J Trauma
-
The significance of occult hypoperfusion (OH) in the development of respiratory complications (RC), multiple system organ failure (MSOF), and death, and the effect of rapid identification and correction of OH in the severely injured trauma patient was investigated. ⋯ Initial lactic acidosis is associated with lower cardiac performance and higher morbidity and mortality. Persistent OH is associated with higher rates of RC, MSOF, and death after severe trauma. Early identification and aggressive resuscitation aimed at correcting continued elevation in serum lactate improves survival and reduces complications in severely injured trauma patients.
-
Comparative Study
Railway train versus motor vehicle collisions: a comparative study of injury severity and patterns.
This study compares the demographics, injury severity, resource use, and injury patterns of patients involved in railway train-motor vehicle (RT-MV) to motor vehicle-motor vehicle (MV-MV) collisions. ⋯ RT-MV collisions are a marker for more severe injuries, but not a different pattern of injury, compared with MV-MV collisions.
-
Despite improvements in burn wound care, infections, particularly pneumonia, remain a major hurdle to recovery from thermal injury. After burns, a variety of systemic immune and inflammatory changes contribute to the risk of infection. Clinically, infection coupled with burn injury seems to adversely affect susceptibility to subsequent infection. ⋯ Small thermal injuries coupled with transient infection of the lungs or peritoneum delay the clearance of bacteria from the lungs and contribute to infection of the lungs, liver, burn site, and blood by endogenous organisms. These studies support the synergy of relatively small thermal injuries with infectious exposures in the pathogenesis of pneumonia and systemic infections after burns.