J Trauma
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To determine the end result of patients who underwent delayed fasciotomy, i.e., more than 35 hours for an established lower limb compartment syndrome. ⋯ One patient died of multiorgan failure and septicemia. The remaining four patients required lower limb amputation, because of local infection and septicemia. The one late amputation was performed 6 months after the injury, because the patient was left with a functionless insensate foot. Where recognition of an established compartment syndrome is delayed for more than 8 to 10 hours, we propose that the traditional inevitable fasciotomy be reassessed.
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To evaluate te feasibility of retrospectively creating a data base useful in trauma systems evaluations. ⋯ Linking records to create the study data base was arduous and could not be practically accomplished on a large scale or on a continuing basis. Because of the growing emphases on trauma system evaluations and outcomes beyond survival at acute care discharge, we recommend the routine inclusion of rehabilitation data in hospital-based trauma registries.
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Colloids are used clinically to minimize edema yet may have detrimental consequences on glomerular filtration. The purpose of this study is to assess the renal and hormonal effects of colloid supplementation in the fluid resuscitation of burn victims. ⋯ These findings illustrate that despite substantially increasing plasma volume, colloid infusions reduce glomerular filtration and may limit any associated diuresis. Furthermore, this study demonstrates that hormonal regulation of blood volume remains intact after moderate burn injury.
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Human burn injury is associated with an inflammatory response and related hyperdynamic cardiovascular profile. Increased production of nitric oxide (NO), a potent endogenous vasodilator, has been reported in patients with inflammatory states, including sepsis, but not after trauma other than burns. We studied whether plasma levels of the stable byproducts of NO, nitrite (NO2-) and nitrate (NO3-), are increased in burn patients. ⋯ Human burn injury is associated with an increase in NO production. In this small-size study, NO production was not proportional to burn area, and seemed to be further enhanced in septic patients.
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The feasibility of using Doppler radar to obtain more accurate measurements of velocity and yaw angle of bullets was investigated. Anesthetized pigs were shot at a range of 9-10 meters, and velocity measurements were obtained using Doppler radar and photocells. The data from the two types of equipment was compared. ⋯ It was possible to detect yaw even with these small calibers, and the radar was not disturbed by additional equipment. Using Doppler radar to measure velocity offers important benefits--simple set up, minimal risk of damage to equipment by stray bullets, and very good accuracy. The results of measuring yaw angles of bullets are promising, as far as determining the point of stability is concerned, but further work is necessary to be able to measure the angle of yaw exactly.