Extracorporeal support for trauma: A trauma quality improvement project (TQIP) analysis in patients with acute respiratory distress syndrome

Henry, Reynold; Ghafil, Cameron; Piccinini, Alice; Liasidis, Panagiotis; Matsushima, Kazuhide; Golden, Adam; Lewis, Meghan; Inaba, Kenji; Strumwasser, Aaron

doi:10.1016/j.ajem.2021.04.083

Cited by 8 publications

(7 citation statements)

References 29 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of this study show that compared with the conventional group, the chain group has lower rates of first aid efficiency indicators and adverse time rates and higher scores on the emergency care quality evaluation questionnaire for severely traumatized patients ( P < 0.05). This shows that this kind of management model can improve the emergency efficiency of acute trauma patients, prevent the occurrence of adverse events, and improve the quality of care, which is similar to the research results of other researchers [ 13 ]. The routine treatment of acute trauma patients is divided into four parts, and they are prehospital first aid, inhospital first aid, specialist consultation, and effective treatment.…”

Section: Discussionsupporting

confidence: 84%

Practice of Multidisciplinary Collaborative Chain Management Model in Constructing Nursing Path for Acute Trauma Treatment

Xiang

Tang

Shang

et al. 2022

Emergency Medicine International

View full text Add to dashboard Cite

Prompt and effective treatment is the key to improve the prognosis of patients with acute trauma, and nursing plays an important role. However, conventional nursing has many limitations. Some studies have pointed out that the multidisciplinary collaborative chain management model can optimize the emergency procedures, ensure the continuity of the emergency treatment process, and optimize the treatment details. This study analyzed the practice of constructing an acute trauma care pathway based on a multidisciplinary collaborative chain management model. The results showed that the application of the multidisciplinary collaborative chain management model in the construction of acute trauma treatment nursing paths can enhance the emergency efficiency and nursing treatment, prevent the occurrence of adverse events, and improve the prognosis of patients.

show abstract

Section: Discussionsupporting

confidence: 84%

Practice of Multidisciplinary Collaborative Chain Management Model in Constructing Nursing Path for Acute Trauma Treatment

Xiang

Tang

Shang

et al. 2022

Emergency Medicine International

View full text Add to dashboard Cite

show abstract

“…ARDS is commonly caused by pneumonia (endogenous) and sepsis (exogenous). [ 10 ] In a clinical study involving 282 ARDS patients, approximately half of the cases were attributed to intra- or extrapulmonary sepsis. [ 11 ] According to the most recent definition of sepsis in 2016, it is characterized as life-threatening organ dysfunction due to dysregulation organ function due to infection.…”

Section: Discussionmentioning

confidence: 99%

Clinical study of rhGM-CSF for the treatment of pulmonary exogenous acute respiratory distress syndrome by modulating alveolar macrophage subtypes: A randomized controlled trial

Sun

Zhang

et al. 2023

Medicine

View full text Add to dashboard Cite

Background: By modulating the oxygen partial pressure of alveolar epithelial cells, the granulocyte-macrophage colony-stimulating factor (GM-CSF) can stimulate and enhance the innate immune response in the lungs. This study aimed to investigate the therapeutic efficacy of rhGM-CSF in patients suffering from extrapulmonary-induced acute respiratory distress syndrome (ARDS). Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted between February 2018 to July 2019, in which 66 sepsis patients with ARDS were recruited. The study randomly allocated the patients into 2 groups: an experimental group (34 cases receiving rhGM-CSF) and a control group (32 cases receiving placebo). The changes in lung function were assessed using the scores of PaO 2 /FIO 2 ratio, acute physiology and chronic health evaluation II, sequential organ failure assessment, and lung injury. Additionally, the study analyzed the levels of inflammatory cells, HLA-DR (%), high mobility group protein B1 (HMGB-1) (ng/mL), tumor necrosis factor-alpha (pg/mL), IL-6 (pg/mL), and GM-CSF (pg/mL) in both blood and bronchoalveolar lavage fluid. Results: The study results revealed that the experimental group significantly enhanced their pulmonary function compared to the control group. Moreover, the experimental group demonstrated higher levels of inflammatory cells and HLA-DR, whereas levels of HMGB-1 and tumor necrosis factor-alpha were lower in blood ( P < .05, respectively). In addition, the experimental group displayed a higher alternatively activated cell ratio and GM-CSF levels in bronchoalveolar lavage fluid (both P < .05); while HMGB-1 levels were significantly reduced ( P < .05). However, no notable difference observed in mortality between the 2 groups ( P > .05). Conclusions: Administering rhGM-CSF to ARDS patients improves lung function and decreases blood inflammation. Nonetheless, while this treatment demonstrates efficacy in reducing these parameters, it does not significantly impact the incidence of ventilator-associated pneumonia or 28-day mortality in ARDS patients.

