The Experts below are selected from a list of 3174 Experts worldwide ranked by ideXlab platform
Ernest E Moore - One of the best experts on this subject based on the ideXlab platform.
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association for academic Surgeryeffect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L Johnson, Carlton C Barnett, Denis D Bensard, Clay Cothren BurlewAbstract:Background In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago.
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effect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L JohnsonAbstract:Background: In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago. Methods: Patients with major abdominal vascular injuries were examined, and the most recent 6-year period was compared with archived data from a similar 6-year period three decades ago. Results: The number of patients with major abdominal vascular injuries decreased from 123 patients in 1975 to 1980 to 64 patients in 2004 to 2009. The mean initial pH decreased from 7.21 to 6.96 (1975 to 1980 versus 2004 to 2009) for patients with overt coagulopathy. Despite increasingly protracted acidosis, mortality attributable to refractory coagulopathy decreased from 46% to 19% (1975 to 1980 versus 2004 to 2009, chi-square ¼ 4.36, P ¼ 0.04). No significant difference was found in mortality from exsanguinating injuries (43% versus 62%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 1.96, P ¼ 0.16). The prehospital transport times were unchanged (22 versus 20 min, 1975 to 1980 versus 2004 to 2009). Despite the administration of additional clotting factors and the advent of Damage Control Surgery, the overall mortality remained largely unchanged (37% versus 33%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 0.385, P ¼ 0.53). Conclusions: The adoption of Damage Control Surgery, including the implementation of a massive transfusion protocol, was associated with a reduction in mortality for abdominal vascular injuries due to coagulopathy; however, patients have continued to die of exsanguination.
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feasibility of Damage Control Surgery in the management of military combat casualties
Archives of Surgery, 2000Co-Authors: Ben Eiseman, Ernest E Moore, Daniel R Meldrum, Christopher D RaeburnAbstract:Unique and expanded applications of staged operative management are undergoing careful evaluation in many civilian level I trauma centers under the rubric of Damage Control Surgery. Recently there have been advocates for its broad application to the early management of critically injured combat casualties. However, the enormous logistic requirements for such strategies are contrary to the demands of the usual wartime scenario. On the basis of experience in civilian trauma centers and combat casualty management, we question the suggested extensive role of Damage Control Surgery during wartime. Each decision point in Damage Control Surgery should be analyzed as it is altered (sensitivity analysis) by conditions of war. It is unwise to adopt such indications unchanged from current civilian trauma policy.
Jeffrey L Johnson - One of the best experts on this subject based on the ideXlab platform.
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effect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L JohnsonAbstract:Background: In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago. Methods: Patients with major abdominal vascular injuries were examined, and the most recent 6-year period was compared with archived data from a similar 6-year period three decades ago. Results: The number of patients with major abdominal vascular injuries decreased from 123 patients in 1975 to 1980 to 64 patients in 2004 to 2009. The mean initial pH decreased from 7.21 to 6.96 (1975 to 1980 versus 2004 to 2009) for patients with overt coagulopathy. Despite increasingly protracted acidosis, mortality attributable to refractory coagulopathy decreased from 46% to 19% (1975 to 1980 versus 2004 to 2009, chi-square ¼ 4.36, P ¼ 0.04). No significant difference was found in mortality from exsanguinating injuries (43% versus 62%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 1.96, P ¼ 0.16). The prehospital transport times were unchanged (22 versus 20 min, 1975 to 1980 versus 2004 to 2009). Despite the administration of additional clotting factors and the advent of Damage Control Surgery, the overall mortality remained largely unchanged (37% versus 33%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 0.385, P ¼ 0.53). Conclusions: The adoption of Damage Control Surgery, including the implementation of a massive transfusion protocol, was associated with a reduction in mortality for abdominal vascular injuries due to coagulopathy; however, patients have continued to die of exsanguination.
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association for academic Surgeryeffect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L Johnson, Carlton C Barnett, Denis D Bensard, Clay Cothren BurlewAbstract:Background In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago.
Max Wohlauer - One of the best experts on this subject based on the ideXlab platform.
