The Journal of surgical research
-
NF-kappaB and AP-1 play important roles in regulation of inflammatory responses that lead to cardiomyocytic injury following cardiopulmonary bypass (CPB) and cardiac global ischemia and reperfusion. It has been reported that heme oxygenase-1 (HO-1) can block those responses. Our aim was to determine whether HO-1 activation could decrease myocardial ischemia-reperfusion injury with cardioplegia during CPB and attenuate apoptosis of cardiomyocytes. ⋯ HO-1 activation can dampen the surge of inflammation-related cytokines during CPB and decrease the occurrence of cardiomyocytic apoptosis via inhibition of NF-kappaB and AP-1 translocation.
-
Improvements in early hemorrhage control could result in more favorable outcomes. Several advanced hemostatic dressings are available; however, none meets the ideal characteristics defined by the United States Army. We studied the effects of a new dextran polymer hemostatic dressing on survival, blood loss, and blood pressure in a swine model of severe liver injury. ⋯ Bloxx is superior to standard laparotomy sponges in this model of lethal liver injury. Further study of this dressing is warranted to determine its potential for use in civilian and military trauma.
-
Controlled Clinical Trial
A prospective study on the influence of a fast-track program on postoperative fatigue and functional recovery after major colonic surgery.
Enhanced Recovery After Surgery (ERAS) programs have demonstrated significant reduction in hospital stay for patients undergoing colonic surgery; however, their impact on long-term outcomes, such as postoperative fatigue (POF), has not been fully established. ⋯ The impact of ERAS programs may extend beyond the commonly reported short-term outcomes, and ERAS may accelerate overall recovery and return to normal function.
-
Comparative Study
Efficacy of three topical hemostatic agents applied by medics in a lethal groin injury model.
Advanced topical hemostatic agents are increasingly utilized to control traumatic hemorrhage. We sought to determine the efficacy of three chitosan based hemostatic agents in a lethal groin injury model when applied by combat medic first responders. ⋯ Chitosan based bandages are significantly more effective at hemorrhage control compared to standard gauze field dressings. The dual-sided chitosan dressing demonstrated better hemorrhage control than the one-sided dressing and the chitosan powder, and was less likely to fail despite application errors.
-
Thoracoabdominal aortic aneurysm open surgery is accompanied by a significant incidence of renal failure due to renal ischemia. The effect of remote ischemic preconditioning (RIPC) in renal ischemia/reperfusion (IR) injury during a thoracoabdominal aortic aneurysm open repair approach was examined on an animal model. ⋯ RIPC induced by a temporary infrarenal aortic occlusion decreased the IR renal injury caused by subphrenic aortic cross-clamping.