show abstract

“…TBI was previously contraindicated for ECMO due to the heightened risk of intracranial hemorrhage from systemic anticoagulation [ 30 , 60 , 61 ]. Recently, advancements in procedures have mitigated this bleeding risk, including low-dose anticoagulation [ 29 , 33 ], delayed anticoagulation (after 48–72 h) [ 9 , 37 ], heparin-free application [ 36 , 41 ], and improved heparin-binding circuits [ 21 , 23 ]. In this study, the survival rate of TBI patients (383, 16 studies) was comparable to non-TBI patients.…”

Section: Discussionmentioning

confidence: 99%

ECMO in adult patients with severe trauma: a systematic review and meta-analysis

Zhang,

Huang

et al. 2023

Eur J Med Res

View full text Add to dashboard Cite

Background Severe trauma can result in cardiorespiratory failure, and when conventional treatment is ineffective, extracorporeal membrane oxygenation (ECMO) can serve as an adjunctive therapy. However, the indications for ECMO in trauma cases are uncertain and clinical outcomes are variable. This study sought to describe the prognosis of adult trauma patients requiring ECMO, aiming to inform clinical decision-making and future research. Methods A comprehensive search was conducted on Pubmed, Embase, Cochrane, and Scopus databases until March 13, 2023, encompassing relevant studies involving over 5 trauma patients (aged ≥ 16 years) requiring ECMO support. The primary outcome measure was survival until discharge, with secondary measures including length of stay in the ICU and hospital, ECMO duration, and complications during ECMO. Random-effects meta-analyses were conducted to analyze these outcomes. The study quality was assessed using the Joanna Briggs Institute checklist, while the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results The meta-analysis comprised 36 observational studies encompassing 1822 patients. The pooled survival rate was 65.9% (95% CI 61.3–70.5%). Specifically, studies focusing on traumatic brain injury (TBI) (16 studies, 383 patients) reported a survival rate of 66.1% (95% CI 55.4–76.2%), while studies non-TBI (15 studies, 262 patients) reported a survival rate of 68.1% (95% CI 56.9–78.5%). No significant difference was observed between these two survival comparisons (p = 0.623). Notably, studies utilizing venoarterial extracorporeal membrane oxygenation (VA ECMO) (15 studies, 39.0%, 95% CI 23.3–55.6%) demonstrated significantly lower survival rates than those using venovenous extracorporeal membrane oxygenation (VV ECMO) (23 studies, 72.3%, 95% CI 63.2–80.7%, p < 0.001). The graded assessment of evidence provided a high degree of certainty regarding the pooled survival. Conclusions ECMO is now considered beneficial for severely traumatized patients, improving prognosis and serving as a valuable tool in managing trauma-related severe cardiorespiratory failure, haemorrhagic shock, and cardiac arrest.

show abstract

Extracorporeal support for trauma: A trauma quality improvement project (TQIP) analysis in patients with acute respiratory distress syndrome

Cited by 8 publications

References 29 publications

Practice of Multidisciplinary Collaborative Chain Management Model in Constructing Nursing Path for Acute Trauma Treatment

Practice of Multidisciplinary Collaborative Chain Management Model in Constructing Nursing Path for Acute Trauma Treatment

Clinical study of rhGM-CSF for the treatment of pulmonary exogenous acute respiratory distress syndrome by modulating alveolar macrophage subtypes: A randomized controlled trial

ECMO in adult patients with severe trauma: a systematic review and meta-analysis

Contact Info

Product

Resources

About