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3. Traumatic Brain Injury in Older Adults: Characteristics, Outcomes, and Considerations. Results From the American Association for the Surgery of Trauma Geriatric Traumatic Brain Injury (GERI-TBI) Multicenter Trial

Author

Adams, Charles, Lueckelm, Stephanie, Murry, Jason, Hsu, Cindy, Bhatti, Umer, Lissauer, Matthew, LaFonte, Marc, Najafi, Kaveh, Lewandowski, Karen, Mukherjee, Kaushik, Imperio-Lagabon, Kristelle, Martin, Niels, Hirsch, Kathleen, Berry, Cherisse, Freitas, Derek, Cullinane, Daniel, Ramwani, Roshini, Truitt, Michael, Pearcy, Chris, Hashimi, Habiba, Kaups, Krista, Claridge, Jeffry, Ladhani, Husayn, Hartwell, Jennifer, Ballou, Jessica, Croce, Martin, Markle, Stephanie, Osserwaarde, Sally, Posluszny, Joseph, Stocker, Benjamin, Hranjec, Tjasa, Solomon, Rachele, Martinek, Lucy, Gupta, Alok, Grabo, Daniel J., Khan, Uzer, Tatum, Danielle, Jacome, Tomas, Gates, Jonathan, Jawani, Alisha, Berndtson, Allison, Curry, Terry, Bala, Miklosh, Dultz, Linda, Houshmand, Natasha, Pieri, Paola, Zielinski, Martin, Hughes, Joy, Malhotra, Ajai, Lee, Tim, Petrone, Patrizio, Joseph, D'andrea, Marshall, Gary, Carrick, Matthew, Pathak, Abhijit, Van Zandt, Andrea, Glass, Nina, Livingston, David, Gregg, Shea, Webb, Travis, Drumheller, Byron, Kozar, Rosemary, Barraco, Robert, Joseph, Bellal, Ghneim, Mira, Brasel, Karen, Vesselinov, Roumen, Albrecht, Jennifer, Liveris, Anna, Watras, Jill, Michetti, Christopher, Haan, James, Lightwine, Kelly, Winfield, Robert, Adams, Sasha, Podbielski, Jeanette, Armen, Scott, Zacko, J. Christopher, Nasrallah, Fady, Schaffer, Kathryn, Dunn, Julie, Smoot, Brittany, Schroeppel, Thomas, Stillman, Zachery, Cooper, Zara, and Stein, Deborah

Published
2022
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6. Beta blockers in critically ill patients with traumatic brain injury: Results from a multicenter, prospective, observational American Association for the Surgery of Trauma study

Author

Ley, Eric J., Leonard, Samuel D., Barmparas, Galinos, Dhillon, Navpreet K., Inaba, Kenji, Salim, Ali, OʼBosky, Karen R., Tatum, Danielle, Azmi, Hooman, Ball, Chad G., Engels, Paul T., Dunn, Julie A., Carrick, Matthew M., Meizoso, Jonathan P., Lombardo, Sarah, Cotton, Bryan A., Schroeppel, Thomas J., Rizoli, Sandro, Chang, David S. J., de León, Luis Alejandro, Rezende-Neto, Joao, Jacome, Tomas, Xiao, Jimmy, Mallory, Gina, Rao, Krishnamurti, Widdel, Lars, Godin, Samuel, Coates, Angela, Benedict, Leo Andrew, Nirula, Raminder, Kaul, Sanjeev, and Li, Tong

Published
2018
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8. Traumatic Brain Injury in Older Adults: Characteristics, Outcomes, and Considerations. Results From the American Association for the Surgery of Trauma Geriatric Traumatic Brain Injury (GERI-TBI) Multicenter Trial

