• Publications
  • Influence
Combat wounds in operation Iraqi Freedom and operation Enduring Freedom.
TLDR
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. Expand
The coagulopathy of trauma: a review of mechanisms.
TLDR
There is limited understanding of the mechanisms by which tissue trauma, shock, and inflammation initiate trauma coagulopathy, and Acute Coagulopathic of Trauma-Shock should be considered distinct from disseminated intravascular coagulation as described in other conditions. Expand
The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital.
TLDR
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. Expand
Death on the battlefield (2001–2011): Implications for the future of combat casualty care
TLDR
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. Expand
Damage control resuscitation: directly addressing the early coagulopathy of trauma.
TLDR
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. Expand
Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB*
TLDR
The AABB developed this guideline to provide clinical recommendations about hemoglobin concentration thresholds and other clinical variables that trigger RBC transfusions in hemodynamically stable adults and children. Expand
Increased Plasma and Platelet to Red Blood Cell Ratios Improves Outcome in 466 Massively Transfused Civilian Trauma Patients
TLDR
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. Expand
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.
TLDR
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. Expand
The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks.
TLDR
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. Expand
United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield.
TLDR
The incidence of fatal head wounds was similar to that in Vietnam in spite of modern Kevlar helmets, and body armor reduced the number of fatal penetrating chest injuries. Expand
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