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Enlace permanente de la investigaciónDamage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm / David Alejandro Mejía Toro
Título : Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm Otros títulos : El control de daños en el choque neurogénico refractario: propuesta de un nuevo algoritmo de manejo Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, Fecha de publicación : 2021 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Hemorrhagic Shock Hypovolemia Spinal Cord Injuries Balloon Occlusion Spinal Cord Ischemia Intensive Care Units REBOA Damage control surgery Resumen : Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients. Mención de responsabilidad : Michael W. Parra, Carlos A. Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Jose Alfonso Uribe, Fernando Velásquez Referencia : Colomb Med (Cali). 2021 Jun 30;52(2):e4164800. DOI (Digital Object Identifier) : 10.25100/cm.v52i2.4800 PMID : 34908624 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4800 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5829 Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm = El control de daños en el choque neurogénico refractario: propuesta de un nuevo algoritmo de manejo [documento electrónico] / David Alejandro Mejía Toro, . - 2021.
Obra : Colombia Médica
Idioma : Inglés (eng)
Palabras clave : Hemorrhagic Shock Hypovolemia Spinal Cord Injuries Balloon Occlusion Spinal Cord Ischemia Intensive Care Units REBOA Damage control surgery Resumen : Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients. Mención de responsabilidad : Michael W. Parra, Carlos A. Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Jose Alfonso Uribe, Fernando Velásquez Referencia : Colomb Med (Cali). 2021 Jun 30;52(2):e4164800. DOI (Digital Object Identifier) : 10.25100/cm.v52i2.4800 PMID : 34908624 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4800 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5829 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001763 AC-2021-079 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2021-079Adobe Acrobat PDF
Título : Hemodynamically unstable pelvic fracture: A damage control surgical algorithm that fits your reality Otros títulos : Trauma pélvico e inestabilidad hemodinámica: Un algoritmo quirúrgico de control de daños que se adapta con su realidad Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, ; Salín Pereira Warr, Fecha de publicación : 2020 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Hemodynamically Unstable Damage Control Pelvic Fracture REBOA Limited Resource Center Resumen : Pelvic fractures occur in up to 25% of all severely injured trauma patients and its mortality is markedly high despite advances in resuscitation and modernization of surgical techniques due to its inherent blood loss and associated extra-pelvic injuries. Pelvic ring volume increases significantly from fractures and/or ligament disruptions which precludes its inherent ability to self-tamponade resulting in accumulation of hemorrhage in the retroperitoneal space which inevitably leads to hemodynamic instability and the lethal diamond. Pelvic hemorrhage is mainly venous (80%) from the pre-sacral/pre-peritoneal plexus and the remaining 20% is of arterial origin (branches of the internal iliac artery). This reality can be altered via a sequential management approach that is tailored to the specific reality of the treating facility which involves a collaborative effort between orthopedic, trauma and intensive care surgeons. We propose two different management algorithms that specifically address the availability of qualified staff and existing infrastructure: one for the fully equipped trauma center and another for the very common limited resource center. Mención de responsabilidad : David Mejia, Michael W. Parra, Carlos A. Ordoñez, Natalia Padilla, Yaset Caicedo, Salin Pereira Warr, Paula Andrea Jurado-Muñoz, Mauricio Torres, Alfredo Martínez, José Julián Serna, Fernando Rodríguez-Holguín, Alexander Salcedo, Alberto García, Mauricio Millán, Luis Fernando Pino, Adolfo González Hadad, Mario Alain Herrera, Ernest E. Moore Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4214510. DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4510 PMID : 33795905 Derechos de uso : CC BY-NC En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4510 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5739 Hemodynamically unstable pelvic fracture: A damage control surgical algorithm that fits your reality = Trauma pélvico e inestabilidad hemodinámica: Un algoritmo quirúrgico de control de daños que se adapta con su realidad [documento electrónico] / David Alejandro Mejía Toro, ; Salín Pereira Warr, . - 2020.
