To describe the organization, delivery, and outcomes of critical care for combat casualties and blast-induced neurotrauma during active hostilities along the Thai Cambodian border, with emphasis on operational strategies applicable to high-risk environments. Military medicine
Conditions
Interventions
A total of 144 casualties were treated, including 32 patients requiring
intensive care. Thirteen patients underwent emergent surgical intervention for
severe injuries, including intracranial hemorrhag
Experimental Drug,No Intervention No treatment
Neurotropic protocol,usual care
Sponsors
Phramongkutklao hospital foundation
Eligibility
Sex/Gender
All
Age
20 Years to No maximum
Inclusion criteria
Inclusion criteria: A total of 144 casualties were treated, including 32 patients requiring intensive care. Thirteen patients underwent emergent surgical intervention for severe injuries, including intracranial hemorrhage, major vascular trauma, airway disruption, and complex polytrauma. Integrated damage-control surgery, forward critical care capability, and coordinated MEDEVAC resulted in zero in-hospital mortality among patients who reached definitive care.
Exclusion criteria
Exclusion criteria: 1. patients with a preexisting or active major neurological disease/condition such as traumatic brain injury, brain tumour-related epilepsy, previous intracerebral haemorrhage and ischaemic stroke, or neurodegenerative disease 2. patients with a diagnosis of brain lesions other than haemorrhagic stroke, such as traumatic brain injury (epidural or subdural haematoma) or hypoxic ischaemic encephalopathy 3. patients with progressive haemorrhagic stroke, haematoma expansion, or unstable haemodynamics 4. patients with a history of significant alcohol abuse or drug intoxication and advanced liver, kidney, cardiac, or pulmonary disease (abnormal values of liver enzymes: total bilirubin more than 4 mg/dl, alkaline phosphatase more than 250 U/L, SGOT more than 150 U/L, SGPT more than 150 U/L, and creatinine more than 3.5 mg/dl) 5. patients with a medical diagnosis of an expected survival less than 1 year 6. patients with active carcinoma of any origin; patients currently under treatment with traditional medications (e.g., vasodilators such as cinnarizine, flunarizine, or nimodipine) 7. patients with any condition that was a contraindication for cerebrolysin use or previous history of cerebrolysin treatment 8. patients who participated in other alternative neurotrophic therapy or therapeutic studies
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Neurological outcome 6 months the Coma Recovery Scale-Revised score | — |
Secondary
| Measure | Time frame |
|---|---|
| disability improvement 6 months mRS and BI scores at 6 months | — |
Countries
Thailand
Contacts
Public ContactPANU BOONTOTERM
Phramongkutklao College of Medicine and Hospital
Outcome results
None listed