J Trauma
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This study aimed to review the need for angiography among patients with traumatic knee dislocations, and to evaluate any adverse consequences associated with the clinical decision to pursue or defer angiography. ⋯ No limb with initial normal vascular examination results was found to have a vascular injury that required treatment. Routine screening angiography may not be necessary for all patients with traumatic knee dislocations.
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The vascular endothelium sustains substantial damage after severe insult. Recently, activated endothelial cells have been reported to produce microparticles in vitro. The objective of this study was to evaluate endothelial microparticle formation and microparticle-leukocyte interaction among patients with severe systemic inflammatory response syndrome (SIRS). ⋯ Activated vascular endothelial cells with increased procoagulant activity enhance production of microparticles with increased binding to leukocytes in patients with severe SIRS. Endothelial microparticles may be involved in the pathogenesis of endothelial injury after severe insult.
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This study aimed to determine whether field end-tidal carbon dioxide CO2 (ETCO2) monitoring decreases inadvertent severe hyperventilation after paramedic rapid sequence intubation. ⋯ The use of ETCO2 monitoring is associated with a decrease in inadvertent severe hyperventilation.
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Injuries to the portal vein are rare but devastating. Contemporary studies have debated the most effective management for this injury. The purpose of this case study was to provide an update on portal vein injury and add information regarding its management. ⋯ Injuries to the portal vein are rare. In this study, exsanguination was the main cause of death. The key to a favorable outcome is prompt control of hemorrhage with an early decision to proceed with either venorrhaphy or ligation. Ligation can be effective for the management of hemodynamically unstable patients.
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Left ventricular ejection time (LVET) measured in central arteries is modified during hypovolemia. We compared modifications of the pulse wave in a central artery (carotid) and in a peripheral artery (digital) during central hypovolemia induced by lower body negative pressure (LBNP) in conscious volunteers. ⋯ Peripheral LVET could reflect variation of central LVET during LBNP and be a reliable noninvasive parameter for monitoring hypovolemia.