Hemorrhage is More Prevalent than Brain Injury in Early Trauma Deaths: The Golden Six Hours

Bansal, Vishal; Fortlage, Dale; Lee, Jeanne G.; Costantini, Todd W.; Potenza, Bruce; Coimbra, Raúl

doi:10.1007/s00068-008-8080-2

Cited by 61 publications

(46 citation statements)

References 14 publications

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“…Within the first day, most deaths occur in the first 6 h after admission, 70% in the TR-DGU and 72% in the TARN. This is in the range of previously published observations of 60-80% [8,9].…”

Section: Discussionsupporting

confidence: 78%

See 1 more Smart Citation

Epidemiology of in-hospital trauma deaths

Lefering

Paffrath

Bouamra

et al. 2011

Eur J Trauma Emerg Surg

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“…Within the first day, most deaths occur in the first 6 h after admission, 70% in the TR-DGU and 72% in the TARN. This is in the range of previously published observations of 60-80% [8,9].…”

Section: Discussionsupporting

confidence: 78%

“…Although severe head injuries could lead to death very quickly, it is not the predominant cause of death within the first few hours. Also, Bansal et al [9] found that hemorrhage is more prevalent in early deaths than TBI.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of in-hospital trauma deaths

Lefering

Paffrath

Bouamra

et al. 2011

Eur J Trauma Emerg Surg

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“…1,2 In response to this realization, the last 10 years has seen a widespread paradigm shift in the resuscitation of critically injured patients. Early in this era, landmark studies identified iatrogenic and resuscitation-associated causes of coagulopathic bleeding after traumatic injury; hypothermia, metabolic acidosis, and dilutional coagulopathy were recognized as primary drivers of bleeding after trauma.…”

mentioning

confidence: 98%

A Paradigm Shift in Trauma Resuscitation

et al. 2013

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“…Mean ICP value was 26.33±16.73 mmHg, with a minimum mean value of 12.83 mmHg and a maximum mean value of 55.33 mmHg. Our patients received an optimised therapeutic management and CPP values being in the range recommended by Brain Trauma Foundation (50-70 mmHg) (9,(18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Intracranial Pressure (ICP) Monitoring as Part of Multimodal Monitoring Management of Critical Polytrauma Patients. Correlation Between Optimized Intensive Therapy According to ICP Parameters and Clinical Picture

Luca¹,

Rogobete²,

Bedreag³

et al. 2015

Turk J Anaesth Reanim

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Amaç: Travmalı hastada, çok sayıda ağır yaralanma veya sekonder komplikasyonlar nedeniyle karmaşık bir tedavi yaklaşımı gerekir. Travmalı hastalarda bulunan en önemli yaralanma, ölüm üzerinde en büyük etkiye sahip olan kafa travmasıdır. Ağır travmatik kafa yaralanmasında intrakranial basınç (İKB) takibi gereklidir, çünkü İKB değerlerine ve serebral perfüzyon basıncına (SPB) dayalı tedaviyi optimize etmektedir.Yöntemler: Ocak 2014 ve Aralık 2014 arasında Temeşvar, Romanya'da "Pius Brinzeu" Acil Şehir Hastanesinin Politravmatoloji Kliniğinde, "Casa Austria" yoğun bakım ünitesine (YBÜ) başvuran toplam 64 hastadan, sadece İKB takibi yapılan hastalar (n=10) analiz edildi. Çalışma popülasyonu travmadan İKB takibinin kurulumuna kadar geçen zamana bağlı olarak (<18 saat, 19-24 saat,>24 saat) çeşitli kategorilere ayrıldı. Ayrıca İKB takibinden yararlanan ve yararlanmayan kafa travmalı hastalar arasında YBÜ'nde yatış günü sayıları ve mortalite açısından karşılaştırma yapıldı.Bulgular: Bulgular İKB takibinin, terapötik etkiyi artırma ihtimali nedeniyle YBÜ'de yatış günleri üzerine olumlu etkisini göster-mektedir. İKB takibinden yararlanan hastalarda İKB takibi olmayanlara kıyasla 1,93 gün daha az yatış mevcuttu.Sonuç: İKB takibi ve İKB ve SPB'ye göre tedavinin optimize edilmesi sağkalım oranı üzerinde önemli bir etkiye sahiptir. İKB takibi güncel kılavuzlara göre kafa travması yaralanması olan tüm hastalarda gereklidir. Kafa yaralanması olan travmalı hastanın tedavisinde başlıca terapötik hedef ilişkili yan etkilerin tahrip edici etkilerini en aza indirmektir.Anahtar kelimeler: İntrakranial basınç, serebral perfüzyon basın-cı, serebral kan akımı, kafa yaralanması, travmatik beyin hasarı, çoklu travmalı hastalar Objective: Trauma patient requires a complex therapeutic management because of multiple severe injuries or secondary complications. The most significant injury found in patients with trauma is head injury, which has the greatest impact on mortality. Intracranial pressure (ICP) monitoring is required in severe traumatic head injury because it optimises treatment based on ICP values and cerebral perfusion pressure (CPP).Methods: From a total of 64 patients admitted in the intensive care unit (ICU) 'Casa Austria', from the Polytraumatology Clinic of the Emergency County Hospital "Pius Brinzeu" Timisoara, Romania, between January 2014 and December 2014; only patients who underwent ICP monitoring (n=10) were analysed. The study population was divided into several categories depending on the time passed since trauma to the time of installation of ICP monitoring (<18 h, 19-24 h and >24 h). Comparisons were made in terms of the number of days admitted in the ICU and mortality between patients with head injury who benefited and those who did not benefit from ICP monitoring. Results:The results show the positive influence of ICP monitoring on the number of admission days in ICU because of the possibility that the number of admission days to augment therapeutic effects in patients who benefited from ICP monitoring reduces by 1...

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Hemorrhage is More Prevalent than Brain Injury in Early Trauma Deaths: The Golden Six Hours

Cited by 61 publications

References 14 publications

Epidemiology of in-hospital trauma deaths

Epidemiology of in-hospital trauma deaths

A Paradigm Shift in Trauma Resuscitation

Intracranial Pressure (ICP) Monitoring as Part of Multimodal Monitoring Management of Critical Polytrauma Patients. Correlation Between Optimized Intensive Therapy According to ICP Parameters and Clinical Picture

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