The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2020
Impact of uric acid on liver injury and intestinal permeability following resuscitated hemorrhagic shock in rats.
Multiorgan failure is a consequence of severe ischemia-reperfusion injury after traumatic hemorrhagic shock (HS), a major cause of mortality in trauma patients. Circulating uric acid (UA), released from cell lysis, is known to activate proinflammatory and proapoptotic pathways and has been associated with poor clinical outcomes among critically ill patients. Our group has recently shown a mediator role for UA in kidney and lung injury, but its role in liver and enteric damage after HS remains undefined. Therefore, the objective of this study was to evaluate the role of UA on liver and enteric injury after resuscitated HS. ⋯ After resuscitated HS, UA is an important mediator in liver and enteric injury. Uric acid represents a therapeutic target to minimize organ damage in polytrauma patients sustaining HS.
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J Trauma Acute Care Surg · Dec 2020
Multicenter StudyTiming of invasive mechanic ventilation in critically ill patients with coronavirus disease 2019.
Invasive mechanical ventilation (IMV) is a lifesaving strategy for critically ill patients with coronavirus disease 2019 (COVID-19). We aim to report the case series of critical patients receiving IMV in Wuhan and to discuss the timing of IMV in these patients. ⋯ Therapeutic, level V.
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J Trauma Acute Care Surg · Dec 2020
Multicenter StudyCurrent challenges in military trauma readiness: Insufficient relevant surgical case volumes in military treatment facilities.
The management of battlefield trauma requires a specific skill set, which is optimized by regular trauma experience. As military casualties from the prolonged conflicts in the Middle East decrease, challenges exist to maintain battlefield trauma readiness. Military surgeons must therefore depend on the Military Health System. The purpose of the study was to evaluate the frequency of surgical cases relevant to deployed combat casualty care performed at military treatment facilities (MTFs). ⋯ Therapeutic/care management study, level V.
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J Trauma Acute Care Surg · Dec 2020
Multicenter Study Comparative Study Observational StudyDramatic decrease of surgical emergencies during COVID-19 outbreak.
During the coronavirus disease 2019 (COVID-19) outbreak, a general decrease in surgical activity was observed. There is perception that this phenomenon has involved also surgical emergency, but no extensive data have been presented to date. The aim of this study was to analyze the real number of admissions and procedures for emergency surgical disease during COVID-19 pandemic. ⋯ Epidemiological, level III.
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J Trauma Acute Care Surg · Dec 2020
Plasmin thrombelastography rapidly identifies trauma patients at risk for massive transfusion, mortality, and hyperfibrinolysis: A diagnostic tool to resolve an international debate on tranexamic acid?
Trauma patients with hyperfibrinolysis and depletion of fibrinolytic inhibitors (DFIs) measured by thrombelastography (TEG) gain clot strength with TXA, but TEG results take nearly an hour. We aimed to develop an assay, plasmin TEG (P-TEG), to more expeditiously stratify risk for massive transfusion (MT), mortality, and hyperfibrinolysis. ⋯ Diagnostic test, level V.