Author

Ghneim, Mira, primary, Brasel, Karen, additional, Vesselinov, Roumen, additional, Albrecht, Jennifer, additional, Liveris, Anna, additional, Watras, Jill, additional, Michetti, Christopher, additional, Haan, James, additional, Lightwine, Kelly, additional, Winfield, Robert, additional, Adams, Sasha, additional, Podbielski, Jeanette, additional, Armen, Scott, additional, Zacko, J. Christopher, additional, Nasrallah, Fady, additional, Schaffer, Kathryn, additional, Dunn, Julie, additional, Smoot, Brittany, additional, Schroeppel, Thomas, additional, Stillman, Zachery, additional, Cooper, Zara, additional, Stein, Deborah, additional, Adams, Charles, additional, Lueckelm, Stephanie, additional, Murry, Jason, additional, Hsu, Cindy, additional, Bhatti, Umer, additional, Lissauer, Matthew, additional, LaFonte, Marc, additional, Najafi, Kaveh, additional, Lewandowski, Karen, additional, Mukherjee, Kaushik, additional, Imperio-Lagabon, Kristelle, additional, Martin, Niels, additional, Hirsch, Kathleen, additional, Berry, Cherisse, additional, Freitas, Derek, additional, Cullinane, Daniel, additional, Ramwani, Roshini, additional, Truitt, Michael, additional, Pearcy, Chris, additional, Hashimi, Habiba, additional, Kaups, Krista, additional, Claridge, Jeffry, additional, Ladhani, Husayn, additional, Hartwell, Jennifer, additional, Ballou, Jessica, additional, Croce, Martin, additional, Markle, Stephanie, additional, Osserwaarde, Sally, additional, Posluszny, Joseph, additional, Stocker, Benjamin, additional, Hranjec, Tjasa, additional, Solomon, Rachele, additional, Martinek, Lucy, additional, Gupta, Alok, additional, Grabo, Daniel J., additional, Khan, Uzer, additional, Tatum, Danielle, additional, Jacome, Tomas, additional, Gates, Jonathan, additional, Jawani, Alisha, additional, Berndtson, Allison, additional, Curry, Terry, additional, Bala, Miklosh, additional, Dultz, Linda, additional, Houshmand, Natasha, additional, Pieri, Paola, additional, Zielinski, Martin, additional, Hughes, Joy, additional, Malhotra, Ajai, additional, Lee, Tim, additional, Petrone, Patrizio, additional, Joseph, D'andrea, additional, Marshall, Gary, additional, Carrick, Matthew, additional, Pathak, Abhijit, additional, Van Zandt, Andrea, additional, Glass, Nina, additional, Livingston, David, additional, Gregg, Shea, additional, Webb, Travis, additional, Drumheller, Byron, additional, Kozar, Rosemary, additional, Barraco, Robert, additional, and Joseph, Bellal, additional

Published
2022
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10. Prehospital Simple Thoracostomy Does Not Improve Patient Outcomes Compared to Needle Thoracostomy in Severely Injured Trauma Patients

Author

Harris, Charles T., Taghavi, Sharven, Bird, Emily, Duchesne, Juan, Jacome, Tomas, and Tatum, Danielle

Abstract

Background ATLS suggests simple thoracostomy (ST) after failure of needle thoracostomy (NT) in thoracic trauma. Some EMS agencies have adopted ST into their practice. We sought to describe our experience implementing ST in the prehospital setting, hypothesizing that prehospital ST would reduce failure rates and improve outcomes compared to NT.Methods This was a retrospective review of adult trauma patients who received prehospital ST or NT from 2017 to 2020.Results There were 48 patients with 64 procedures included. 83.7% were male and 65.8% injured by penetrating mechanism and of median (IQR) age of 31 (25-46) years. 28 (43.8%) procedures were NT and 36 (56.3%) were ST. Rates of improved patient response (P= .15), noted return of blood/air (P= .19), and return of spontaneous circulation (P= .62) did not differ. On-scene times were higher for ST (16.8 vs 11.5 minutes; P< .02). Overall mortality did not differ between ST and NT (68.2% vs 46.4%, respectively; P= .125). For patients that survived beyond the ED, procedure-related complication rates were 2 of 21 patients (9.5%) in ST and 1 of 12 (8.3%) in NT. In penetrating trauma, simple thoracostomy had longer on-scene time and total prehospital time.Discussion ST did not improve success rates of ROSC and was associated with prolonged prehospital times, especially in penetrating trauma patients. Given the benefit of “scoop and run” in urban penetrating trauma, consideration should be given to direct transport in lieu of ST. Use of ST in blunt trauma should be evaluated prospectively.

