J Trauma
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To determine the degree of neutrophil activation caused by hemorrhagic shock and resuscitation. ⋯ Neutrophil activation occurring after LR resuscitation and LR infusion without hemorrhage, but not after resuscitation with shed blood or HTS, suggests that the neutrophil activation may be caused by LR and not by reperfusion.
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Changing methods of evaluating blunt abdominal trauma and expanding selection criteria for nonoperative management (NOM) of splenic injury can increase the number of patients managed nonoperatively without affecting success rates. ⋯ Use of computed tomography increased NOM of splenic trauma from 11 to 71% during the 5-year period for injuries of equivalent severity. Age > 55 years or abnormal neurologic status should not preclude NOM, because success was related only to injury grade.
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Although hemorrhage or trauma (laparotomy) alone in mice produces a marked immunosuppression for 3 to 4 days and trauma plus hemorrhage produces immune depression for 5 days after resuscitation, it remains unknown when the immune functions return to normal after trauma-hemorrhage and whether lymphocyte and macrophage functions are similarly affected by trauma-hemorrhage. ⋯ The results indicate that a more severe and prolonged immunodepression occurs after combined trauma and hemorrhage than after trauma or hemorrhage alone.