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Results of a two-year chronic toxicity and oncogenicity study of 2,3,7,8-tetrachlorodibenzo-p-dioxin in rats.
Combat wounds in operation Iraqi Freedom and operation Enduring Freedom.
- B. Owens, J. Kragh, J. Wenke, J. Macaitis, C. Wade, J. Holcomb
- Medicine, Political ScienceThe Journal of trauma
- 30 January 2008
The wounding patterns currently seen in Iraq and Afghanistan resemble the patterns from previous conflicts, with some notable exceptions: a greater proportion of head and neck wounds, and a lower proportion of thoracic wounds.
The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital.
In patients with combat-related trauma requiring massive transfusion, a high 1:1.4 plasma to RBC ratio is independently associated with improved survival to hospital discharge, primarily by decreasing death from hemorrhage.
Death on the battlefield (2001–2011): Implications for the future of combat casualty care
- B. Eastridge, R. Mabry, L. Blackbourne
- MedicineThe journal of trauma and acute care surgery
- 1 December 2012
To significantly impact the outcome of combat casualties with PS injury, strategies must be developed to mitigate hemorrhage and optimize airway management or reduce the time interval between the battlefield point of injury and surgical intervention.
Damage control resuscitation: directly addressing the early coagulopathy of trauma.
Reports of lactated Ringer s solution and normal saline increasing reperfusion injury and leukocyte adhesion lead one to conclude that the standard crystalloid based resuscitation guidelines in pre hospital trauma life support (PHTLS) and advanced traumaLife support (ATLS) may worsen the presenting acidosis and coagulopathy in severely injured trauma patients, and possibly increase ARDS, SIRS, and MOF.
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.
Among patients with severe trauma and major bleeding, early administration of plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1-1:2 ratio did not result in significant differences in mortality at 24 hours or at 30 days, but more patients in the 1:2:2 group achieved hemostasis and fewer experienced death due to exsanguination by 24 hours.
Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations.
Improvements in early hemorrhage control and resuscitation and the prevention and aggressive treatment of coagulopathy appear to have the greatest potential to improve outcomes in severely injured trauma patients.
Increased Plasma and Platelet to Red Blood Cell Ratios Improves Outcome in 466 Massively Transfused Civilian Trauma Patients
The combination of high plasma and high platelet to RBC ratios were associated with decreased truncal hemorrhage, increased 6-hour, 24 hours, and 30-day survival, and increased intensive care unit, ventilator, and hospital-free days, with no change in multiple organ failure deaths.
The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks.
Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission, and among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or Platelet ratios.
Understanding combat casualty care statistics.
- J. Holcomb, L. Stansbury, H. Champion, C. Wade, R. Bellamy
- Political ScienceThe Journal of trauma
- 1 February 2006
The objective was to arrive at terminology and equations that would produce the best insight into the effectiveness of care at different stages of treatment, either pre or post medical treatment facility care.