Published
2023
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11. Impact of time to surgery on mortality in hypotensive patients with noncompressible torso hemorrhage: An AAST multicenter, prospective study

Author

Duchesne, Juan, primary, Slaughter, Kevin, additional, Puente, Ivan, additional, Berne, John D., additional, Yorkgitis, Brian, additional, Mull, Jennifer, additional, Sperry, Jason, additional, Tessmer, Matthew, additional, Costantini, Todd, additional, Berndtson, Allison E., additional, Kai, Taylor, additional, Rokvic, Giannina, additional, Norwood, Scott, additional, Meadows, Katelyn, additional, Chang, Grace, additional, Lemon, Brittney M., additional, Jacome, Tomas, additional, Van Sant, Lauren, additional, Paul, Jasmeet, additional, Maher, Zoe, additional, Goldberg, Amy J., additional, Madayag, Robert M., additional, Pinson, Greg, additional, Lieser, Mark J., additional, Haan, James, additional, Marshall, Gary, additional, Carrick, Matthew, additional, and Tatum, Danielle, additional

Published
2022
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12. Predictors of Mortality, Withdrawal of Life-Sustaining Measures, and Discharge Disposition in Octogenarians with Subdural Hematomas

Author

Kashkoush, Ahmed, primary, Petitt, Jordan C., additional, Ladhani, Husayn, additional, Ho, Vanessa P., additional, Kelly, Michael L., additional, Ghneim, Mira, additional, Albrecht, Jennifer S., additional, Brasel, Karen, additional, Livaris, Anna, additional, Watras, Jill B., additional, Michetti, Christopher P., additional, Haan, James M., additional, Lightwine, Kelly, additional, Winfield, Robert D., additional, Adams, Sasha D., additional, Podbielski, Jeanette M., additional, Armen, Scott B., additional, Zacko, J. Christopher, additional, Nasrallah, Fady S., additional, Schaffer, Kathryn B., additional, Dunn, Julie, additional, Widdel, Lars, additional, Schroeppel, Thomas J., additional, Stillman, Zachery, additional, Cooper, Zara, additional, Stein, Deborah, additional, Adams, Charles, additional, Lueckel, Stephanie, additional, Murry, Jason, additional, Patel, Nikita, additional, Hsu, Cindy, additional, Bhatti, Umer F., additional, Lissauer, Matthew E., additional, LaFonte, Marc, additional, Najafi, Kaveh, additional, Lewandowski, Karen, additional, Mukherjee, Kaushik, additional, Imperio-Lagabon, Kristelle J., additional, Martin, Niels D., additional, Hirsch, Kathleen, additional, Berry, Cherisse, additional, Freitas, Derek, additional, Cullinane, Daniel, additional, Ramawi, Roshini, additional, Truitt, Michael, additional, Pearcy, Chris, additional, Hashimi, Habiba, additional, Kaups, Krista, additional, Claridge, Jeffrey, additional, Hartwell, Jennifer L., additional, Ballou, Jessica, additional, Croce, Martin, additional, Markle, Stephanie, additional, Osserwaarde, Sally, additional, Posluszny, Joseph, additional, Stocker, Benjamin, additional, Hranjec, Tjasa, additional, Solomon, Rachele, additional, Martinek, Lucy, additional, Gupta, Alok, additional, Grabo, Daniel J., additional, Khan, Uzer, additional, Tatum, Danielle, additional, Jacome, Tomas, additional, Gates, Jonathan, additional, Jawani, Alisha, additional, Berndtson, Allison E., additional, Curry, Terry G., additional, Bala, Miklosh, additional, Dultz, Linda A., additional, Houshmand, Natasha N., additional, Pieri, Paola, additional, Zielinski, Martin D., additional, Hughes, Joy D., additional, Hartwell, Jennifer, additional, Malhotra, Ajai K., additional, Lee, Tim, additional, Petrone, Patrizio, additional, Joseph, D'andrea, additional, Marshall, Gary T., additional, Carrick, Matthew M., additional, Pathak, Abhijit, additional, Van Zandt, Andrea, additional, Glass, Nina, additional, Livingston, David, additional, Gregg, Shea, additional, Webb, Travis, additional, Drumheller, Byron, additional, Kozar, Rosemary, additional, Barraco, Robert, additional, and Joseph, Bellal, additional

