J Trauma
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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.
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In the injured patient, rapid assessment of the thorax can yield critical information for patient management and triage. ⋯ Surgeons can accurately perform and interpret a focused thoracic ultrasonographic examination to detect traumatic effusion. Surgeon-performed thoracic ultrasonography is as accurate but is significantly faster than supine portable chest radiography for the detection of traumatic effusion.
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Case Reports
Endovascular treatment of intractable oronasal bleeding associated with severe craniofacial injury.
Severe craniofacial injury may cause intractable oronasal bleeding, which is refractory to conventional treatments. This study will evaluate the efficacy of endovascular treatment for such oronasal bleeding. ⋯ Endovascular treatment is an acceptable treatment for intractable oronasal bleeding associated with severe craniofacial injuries when conventional treatments have failed.
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Clinical Trial Controlled Clinical Trial
The impact of antioxidant and splanchnic-directed therapy on persistent uncorrected gastric mucosal pH in the critically injured trauma patient.
Critically ill trauma patients with gastric intramucosal acidosis, as measured by gastric tonometry, have an increased incidence of multiple organ dysfunction syndrome despite supranormal O2 delivery. We altered our resuscitation protocol to maximize splanchnic blood flow and decrease oxygen-derived free radical damage. ⋯ Gastric tonometry-guided resuscitation and antioxidant/splanchnic therapy in critically ill trauma patients with persistent gastric mucosal acidosis may decrease multiple organ dysfunction syndrome.