The Journal of surgical research
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Cutaneous thermal injuries (i.e., burns) remain a common form of debilitating trauma, and outcomes are often worsened by wound infection with environmental bacteria, chiefly Pseudomonas aeruginosa. ⋯ These data suggest that early administration of azithromycin following burn-related trauma and infection may reduce P aeruginosa infection and potential interactions with other antibiotics should be considered when designing future studies.
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Remifentanil protects against ischemia/reperfusion (I/R)-induced organ injury, although its underlying mechanism remains elusive. This study was designed to examine the protective effect of remifentanil preconditioning, if any, against hepatic I/R injury in rats and the underlying mechanism involved. ⋯ Our data revealed that remifentanil preconditioning may turn on multiple cellular pathways in hepatocytes to protect the liver from I/R injury by alleviating hepatic apoptosis.
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Randomized Controlled Trial
Which side of lateral ventricles to choose during external ventricular drainage in patients with intraventricular hemorrhage: ipsilateral or contralateral?
We attempted to investigate the effect of external ventricular drainage (EVD) plus intraventricular fibrinolysis from ipsilateral or contralateral ventricle on clinical outcomes in patients with intraventricular hemorrhage. ⋯ External ventricular drainage plus EVT from the ipsilateral or contralateral ventricle has similar short-term outcomes and complications in patients with intraventricular hemorrhage. Faster clot clearance in the third and fourth ventricles but higher ICP levels at the early stage may be expected in patients with EVD from the ipsilateral ventricle, compared with those from with EVD from the contralateral ventricle.
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Deceased cardiac donors (DCDs) have become a useful source of organs for liver transplantation; nevertheless, there are concerns about the longevity of these grafts. The aim of this study was to evaluate the use of extracorporeal membrane oxygenation (ECMO) to resuscitate DCD porcine livers as a preclinical model using hepatocyte isolation and viability as a marker to assess whole-graft preservation. ⋯ This preclinical study suggests that ECMO is a viable technique for liver preservation that gives an improved yield of hepatocytes when isolated from a DCD liver, suggesting improved liver preservation.
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Optimal management of adolescent trauma patients with blunt abdominal solid organ injury (SOI) remains controversial. The purpose of this study was to identify management differences in adolescents with SOI treated at adult trauma centers (ATC) versus pediatric trauma centers (PTC). We hypothesized that adolescents with SOI would undergo different treatment at ATC and PTC. ⋯ Significant differences in the management of adolescents with SOI were identified in Pennsylvania. Operative intervention for SOI was more often performed at ATC than at PTC. Further study will be needed to address the impact of these disparities on patient outcomes.