The Journal of surgical research
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Meta Analysis
The effect of early goal-directed therapy on mortality in patients with severe sepsis and septic shock: a meta-analysis.
The Surviving Sepsis Campaign has recommended early goal-directed therapy (EGDT) as an essential strategy to decrease mortality among patients with severe sepsis and septic shock. However, three latest multicenter trials failed to show its benefit in the patients with severe sepsis and septic shock. This article was to evaluate the effect of EGDT on the mortality of patients with severe sepsis and septic shock. ⋯ This meta-analysis suggests that EGDT can significantly reduce the mortality among patients with severe sepsis and septic shock.
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Observational Study
Thoracic irrigation prevents retained hemothorax: a pilot study.
Upward of 20% of patients undergoing thoracostomy tube (TT) placement develop retained hemothorax (HTx) requiring secondary intervention. The aim of this study was to define the rate of secondary intervention in patients undergoing prophylactic thoracic irrigation. ⋯ Thoracic irrigation at the time of TT placement for traumatic HTx may decrease the rate of retained HTx.
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National adoption of sphincter-preserving surgery (SPS) and minimally invasive surgery (MIS) has not been well documented. We examined national trends in use of SPS and MIS. ⋯ SPS and MIS rates have increased nationally, especially in high-volume centers. In addition, the perioperative benefits seen in randomized clinical trials are maintained in a national database. Further studies should focus on understanding differences in survival and oncologic outcomes with MIS techniques.
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As a common and life-threatening infectious syndrome, sepsis contributes significantly to morbidity and mortality in clinical settings. Vascular endothelial injury and hyperpermeability play an important role in the development of sepsis-induced organ dysfunction. Heat shock protein A12B (HSPA12B) is one of the HSP70 superfamily members and is mainly expressed in vascular endothelial cells. The present study was performed to investigate the role of HSPA12B in endothelial barrier dysfunction during sepsis. ⋯ HSPA12B plays a protective role in vascular endothelial barrier dysfunction by preserving the endothelial permeability during sepsis.
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This study was conducted to investigate whether Xuebijing injection can rectify the dysfunction of microcirculation in septic shock and assessed the microcirculatory parameters directly via orthogonal polarization spectral and software AVA 3.0. ⋯ Based on the adequate fluid resuscitation, Xuebijing injection plays a helpful role of improving microcirculation in septic shock.