Surgery
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This study evaluates the correlation between a ratio of two hepatic proteins, C-reactive protein (CRP) and prealbumin (PALB), and the severity of organ dysfunction as measured by the multiple organ dysfunction score (MODS). ⋯ This study demonstrates a strong correlation between the severity of organ dysfunction and the ratio of two hepatic proteins, CRP and PALB. There was no correlation between the degree of energy expenditure and the MODS, Acute Physiology and Chronic Health Evaluation II score, or the ratio of CRP/PALB. The use of inflammatory markers may be an easy, inexpensive method of assessing severity of illness in the critically ill.
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Early tracheostomy has been advocated for ventilator-dependent patients with blunt trauma, but its advantages have not been examined critically. ⋯ ET in this patient group resulted in significantly lowered use of resources with no adverse effect on outcome.
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Hypertonic saline solutions may have beneficial hemodynamic effects in the resuscitation of hemorrhagic shock. The effects on cardiac function and potential interaction with lung function are controversial and served as the basis for this study. ⋯ Although LR and HSD were equally effective in the early resuscitation of hemorrhagic shock, this occurred at the expense of significantly greater volume requirements for resuscitation with LR. This may contribute to cardiac dysfunction in this setting. Enhanced regional myocardial blood flow after HSD resuscitation may be beneficial against ongoing myocardial stress.