J Trauma
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In previous animal studies, induction of therapeutic hypothermia (HT) in hemorrhagic shock (HS) had beneficial effects on the hemodynamic and metabolic parameters and on the survival. However, the effect of induced HT on acute lung injury (ALI) in HS has not been investigated. We sought to determine the effects of HT on ALI in HS. ⋯ HT attenuates HS-induced ALI in rats by the modulation of GSK, HSP 72, iNOS, and NF-kappaB.
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The homodigital reverse vascular island flap-a regional, axial-patterned skin flap elevated with a vascular pedicle from the proximal digit-is a one-step procedure used to replace skin and soft tissue loss or destruction in the distal finger. The purpose of this study was to evaluate the clinical outcome. ⋯ The homodigital reverse island flap is an ideal surgical treatment for distal digital defects with a lower complication rate and good functional result, and the indication of age can be extended for older patients with a good preoperative evaluation.
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Early prediction of the need for massive transfusion (MT) remains difficult. We hypothesized that MT protocol (MTP) utilization would improve by identifying markers for MT (>10 units packed red blood cell [PRBC] in 24 hours) in torso gunshot wounds (GSW) requiring early transfusion and operation. ⋯ In patients requiring early operation and transfusion after torso GSW: (1) early initiation of MTP is reasonable for transpelvic and multicavitary trajectories regardless of initial hemodynamic status as multiple or difficult to control bleeding sources are likely and (2) early initiation of MTP in patients with LRT may be guided by a combination of hypotension and acidosis, indicating massive blood loss.