Simultaneous C5 and CD14 inhibition limits inflammation and organ dysfunction in pig polytrauma.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 19. Am J Surg. 2023 Jun;225(6):1091-1095. doi: 10.1016/j.amjsurg.2022.11.035. Epub 2022 Nov 30. REBOA in trauma and the risk of venous thromboembolic complications: A matched-cohort study. Wu YT(1), Nichols C(2), Chien CY(3), Lewis MR(2), Demetriades D(4). Author information: (1)Division of Trauma, Emergency Surgery, and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. (2)Division of Trauma, Emergency Surgery, and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA. (3)Division of Trauma, Emergency Surgery, and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA; Department of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan. (4)Division of Trauma, Emergency Surgery, and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA. Electronic address: demetrios.demetriades@med.usc.edu. BACKGROUND: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has been used as a damage control procedure in trauma patients. We hypothesized that REBOA increases risk of venous thromboembolic (VTE) complications. METHODS: This was an American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) database study. Excluded were transfers, deaths within 24 h, and severe head injuries. Included were trauma patients receiving REBOA within 4 h from arrival. Outcomes in the two groups were compared after using propensity score matching (PSM) for demographic and clinical characteristics, body area abbreviated injury scale, injury severity score, pelvis and lower extremity fractures, angiographic intervention, preperitoneal pelvic packing, pharmacological VTE prophylaxis, laparotomy, laparotomy and specific orthopedic procedures. RESULTS: After PSM, 339 REBOA patients were matched with 663 patients with No REBOA. REBOA patients were significantly more likely to develop pulmonary embolism (PE) (5.3% vs. 2.7%, p = .037) and VTE (14.7% vs. 10.0%, p = .025). CONCLUSION: REBOA is associated with an increased risk of PE and VTE complications. Patients managed with REBOA should receive adequate thromboprophylaxis and be monitored closely for VTE complications. Copyright © 2022 Elsevier Inc. All rights reserved. DOI: 10.1016/j.amjsurg.2022.11.035