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effect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L JohnsonAbstract:Background: In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago. Methods: Patients with major abdominal vascular injuries were examined, and the most recent 6-year period was compared with archived data from a similar 6-year period three decades ago. Results: The number of patients with major abdominal vascular injuries decreased from 123 patients in 1975 to 1980 to 64 patients in 2004 to 2009. The mean initial pH decreased from 7.21 to 6.96 (1975 to 1980 versus 2004 to 2009) for patients with overt coagulopathy. Despite increasingly protracted acidosis, mortality attributable to refractory coagulopathy decreased from 46% to 19% (1975 to 1980 versus 2004 to 2009, chi-square ¼ 4.36, P ¼ 0.04). No significant difference was found in mortality from exsanguinating injuries (43% versus 62%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 1.96, P ¼ 0.16). The prehospital transport times were unchanged (22 versus 20 min, 1975 to 1980 versus 2004 to 2009). Despite the administration of additional clotting factors and the advent of Damage Control Surgery, the overall mortality remained largely unchanged (37% versus 33%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 0.385, P ¼ 0.53). Conclusions: The adoption of Damage Control Surgery, including the implementation of a massive transfusion protocol, was associated with a reduction in mortality for abdominal vascular injuries due to coagulopathy; however, patients have continued to die of exsanguination.
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association for academic Surgeryeffect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L Johnson, Carlton C Barnett, Denis D Bensard, Clay Cothren BurlewAbstract:Background In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago.
Fredric M Pieracci - One of the best experts on this subject based on the ideXlab platform.
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effect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L JohnsonAbstract:Background: In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago. Methods: Patients with major abdominal vascular injuries were examined, and the most recent 6-year period was compared with archived data from a similar 6-year period three decades ago. Results: The number of patients with major abdominal vascular injuries decreased from 123 patients in 1975 to 1980 to 64 patients in 2004 to 2009. The mean initial pH decreased from 7.21 to 6.96 (1975 to 1980 versus 2004 to 2009) for patients with overt coagulopathy. Despite increasingly protracted acidosis, mortality attributable to refractory coagulopathy decreased from 46% to 19% (1975 to 1980 versus 2004 to 2009, chi-square ¼ 4.36, P ¼ 0.04). No significant difference was found in mortality from exsanguinating injuries (43% versus 62%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 1.96, P ¼ 0.16). The prehospital transport times were unchanged (22 versus 20 min, 1975 to 1980 versus 2004 to 2009). Despite the administration of additional clotting factors and the advent of Damage Control Surgery, the overall mortality remained largely unchanged (37% versus 33%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 0.385, P ¼ 0.53). Conclusions: The adoption of Damage Control Surgery, including the implementation of a massive transfusion protocol, was associated with a reduction in mortality for abdominal vascular injuries due to coagulopathy; however, patients have continued to die of exsanguination.
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association for academic Surgeryeffect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L Johnson, Carlton C Barnett, Denis D Bensard, Clay Cothren BurlewAbstract:Background In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago.
Walter L Biffl - One of the best experts on this subject based on the ideXlab platform.
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effect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L JohnsonAbstract:Background: In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago. Methods: Patients with major abdominal vascular injuries were examined, and the most recent 6-year period was compared with archived data from a similar 6-year period three decades ago. Results: The number of patients with major abdominal vascular injuries decreased from 123 patients in 1975 to 1980 to 64 patients in 2004 to 2009. The mean initial pH decreased from 7.21 to 6.96 (1975 to 1980 versus 2004 to 2009) for patients with overt coagulopathy. Despite increasingly protracted acidosis, mortality attributable to refractory coagulopathy decreased from 46% to 19% (1975 to 1980 versus 2004 to 2009, chi-square ¼ 4.36, P ¼ 0.04). No significant difference was found in mortality from exsanguinating injuries (43% versus 62%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 1.96, P ¼ 0.16). The prehospital transport times were unchanged (22 versus 20 min, 1975 to 1980 versus 2004 to 2009). Despite the administration of additional clotting factors and the advent of Damage Control Surgery, the overall mortality remained largely unchanged (37% versus 33%, 1975 to 1980 versus 2004 to 2009, chi-square ¼ 0.385, P ¼ 0.53). Conclusions: The adoption of Damage Control Surgery, including the implementation of a massive transfusion protocol, was associated with a reduction in mortality for abdominal vascular injuries due to coagulopathy; however, patients have continued to die of exsanguination.
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association for academic Surgeryeffect of Damage Control Surgery on major abdominal vascular trauma
Journal of Surgical Research, 2012Co-Authors: Talia A Sorrentino, Ernest E Moore, Max Wohlauer, Walter L Biffl, Fredric M Pieracci, Jeffrey L Johnson, Carlton C Barnett, Denis D Bensard, Clay Cothren BurlewAbstract:Background In 1982, we reported our experience with abdominal vascular trauma, highlighting the critical role of hypothermia, acidosis, and coagulopathy. Damage Control Surgery was subsequently introduced to address this “lethal triad.” The purpose of the present study was to evaluate the outcomes from our most recent 6-year experience compared with a cohort from 30 years ago.