Published
2022
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13. Delta Systolic Blood Pressure (SBP) Can be a Stronger Predictor of Mortality Than Pre-Aortic Occlusion SBP in Non-Compressible Torso Hemorrhage : an Abotrauma and AORTA Analysis

Author

Duchesne, Juan, McGreevy, David, Nilsson, Kristofer F., DuBose, Joseph, Rasmussen, Todd E., Brenner, Megan, Jacome, Tomas, Hörer, Tal M., Tatum, Danielle, Duchesne, Juan, McGreevy, David, Nilsson, Kristofer F., DuBose, Joseph, Rasmussen, Todd E., Brenner, Megan, Jacome, Tomas, Hörer, Tal M., and Tatum, Danielle

Abstract

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is becoming a standardized adjunct for the management in patients with severe non-compressible torso hemorrhage (NCTH). Although guidelines have been developed to help with the best indications for REBOA utilization, no studies have addressed the significance of change in systolic blood pressure (ΔSBP) after REBOA insufflation. We hypothesized that ΔSBP would predict mortality in patients with NCTH and have utility as a surrogate marker for hemorrhage status. STUDY DESIGN: This was an international, multicenter retrospective review of all patients managed with REBOA from the ABOTrauma Registry and the AORTA database. ΔSBP was defined as the difference between pre- and post-REBOA insertion SBP. Based on post-insertion SBP, patient hemorrhage status was categorized as responder or non-responder. A non-responder was defined as a hypotensive patient with systolic blood pressure (SBP) < 90 mmHg after REBOA placement with full aortic occlusion. Significance was set at P < 0.05. RESULTS: A total of 524 patients with NCTH were included. Most (74%) were male, 77% blunt injured with a median (IQR) age of 40 (27 - 58) years and ISS 34 (25 - 45). Overall mortality was 51.0%. 20% of patients were classified as non-responders. Demographic and injury descriptors did not differ between groups. Mortality was significantly higher in non-responders vs responders (64% vs 46%, respectively; P = 0.001). Non-responders had lower median pre-insertion SBP (50mmHg vs 67mmHg; P < 0.001) and lower ΔSBP (20mmHg vs 48mmHg; P < 0.001). CONCLUSION: REBOA non-responders present and remain persistently hypotensive and are more likely to die than responders, indicating a potential direct correlation between ΔSBP as a surrogate marker of hemorrhage volume status and mortality. Future prospective studies will need to further elucidate the impact of Damage Control Resuscitation efforts on ΔSBP and mortality.

Published
2020
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14. To Ultrasound or not to Ultrasound : A REBOA Femoral Access Analysis from the ABOTrauma and AORTA Registries

Author

Duchesne, Juan, McGreevy, David, Nilsson, Kristofer F., DuBose, Joseph, Rasmusse, Todd E., Brenner, Megan, Jacome, Tomas, Hörer, Tal M., Tatum, Danielle, Duchesne, Juan, McGreevy, David, Nilsson, Kristofer F., DuBose, Joseph, Rasmusse, Todd E., Brenner, Megan, Jacome, Tomas, Hörer, Tal M., and Tatum, Danielle

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is becoming a standardized adjunct in the management of non-compressible hemorrhage. Ultrasound (US)-guided femoral access has been taught as the best practice for femoral artery cannulation. However, there is a lack of evidence to support its use in patients in extremis with severe hemorrhage. We hypothesize that no differences in outcome will exist between US-guided and to blind percutaneous or cutdown access methods. Methods: This was an international, multicenter retrospective review of all patients managed with REBOA from the ABOTrauma Registry and the AORTA database. REBOA characteristics and outcomes were compared among puncture access methods. Significance was set at P < 0.05. Results: The cohort included 523 patients, primarily male (74%), blunt injured (77%), with median age 40 (27-58), and an Injury Severity Score of 34 (25-45). Percutaneous using external landmarks/palpation was the most common femoral puncture method (53%) used followed by US-guided (27.9%). There was no significant difference in overall complication rates (37.4% vs 34.9%; P = 0.615) or mortality (47.8% vs 50.3%; P = 0.599) between percutaneous and US-guided methods; however, access by cutdown was significantly associated with emergency department (ED) mortality (P = 0.004), 24 hour mortality (P = 0.002), and in-hospital mortality (P = 0.007). Conclusions: In patients with severe hemorrhage in need of REBOA placement, the percutaneous approach using anatomic landmarks and palpation, when compared with US-guided femoral access, was used more frequently without an increase in complications, access attempts, or mortality.

