J Trauma
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Comparative Study
Diaspirin cross-linked hemoglobin resuscitation improves cerebral perfusion after head injury and shock.
Shock associated with traumatic brain injury (TBI) doubles the mortality of TBI alone by inducing a secondary ischemic injury. Rapid correction of cerebral perfusion pressure (CPP) is thought to be essential to improving outcome. Diaspirin cross-linked hemoglobin (DCLHb) has been shown to improve cerebral blood flow, increase mean arterial pressure (MAP), and reduce lesion size in models of occlusive cerebral ischemia but has not been evaluated in a model of TBI combined with hemorrhagic shock. ⋯ These data suggest that DCLHb is beneficial in the early resuscitation of head injury and shock and that further investigation is warranted. Key Words: Diaspirin cross-linked hemoglobin, Head injury, Shock, Cerebral perfusion pressure.
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To review our experience with craniocerebral injuries caused by plastic bullets, and to delineate prognostic factors for outcome. ⋯ Plastic bullet-induced craniocerebral injuries carry a lower morbidity and mortality rate compared with other gunshot wounds. However, plastic bullets do incur a significant risk of injury. Their use should be carefully regulated.
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To identify preventable prehospital deaths, caused by trauma. ⋯ Upgrading of the emergency medical care service is required.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of volume control and pressure control ventilation: is flow waveform the difference?
To examine the hypothesis that a decelerating inspiratory flow waveform is responsible for improvements in gas exchange during pressure control ventilation for acute lung injury. ⋯ Both pressure control ventilation and volume control ventilation with a decelerating flow waveform provided better oxygenation at a lower peak inspiratory pressure and higher mean airway pressure compared to volume control ventilation with a square flow waveform. The results of our study suggest that the reported advantages of pressure control ventilation over volume control ventilation with a square flow waveform can be accomplished with volume control ventilation with a decelerating flow waveform.