Medical Management of Severe Traumatic Brain Injury in Afghanistan at Forward Deployed Surgical Units Demonstrates a Potential Knowledge or Utilization Gap in Patient Management
G Baluh, MD, E Mann-Salinas, PhD, A Staudt, PhD, J Gurney, MD, S Shackelford, MD, J Nielsen, MD, T Becker, MD. SAMMCObjectives: Military surgeons deployed to locations with limited resources, i.e. Role 2 medical treatment facilities (MTF), are often required to care for patients sustaining severe traumatic brain injuries (sTBI). It is paramount in sTBI… Continue Reading
COMBAT THORACIC SURGERY IN RECENT CONFLICTS: 2002-2016.
Zsolt Stockinger, MD, Caryn Turner, MPH, Jennifer Gurney, MD. Joint Trauma SystemObjectives: Thoracic surgery constitutes 2.5% of surgical procedures performed in theater, but these are increasingly foreign to military surgeons. This study examines thoracic surgical workload in Iraq and Afghanistan to help define surgical training gaps. Methods: Retrospective analysis of Department of Defense Trauma Registry… Continue Reading
INHIBITION OF TLR-4 ATTENUATES SYSTEMIC IMMUNE RESPONSE IN HEMORRHAGIC SHOCK
Samuel W Hoppe, MD, William Chang, MD, Michael Kilbourne, MD, Balakrishna M Prasad, PhD. Dwight D Eisenhower Army Medical CenterOBJECTIVES: Activation of toll-like receptor 4 (TLR-4) by damage associated molecular patterns (DAMPs) has been implicated in the systemic activation of the immune system in hemorrhagic shock. This immune response may be deleterious in some patients. … Continue Reading
Plasma Co-Administration Improves Resuscitation with Tranexamic Acid or Prothrombin Complex in a Porcine Hemorrhagic Shock Model
John P Kuckelman, Morgan Barron, MD, Donald Moe, Michael Lallemand, John McClellan, Shannon Marko, Matthew Eckert, Matthew Martin. Madigan Army Medical CenterOBJECTIVE: Traumatic coagulopathy has now been well characterized, but still carries high rates of mortality due to bleeding. A "factor-based" resuscitation strategy using pro-coagulant drugs and factor concentrates in lieu of plasma is being… Continue Reading
A Novel Bioresorbable/Biointegratable/Biocompatible Dressing for Negative Pressure Wound Therapy
Samuel Tahk, MD, PhD1, Renford Cindass, MD1, Kevin Wu, MD2, Nicholas Robbins, DO3, Jian Ling, PhD4, Bijaya Parida, PhD2, Vijay Gorantla, MD, PhD5, Erik Weitzel, MD2, Michael Davis, MD2. 1San Antonio Military Medical Center, 259th Medical Wing United States Air Force, 3University of Texas Health Sciences Center, 4Southwest Research Institute at San Antonio, 5University of… Continue Reading
AN EVALUATION OF NOVEL MEDICAL DEVICES AND OTHER INTERVENTIONS IN THE TREATMENT OF TENSION PNEUMOTHORAX IN A SWINE MODEL
Rowan R Sheldon, MD, Michael J Derickson, MD, Woo S Do, MD, Dominic M Forte, MD, Jessica B Weiss, MD, Matthew J Eckert, Matthew J Martin, MD. Madigan Army Medical Center, Tacoma, WAObjectives: Tension pneumothorax (tPTX) is the second most common cause of preventable death in trauma. Needle decompression is the first-line intervention but has… Continue Reading
Final Report of a Randomized Phase 1b Trial to Assess Sequencing of the E39 and E39′ Vaccines to Optimize Long-term Antitumor Immunity in Folate Binding Protein (FBP)-Expressing Breast and Ovarian Tumors
John W Myers, MD1, Kaitlin M Peace, MD1, Timothy J Vreeland, MD2, Diane F Hale, MD1, Doreen O Jackson, MD1, Julia M Greene, MD1, Tommy A Brown, MD1, Guy T Clifton, MD1, George E Peoples, MD3, Elizabeth A Mittendorf, MD, PhD2. 1Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX, 2The University of… Continue Reading
Vasopressin Administration During Fluid Resuscitation Alters Expression of Epigenetic Enzymes of Renal Artery in a Pig Model of Hemorrhagic Shock
Jillian M Piaggione, MD1, Lee-Ann M Murata, MSc2, Catherine F Uyehara, PhD2, Dao H Ho, PhD2. 1Department of General Surgery, Tripler Army Medical Center, 2Department of Clinical Investigation, Tripler Army Medical CenterObjectives. Trauma accounts for ~50% of combat-related deaths. Rapid blood loss from trauma can lead to hemorrhagic shock resulting in organ damage. Renal function… Continue Reading
EXTENDING THE GOLDEN HOUR FOR ZONE 1 REBOA: IMPROVED SURVIVAL AND REPERFUSION INJURY WITH INTERMITTENT VERSUS CONTINUOUS REBOA IN A PORCINE SEVERE TRUNCAL HEMORRHAGE MODEL
John Kuckelman, Morgan Barron, Donald Moe, Michael Derickson, Cody Phillips, Joseph Kononchik, Michael Lallemand, Shannon Marko, Matthew Eckert, Matthew Martin. Madigan Army Medical CenterINTRODUCTION: Non-compressible truncal hemorrhage can be temporarily controlled using resuscitative endovascular occlusion of the aorta (REBOA). Prolonged ischemia has limited REBOA application, but intermittent inflation schedules may be a strategy to mitigate… Continue Reading