Published
2020
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18. The 9-arginine residue of alpha-conotoxin GI is responsible for its selective high affinity for the alphagamma agonist site on the electric organ acetylcholine receptor

Author

Hann, Richard M., Pagan, One R., Gregory, Liza M., Jacome, Tomas, and Eterovic, Vesna A.

Subjects
Acetylcholine -- Receptors, Proteins -- Receptors, Biological sciences, Chemistry
Abstract

Studies of synthetic analogues of SI and GI were analyzed to identify the determinants of GI's alphagamma selectivity. Results have shown that an SI analogue with alanine at the site of proline cannot distinguish between the two agonist sites and displayed about the same affinity at SI, indicating the importance of the arginyl cation. Residue interchanges did not affect peptide selectivity.

Published
1997

24. Impact of catastrophic brain injury guidelines on organ donation rates: Results of an EAST multicenter trial.

Author

Nordham KD, Tatum D, Attia AS, Patel MB, Paramesh A, Duchesne JC, Nahmias J, Maiga AW, Peetz AB, Udekwu PO, Stiles A, Shell C, Stodghill JD, Maghsoudi T, Iacullo E, McLafferty B, Coonan E, Boudreau RM, Zimmerman SA, Shammassian B, Egodage T, Aramento I, Morris P, Metheny J, Farrell MS, Painter MD, McCabe OT, Spadafore P, Wong DT, Serrano J, Sciarretta JD, Kim P, Hayton R, Gonzales D, Murry J, Meadows K, Jacobson LE, Williams JM, Bernard AC, Smith B, Morrissey SL, Patel N, Tabello D, Teicher E, Chowdhury SM, Ahmad F, Marcos BS, West MA, Jacome TH, Davis G, Marks JA, Rattigan D, Haan JM, Lightwine K, Matsushima K, Park S, Santos A, Shrestha K, Sawyer R, VandenBerg S, Jean RJ, Hicks RC, Lueckel S, Bugaev N, Abosena W, Alvarez C, Lieser MJ, McDonald H, Dumas RP, Fitzgerald CA, Terzian WTH, Tian Y, Mousafeiris V, Mulita F, Berne JD, Mederos DR, Smith AA, and Taghavi S

Abstract

Background: One third of organ donors suffer catastrophic brain injury (CBI). There are no standard guidelines for the management of traumatic CBI prior to brain death, and not all trauma centers have institutional CBI guidelines. In addition, there is high variability in management between institutions with guidelines. Catastrophic brain injury guidelines vary and may include various combinations of hormone therapy, vasopressors, fluid resuscitation, and other practices. We hypothesized that centers with CBI guidelines have higher organ donation rates than those without., Methods: This prospective, observational EAST-sponsored multicenter trial included adult (18+ years old) traumatic-mechanism CBI patients at 33 level I and II trauma centers from January 2022 to May 2023. Catastrophic brain injury was defined as a brain injury causing loss of function above the brain stem and subsequent death. Cluster analysis with linear mixed-effects model including UNOS regions and hospital size by bed count was used to determine whether CBI guidelines are associated with organ donation., Results: A total of 790 CBI patients were included in this analysis. In unadjusted comparison, CBI guideline centers had higher rates of organ donation and use of steroids, whole blood, and hormone therapy. In a linear mixed-effects model, CBI guidelines were not associated with organ donation. Registered organ donor status, steroid hormones, and vasopressin were associated with increased relative risk of donation., Conclusion: There is high variability in management of CBI, even at centers with CBI guidelines in place. While the use of institutional CBI guidelines was not associated with increased organ donation, guidelines in this study were not identical. Hormone replacement with steroids and vasopressin was associated with increased donation. Hormone resuscitation is a common feature of CBI guidelines. Further analysis of individual practices that increase organ donation after CBI may allow for more effective guidelines and an overall increase in donation to decrease the long waiting periods for organ transplant recipients., Level of Evidence: Prognostic; Level III., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2024
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