitoshi Ohto
    Transfusion and Apheresis Science.2022; 61(2): 103408.     CrossRef
  • Transfusion-Associated Hyperkalemic Cardiac Arrest in Neonatal, Infant, and Pediatric Patients
    Morgan Burke, Pranava Sinha, Naomi L. C. Luban, Nikki Gillum Posnack
    Frontiers in Pediatrics.2021;[Epub]     CrossRef
  • Double-filtered leukoreduction as a method for risk reduction of transfusion-associated graft-versus-host disease
    Sejong Chun, Minh-Trang Thi Phan, Saetbyul Hong, Jehoon Yang, Yeup Yoon, Sangbin Han, Jungwon Kang, Mark H. Yazer, Jaehyun Kim, Duck Cho, Senthilnathan Palaniyandi
    PLOS ONE.2020; 15(3): e0229724.     CrossRef
  • Anticoagulation Therapy during Extracorporeal Membrane Oxygenator Support in Pediatric Patients
    Hwa Jin Cho, Do Wan Kim, Gwan Sic Kim, In Seok Jeong
    Chonnam Medical Journal.2017; 53(2): 110.     CrossRef
  • Blood Transfusion Strategies in Patients Supported by Extracorporeal Membrane Oxygenation
    Yoon Hee Kim
    The Korean Journal of Critical Care Medicine.2015; 30(3): 139.     CrossRef
Review
Transfusion-related Acute Lung Injury
Miok Kim
Korean J Crit Care Med. 2012;27(1):1-4.
DOI: https://doi.org/10.4266/kjccm.2012.27.1.1
  • 2,766 View
  • 219 Download
  • 3 Crossref
AbstractAbstract PDF
Transfusion-related acute lung injury (TRALI) is a significant cause of iatrogenic injuries in patients. It is also the major cause of transfusion-associated fatalities. Pathophysiologic mechanism is an implicated donor of HLA. Neutrophil antibodies and biologic response modifiers are accumulated in the stored blood products. Pulmonary endothelial activation of the host may be the response from these mediators. Treatment is supportive and will be subjected to other forms of ALL/ARDS. Diverting donors at high risk for alloimmunization may decrease the incidence of such cases.

Citations

Citations to this article as recorded by  
  • Transfusion-related acute lung injury in a parturient diagnosed with myelodysplastic syndrome - A case report -
    Tae-Yun Sung, Young Seok Jee, Seok-jin Lee, Hwang Ju You, Ki Soon Jeong, Po-Soon Kang
    Anesthesia and Pain Medicine.2019; 14(1): 35.     CrossRef
  • Correlation between Allergic Rhinitis Prevalence and Immune Responses of Children in Ulsan: A Case-control Study
    Jiho Lee, Inbo Oh, Ahra Kim, Minho Kim, Chang sun Sim, Yangho Kim
    Korean Journal of Environmental Health Sciences.2015; 41(4): 249.     CrossRef
  • Transfusion-Related Acute Lung Injury after Stored Packed Red Blood Cell Transfusion - A Case Report -
    Ho-Hyun Kim, Dong-Kyu Lee, Chan-Yong Park, Jae-Kyoon Ju, Jung-Chul Kim
    Korean Journal of Critical Care Medicine.2013; 28(2): 141.     CrossRef
Case Reports
A Case of Acute Lung Injury after Transfusion during Cesarean Section: A Case Report
Hee Jong Lee, Mi Ae Jeong, Ji Seon Jeong, Min Kyu Han, Jong Hun Jun
Korean J Crit Care Med. 2011;26(3):184-187.
DOI: https://doi.org/10.4266/kjccm.2011.26.3.184
  • 2,937 View
  • 52 Download
  • 4 Crossref
AbstractAbstract PDF
Transfusion-related acute lung injury (TRALI) is a serious complication following the transfusion of blood products. TRALI is under-diagnosed and under-reported because of a lack of awareness. TRALI occurs within 6 hours of transfusion in the majority of cases and its presentation is similar to other forms of acute lung injury. We report on the case of a 34-year-old pregnant woman who suffered from TRALI after transfusion during Cesarean section.

Citations

Citations to this article as recorded by  
  • Transfusion-related acute lung injury in a parturient diagnosed with myelodysplastic syndrome - A case report -
    Tae-Yun Sung, Young Seok Jee, Seok-jin Lee, Hwang Ju You, Ki Soon Jeong, Po-Soon Kang
    Anesthesia and Pain Medicine.2019; 14(1): 35.     CrossRef
  • A Case Report of Transfusion-Related Acute Lung Injury Induced in the Patient with HLA Antibody after Fresh Frozen Plasma Transfusion
    Ki Sul Chang, Dae Won Jun, Youngil Kim, Hyunwoo Oh, Min Koo Kang, Junghoon Lee, Intae Moon
    The Korean Journal of Blood Transfusion.2015; 26(3): 309.     CrossRef
  • Transfusion-Related Acute Lung Injury after Stored Packed Red Blood Cell Transfusion - A Case Report -
    Ho-Hyun Kim, Dong-Kyu Lee, Chan-Yong Park, Jae-Kyoon Ju, Jung-Chul Kim
    Korean Journal of Critical Care Medicine.2013; 28(2): 141.     CrossRef
  • A case of transfusion-related acute lung injury induced by anti-human leukocyte antigen antibodies in acute leukemia
    Sun Mi Jin, Moon Ju Jang, Ji Young Huh, Myoung Hee Park, Eun Young Song, Doyeun Oh
    The Korean Journal of Hematology.2012; 47(4): 302.     CrossRef
The Care of a Jehovah's Witness with Life-threatening Anemia Refusing Ventilator Care: A Case Report
Ji Hyeon Lee, So Ron Choi, Young Jhoon Chin, Soo Il Lee, Chan Jong Chung, Jong Hwan Lee, Seung Cheol Lee
Korean J Crit Care Med. 2010;25(1):52-55.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.52
  • 2,563 View
  • 31 Download
AbstractAbstract PDF
Jehovah's Witnesses refuse the transfusion of blood and blood products, even when it can be lifesaving. Their religious conviction against receiving blood can create a difficult clinical dilemma, particularly in the life threatening situations. We report a case of a 42-year-old female Jehovah's Witness patient who had life-threatening anemia after postpartum hemorrhage. Despite severe anemia, she had a good postoperative recovery without complications.

ACC : Acute and Critical Care