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The first edition of this publication was aimed at defining the current concepts of trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It served as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader is provided with a full understanding of the tests that are used to study trauma induced coagulopathy. With the growing interest in understanding and managing coagulation in trauma, this second edition has been expanded to 46 chapters from its original 35 to incorporate the massive global efforts in understanding, diagnosing, and treating trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications is reviewed in detail. The text provides therapeutic strategies to treat specific coagulation abnormalities following severe injury, which goes beyond the first edition that largely was based on describing the mechanisms causing coagulation abnormalities. Trauma Induced Coagulopathy 2nd Edition is a valuable reference to clinicians that are faced with specific clinical challenges when managing coagulopathy.
In this first version of the book Hemorrhagic Shock: Recognition, Pathophysiology and Management, the entire spectrum of hemorrhage in various pathologic conditions is explored with a particular emphasis on bleeding from injury. World class experts have summarised their benchtop or clinical investigation of severe bleeding and the subsequent hosts response. Furthermore, contemporary content experts have been assembled to relate their own clinical expertise flanked by literature consensus in the subject. Navigation through the different chapters reveals succinct discussions about epidemiology, pathophysiology, bedside assessment and laboratory investigations. In addition, an important part of the content is practical approaches to the management and/or control of difficult hemorrhage sites including the diagnosis, management, adjunct, pharmaceutical and operative options available for the care of these patients. Additionally, separate chapters are presented for exploring areas related to bleeding in unique patients, including maternal-fetal medicine, prehospital and austere environment settings. Finally, the most novel and cutting edge materials, adjuncts and pharmacological agents are discussed as well as a concerted vision of what the future is likely going to bring to the care of these patients. The authorship reflects a multitude of backgrounds and disciplines, all focused on mitigating the impact of hemorrhage and hemorrhagic shock in its multiple facets. Trainees, advanced practice providers, fellows, attending surgeons, traumatologists, anesthesiologists, emergency physicians and intensivists will find valuable information derived from the vast experiences of the authors and their concise presentation of the most current literature in this dynamic field.
This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.
This book provides a comprehensive overview of damage control resuscitation (DCR), an evidence-based approach to the resuscitation of patients with severe life-threatening hemorrhage (LTH). It focuses on both civilian and military applications as DCR is utilized in civilian trauma situations as well as combat casualty care settings. The book covers the history of fluid resuscitation for bleeding, epidemiology of severe traumatic injuries, prediction of life-threatening hemorrhage, pathophysiology and diagnosis of blood failure, and permissive hypotension. Chapters provide in-depth detail on hemostatic resuscitation principles, dried plasma, dried platelet surrogates, and recent developments in frozen red blood cells and oxygen carriers. The book also discusses how DCR principles can be used in a variety of situations such as when there are large numbers of patients with hemorrhagic lesions, non-trauma scenarios, and on distinct populations such as children. Finally, it concludes with a discussion of training and education methods for the implementation of DCR and remote DCR principles as well as learning healthcare system principles to facilitate the implementation of DCR and ultimately improve outcomes for patients with life-threatening hemorrhage. Damage Control Resuscitation: Identification and Treatment of Life-Threatening Hemorrhage is an essential resource for physicians and related professionals, residents, nurses and medical students in emergency medicine, anesthesia, surgery, and critical care, as well as civilian and military EMS providers.
Advanced Perioperative Crisis Management is a high-yield, clinically-relevant resource for understanding the epidemiology, pathophysiology, assessment, and management of a wide variety of perioperative emergencies. Three introductory chapters review a critical thinking approach to the unstable or pulseless patient, crisis resource management principles to improve team performance and the importance of cognitive aids in adhering to guidelines during perioperative crises. The remaining sections cover six major areas of patient instability: cardiac, pulmonary, neurologic, metabolic/endocrine, and toxin-related disorders, and shock states, as well as specific emergencies for obstetrical and pediatric patients. Each chapter opens with a clinical case, followed by a discussion of the relevant evidence. Case-based learning discussion questions, which can be used for self-assessment or in the classroom, round out each chapter. Advanced Perioperative Crisis Management is an ideal resource for trainees, clinicians, and nurses who work in the perioperative arena, from the operating room to the postoperative surgical ward.
This book provides a practical guide to decision making within the realm of trauma surgery. Each chapter covers the ideal approach, rather than customary care, for the treatment of the chosen difficult decision or controversy. A broad range of topics are covered with particular attention given to resuscitation, wound management, thoracic and abdominal trauma, antimicrobial management, transplant considerations, vascular trauma, traumatic brain injury, pediatric trauma and ethics. Difficult Decisions in Trauma Surgery aims to help improve the treatment of trauma patients and is relevant to surgical trainees and practicing surgeons, and as well as medical professionals working within trauma medicine.
This book is designed to offer the reader first-rate guidance on shock management in the real world. Comprehensive, evidence-based, and up-to-date instruction is provided on optimal care of patients with different types of shock – septic, hemorrhagic, cardiogenic, anaphylactic, and obstructive – at all stages from initial response through to ICU admission. As well as management, the coverage encompasses pathophysiology, clinical presentation, diagnosis, and emerging trends. A further key feature is the use of a scenario-based approach to present a series of cases based on real-life experiences. Here, a narrative style and Q&A form are employed to vividly convey scenarios that may be encountered in clinical practice and to elucidate decision making in complex circumstances. When readers experience difficulty in answering the questions, the earlier sections can be consulted to identify the correct response. This book will be of great value for all health care professionals. In particular, it will be very helpful for novice or inexperienced practitioners in emergency medicine, critical care medicine, and traumatology.
In this book current knowledge of the pathophysiology of shock, sepsis and multi organ failure is presented. The rapid progress which has been made and the results achieved in intensive care medicine are based on sound basic research, which is duly reflected in these chapters. Multiorgan failure is the foremost cause of postoperative and posttraumatic death and many complex mechanisms are involved. Only with a good foundation of basic research can abnormalities in the physiological, biochemical, and morphological course of shock be recognized and the necessary conclusions for treatment drawn. Therapy must proceed from profound knowledge of the multi variant physiological events in order to influence shock, sepsis and organ failure. Although numerous possibilities for therapy have arisen from pharmaceutical research in recent years, they are beyond the scope of this book and are not discussed here. To gain a better understanding of the pathophysiological events it was necessary to examine and to describe different models that simulate and reproduce these events. Here we describe the causative agents (shock) and the consequences (sepsis, organ failure) in two main sections, divided on the basis of their pathophysiology.
The aim of this book is to identify and shed new light on the main surgical practices involved in acute care and trauma surgery. Adopting an evidence-based approach, a multidisciplinary team of surgeons and intensivists illustrate basic and advanced operative techniques, accompanied by a comprehensive and updated reference collection. Emerging surgical procedures in Acute Care Surgery are also explored step by step with the help of ample illustrations. Further, the book offers an overview of treatment options for acute organ failure, with a focus on peculiar clinical situations that call for special treatment, including: extracorporeal membrane oxygenation (ECMO), circulatory support and urgent liver transplantation. In order to identify the key determinants in decision-making and therapeutic support that can help avoid critical errors, authors not only define and discuss specific surgical techniques, but also present major issues and controversies related to it. In essence, the book can be considered a “What to do guide” that offers easy access to both basic and advanced lifesaving surgical procedures, due in part to text boxes highlighting “Tips, Tricks and Pitfalls” as well as advice on “Complications Management”. Many chapters are enriched by providing clinical case scenarios, an important educational resource including self–assessment questionnaires.
The world's most renowned researchers in fluid management explain what you should know when providing infusion fluids to surgical patients.