Langenbeck's archives of surgery
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Langenbecks Arch Surg · Nov 2004
ReviewSurgical trauma: hyperinflammation versus immunosuppression?
Experimental and clinical studies have brought evidence that surgical trauma markedly affects the immune system, including both the specific and the non-specific immune response. ⋯ When drawing up the therapeutic regimen the physician should not consider hyperinflammation versus immunosuppression, but hyperinflammation and immunosuppression, aiming at restoring an appropriate mediator- and immune cell-associated balance.
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Langenbecks Arch Surg · Nov 2004
ReviewVolume replacement and microhemodynamic changes in polytrauma.
Though fluid administration is one of the most basic concepts in resuscitation, there is ongoing controversy and continuing research on the definition of the ideal fluid for resuscitation of trauma and hemorrhage and for intraoperative volume support. In general, crystalloids and colloids, as well as blood, blood substitutes and oxygen therapeutics, are available. This report briefly revisits the physiological mechanisms underlying resuscitation with crystalloids and colloids, emphasizing colloid-supplemented resuscitation with hypertonic saline. Finally, potential applications of oxygen therapeutics are briefly considered.