J Trauma
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We performed this study to evaluate the hemostatic efficacy of the FAST Dressing in treating a grade V liver injury in noncoagulopathic swine. ⋯ The FAST Dressing reduced blood loss and improved survival compared with placebo in a noncoagulopathic, grade V liver injury swine model.
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Hypertonic saline solutions in combination with colloids may have some applications in critically ill patients. Our aim was to examine the effects of small volumes (0.7-1 mL/kg intravenous) of 7.5% NaCl with different colloids on cardiac stability, hemodynamics, and mortality after severe hemorrhagic shock. ⋯ Small volumes of 7.5% NaCl led to fewer arrhythmias and a 2.6 times survival benefit over untreated rats, and a partial resuscitation of MAP into the "permissive range." Dextran-70 or HES in 7.5% NaCl were proarrhythmic and HES led to increased mortality (p < 0.05). Because optimal heart function is critical for successful resuscitation, care should be exercised when using dextran-70 or 6 and 10% HES in small volume hypertonic saline solutions for early hypotensive resuscitation.
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As trauma care evolves, there has been increased reliance on imaging. The purpose of this study was to examine changes in trauma imaging and radiation exposure over time. Our hypothesis was that there has been an increased usage of imaging in the management of trauma patients without measurable improvements in outcomes. ⋯ From 2002 to 2007, there was a significant increase in the use of CT and plain radiographs in the management of trauma patients, leading to significantly higher radiation exposure with no demonstrable improvements in the diagnosis of missed injuries, mortality, or length of stay.
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The amount of free fluid that can normally be present in a pregnant patient is unknown. Evaluation of pelvic free fluid in a population of pregnant patients without early history of trauma would help determine what amount of free fluid should raise suspicion of intra-abdominal injury in those who have suffered trauma. ⋯ These results suggest that the presence of pelvic free fluid in pregnant patients without antecedent trauma is very low. After blunt abdominal trauma, the presence of free fluid in the pelvis of a pregnant patient may not be physiologic, especially if there is >2 mm to 4 mm, and there is no history of ovarian hyperstimulation syndrome or other known associations.
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Nicotine at a low concentration was suggested as a new topical drug for clinical application. It has been reported to be capable of enhancing skin wound healing. This study was designed to assess the effect of nicotine administration at a low dose on bone regeneration using a rabbit model of mandibular distraction osteogenesis. ⋯ These findings imply a potential risk of compromised bone healing in patients taking nicotine medication. Further clinical studies are necessary to assess the risk of nicotine medication on reconstructive surgery.