The diamond of death: Hypocalcemia in trauma and resuscitation

Wray, Jesse; Bridwell, Rachel E.; Schauer, Steven G; Shackelford, Stacy; Bebarta, Vikhyat S.; Wright, Franklin L.; Bynum, James A.; Long, Brit

doi:10.1016/j.ajem.2020.12.065

Cited by 97 publications

(94 citation statements)

References 31 publications

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“…A substantial percentage of COVID-19 patients requires hospitalization for supplemental oxygen or invasive ventilation [ 1 ]. In hospitalized COVID-19 patients, the reported cardiovascular complications are predominantly acute myocardial injury [ 2 , 3 ], venous thrombo-embolic events [ 4 , 5 ] and arrhythmia [ 5 ]. Myocardial function assessed by echocardiography, indicated that left ventricular (LV) systolic dysfunction occurred in 10–27%, and right ventricular (RV) systolic dysfunction in 10–39% of non-selected hospitalized COVID-19 patients [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison between myocardial function assessed by echocardiography during hospitalization for COVID-19 and at 4 months follow-up

Heuvel

Vos

Bakel³

et al. 2021

Int J Cardiovasc Imaging

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In patients hospitalized for corona virus infectious disease 19 (COVID-19) it is currently unknown whether myocardial function changes after recovery and whether this is related to elevated cardiac biomarkers. In this single center, prospective cohort study we consecutively enrolled hospitalized COVID-19 patients between 1 April and 12 May 2020. All patients underwent transthoracic echocardiography (TTE) evaluation during hospitalization and at a median of 131 days (IQR; 116–136) follow-up. Of the 51 patients included at baseline, 40 (age: 62 years (IQR; 54–68), 78% male) were available for follow-up TTE. At baseline, 68% of the patients had a normal TTE, regarding left ventricular (LV) and right ventricular (RV) volumes and function, compared to 83% at follow-up (p = 0.07). Median LV ejection fraction (60% vs. 58%, p = 0.54) and tricuspid annular plane systolic excursion (23 vs 22 mm, p = 0.18) were comparable between hospitalization and follow-up, but a significantly lower RV diameter (39 vs. 34 mm, p = 0.002) and trend towards better global longitudinal strain (GLS) (− 18.5% vs − 19.1%, p = 0.07) was found at follow-up. Subgroup analysis showed no relation between patients with and without elevated TroponinT and/or NT-proBNP during hospitalization and myocardial function at follow-up. Although there were no significant differences in individual myocardial function parameters at 4 months follow-up compared to hospitalisation for COVID-19, there was an overall trend towards normalization in myocardial function, predominantly due to a higher rate of normal GLS at follow-up.

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Section: Introductionmentioning

confidence: 99%

Comparison between myocardial function assessed by echocardiography during hospitalization for COVID-19 and at 4 months follow-up

Heuvel

Vos

Bakel³

et al. 2021

Int J Cardiovasc Imaging

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“…In recent years, clinical studies have mainly focused on the pathophysiological process of sepsis or AKI after trauma. Although monitoring and treatment techniques have been innovated and developed, the prognosis of sepsis and AKI has not been significantly improved and is still a risk factor for death in patients with severe trauma [ 2 , 3 ]. It is of great significance to further understand the factors related to the occurrence of complications and carry out active prevention and treatment according to them.…”

Section: Introductionmentioning

confidence: 99%

Influencing Factors and Prevention of Sepsis or Acute Kidney Injury in 85 Patients with Severe Trauma

Zhang

Chen

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Severe trauma can cause systemic reactions, leading to massive bleeding, shock, asphyxia, and disturbance of consciousness. At the same time, patients with severe trauma are at high risk of sepsis and acute renal injury. The occurrence of complications will increase the difficulty of clinical treatment, improve the mortality rate, and bring heavy physical and mental burdens and economic pressure to patients and their families. It is of great clinical significance to understand the high risk factors of sepsis and AKI and actively formulate prevention and treatment measures. In this study, the clinical data of 85 patients with severe trauma were analyzed by univariate and multivariate logistic regression to identify the risk factors leading to sepsis or AKI and analyze the prevention and treatment strategies. The results showed that multiple injuries, APACHE II score on admission, SOFA score on admission, and mechanical ventilation were independent influencing factors of sepsis in patients with severe trauma, while hemorrhagic shock, APACHE II score on admission, CRRT, and sepsis were independent influencing factors of AKI in patients with severe trauma. Severe trauma patients complicated with sepsis or AKI will increase the risk of death. In the course of treatment, prevention and intervention should be given as far as possible to reduce the incidence of complications.

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“…RCTs on the effect of LTOWB on mortality are years away from completion. However, it is important to consider LTOWB in the context of a modern trauma resuscitationtoday we are more aware of the physiology of trauma and have updated our approach to trauma patients accordingly; tranexamic acid is commonly used [50], blood pressure targets (90-110 mmHg SBP, >110 mmHg for patients with brain injury) have evolved to reflect tissue perfusion requirements [51], care is taken to avoid hypocalcemia [52], blood products are provided early in the resuscitation and in a balanced ratio [36,53], at least initially, and the area of damage control resuscitation continues to be studied and refined [54,55]. LTOWB is a part of the larger process of resuscitating a trauma patient and so its effect should be analyzed in light of all of the other advances in the field, i.e.…”

Section: Discussionmentioning

confidence: 99%

The rebirth of the cool: a narrative review of the clinical outcomes of cold stored low titer group O whole blood recipients compared to conventional component recipients in trauma

et al. 2021

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The diamond of death: Hypocalcemia in trauma and resuscitation

Cited by 97 publications

References 31 publications

Comparison between myocardial function assessed by echocardiography during hospitalization for COVID-19 and at 4 months follow-up

Comparison between myocardial function assessed by echocardiography during hospitalization for COVID-19 and at 4 months follow-up

Influencing Factors and Prevention of Sepsis or Acute Kidney Injury in 85 Patients with Severe Trauma

The rebirth of the cool: a narrative review of the clinical outcomes of cold stored low titer group O whole blood recipients compared to conventional component recipients in trauma

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