The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Aug 2012
Long-term administration of amnion-derived cellular cytokine suspension promotes functional recovery in a model of penetrating ballistic-like brain injury.
Previous work has shown that human amnion-derived progenitor (AMP) cell therapy is neuroprotective in a penetrating ballistic-like brain injury (PBBI) model. However, the neuroprotective capacity of AMP cells seemed to be mediated by the sustained secretion of AMP cell-derived neurotrophic factors, which are abundant in the amnion-derived cellular cytokine suspension (ACCS). To test this theory, the current study assessed the neuroprotective efficacy of long-term ACCS delivery in the PBBI model. ⋯ Collectively, our results support the hypothesis that the neuroprotective effects of AMP cells are mediated through a sustained delivery of ACCS, which implicates ACCS as a promising neuroprotection agent for clinical study.
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J Trauma Acute Care Surg · Aug 2012
Resuscitation with washed aged packed red blood cell units decreases the proinflammatory response in mice after hemorrhage.
Resuscitation with blood products instead of crystalloid in the treatment of hemorrhagic shock has been associated with improved outcomes in trauma patients requiring massive transfusions and transfusion of fresh products results in reduced morbidity and mortality compared with aged blood. Processes to eliminate harmful components of aged blood are under investigation. We hypothesized that washing blood would reduce levels of proinflammatory mediators in stored units, and resuscitation with washed units would attenuate the proinflammatory response in mice after hemorrhagic shock. ⋯ Aged pRBC units have elevated levels of proinflammatory cytokines compared with fresh units, and washing aged units after storage reduces cytokine concentrations. Resuscitation with washed units blunts the proinflammatory response in mice after hemorrhage. Washing aged pRBCs may improve the safety profile of aged units and may result in improved outcomes in subjects after hemorrhagic shock and resuscitation.
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J Trauma Acute Care Surg · Aug 2012
Percutaneous tracheostomy: a new approach to the emergency airway.
Endotracheal intubation is the preferred method of airway control. Current surgical standard of care for the emergent airway when endotracheal intubation cannot be performed is cricothyroidotomy. Percutaneous tracheostomy (PT) is a widely accepted technique for elective long-term airway management in the critical care setting. We describe our experience with successful placement of PT for emergency airway control. ⋯ PT provided a safe, effective emergency airway in adult patients who presented with a variety of indications, in varying locations throughout the hospital. PT performed by appropriately trained personnel may be a potential adjunct for emergent airway control in diverse settings.
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J Trauma Acute Care Surg · Aug 2012
Treatment with low-dose methamphetamine improves behavioral and cognitive function after severe traumatic brain injury.
Methamphetamine increases the release and blocks the reuptake of dopamine. The moderate activation of dopamine receptors may elicit neuroprotective effects. We have recently demonstrated that low doses of methamphetamine reduce neuronal loss after ischemic injury. On the basis of this finding, we hypothesized that methamphetamine could also prevent neuronal loss and improve functional behavior after severe traumatic brain injury (TBI). ⋯ Treatment with low-dose methamphetamine after severe TBI elicits a robust neuroprotective response resulting in significant improvements in behavioral and cognitive functions.
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J Trauma Acute Care Surg · Aug 2012
Comparative StudyEffect of local anesthetic on microorganisms in a murine model of surgical site infection.
Surgical site infections are common, with an incidence of 1.5% to 5% for all types of surgery. In vitro studies suggest an antimicrobial effect of local anesthetic. We hypothesized that subcutaneous infiltration of local anesthetic before surgical incision would reduce the incidence of postoperative wound infection. ⋯ Infiltrate, whether saline, lidocaine, or lidocaine mixed with Marcaine, did not result in significantly different bacterial presence or higher degree of inflammation when controlling for experimental condition of bacterial inocula. Thus, subcutaneous infiltration of local anesthetic before a surgical incision is made does not reduce the incidence of bacterial growth or influence the degree of inflammation which alters infection rates.