Obra : Colombia Médica
Idioma : Inglés (eng)
Palabras clave : Hemodynamically Unstable Damage Control Pelvic Fracture REBOA Limited Resource Center Resumen : Pelvic fractures occur in up to 25% of all severely injured trauma patients and its mortality is markedly high despite advances in resuscitation and modernization of surgical techniques due to its inherent blood loss and associated extra-pelvic injuries. Pelvic ring volume increases significantly from fractures and/or ligament disruptions which precludes its inherent ability to self-tamponade resulting in accumulation of hemorrhage in the retroperitoneal space which inevitably leads to hemodynamic instability and the lethal diamond. Pelvic hemorrhage is mainly venous (80%) from the pre-sacral/pre-peritoneal plexus and the remaining 20% is of arterial origin (branches of the internal iliac artery). This reality can be altered via a sequential management approach that is tailored to the specific reality of the treating facility which involves a collaborative effort between orthopedic, trauma and intensive care surgeons. We propose two different management algorithms that specifically address the availability of qualified staff and existing infrastructure: one for the fully equipped trauma center and another for the very common limited resource center. Mención de responsabilidad : David Mejia, Michael W. Parra, Carlos A. Ordoñez, Natalia Padilla, Yaset Caicedo, Salin Pereira Warr, Paula Andrea Jurado-Muñoz, Mauricio Torres, Alfredo Martínez, José Julián Serna, Fernando Rodríguez-Holguín, Alexander Salcedo, Alberto García, Mauricio Millán, Luis Fernando Pino, Adolfo González Hadad, Mario Alain Herrera, Ernest E. Moore Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4214510. DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4510 PMID : 33795905 Derechos de uso : CC BY-NC En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4510 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5739 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001691 AC-2020-149 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2020-149Adobe Acrobat PDF
Título : REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients Otros títulos : El REBOA como nuevo actor en el control de daños del paciente hemodinámicamente inestable con hemorragia no compresible del torso Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, Fecha de publicación : 2020 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Resuscitative Endovascular Balloon Occlusion of the Aorta Damage Control Non-Compressible Torso Hemorrhage Hemodynamically Unstable Wounds Gunshot Injury Severity Score Trauma Centers Advanced Trauma Life Support Care Balloon Occlusion Nonpenetrating Endovascular Procedures REBOA Resumen : Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient. Mención de responsabilidad : Carlos A. Ordoñez, Michael W. Parra, Yaset Caicedo, Natalia Padilla, Fernando Rodríguez-Holguín, José Julián Serna, Alexander Salcedo, Alberto García, Claudia Orlas, Luis Fernando Pino, Ana Milena del Valle, David Mejia, Juan Carlos Salamea-Molina, Megan Brenner, Tal Hörer Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4064506 DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4506 PMID : 33795901 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4506/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5733 REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients = El REBOA como nuevo actor en el control de daños del paciente hemodinámicamente inestable con hemorragia no compresible del torso [documento electrónico] / David Alejandro Mejía Toro, . - 2020.
Obra : Colombia Médica
Idioma : Inglés (eng)
Palabras clave : Resuscitative Endovascular Balloon Occlusion of the Aorta Damage Control Non-Compressible Torso Hemorrhage Hemodynamically Unstable Wounds Gunshot Injury Severity Score Trauma Centers Advanced Trauma Life Support Care Balloon Occlusion Nonpenetrating Endovascular Procedures REBOA Resumen : Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient. Mención de responsabilidad : Carlos A. Ordoñez, Michael W. Parra, Yaset Caicedo, Natalia Padilla, Fernando Rodríguez-Holguín, José Julián Serna, Alexander Salcedo, Alberto García, Claudia Orlas, Luis Fernando Pino, Ana Milena del Valle, David Mejia, Juan Carlos Salamea-Molina, Megan Brenner, Tal Hörer Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4064506 DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4506 PMID : 33795901 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4506/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5733 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001672 AC-2020-143 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2020-143Adobe Acrobat PDF
