J Trauma
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Enoxaparin is the only low molecular-weight heparin (LMWH) with documented efficacy for the prevention of venous thromboemobolism (VTE) following trauma, and it is currently considered the treatment of choice. Recent reports have suggested that the pharmacokinetics (PK) and pharmacodynamics of LMWH products may be altered in critically ill patients. ⋯ The standard dose of enoxaparin recommended for the prevention of VTE following multiple trauma provides unreliable and highly variable anti-Xa activity in critically ill trauma patients, and is strongly affected by the presence of significant peripheral edema.
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Uncontrolled intra-abdominal bleeding is a common cause of death in trauma patients in the prehospital and perioperative settings. The detrimental effects of abdominal hypertension are well studied, but the potential therapeutic use of abdominal insufflation for hemostasis has not been fully explored. We measured the effect of abdominal insufflation on blood loss and physiologic outcomes in a swine model of blunt liver injury. ⋯ In a swine model of catastrophic blunt hepatic injury, abdominal insufflation significantly decreased blood loss and mortality.
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Accurate burn depth assessment is important for determining the appropriate treatment plan for severe burn patients. However, conventional methods of diagnoses, such as visual observation and pinprick test, are often inaccurate. We previously proposed a new method for burn diagnosis in which photoacoustic signals originating from the blood in healthy tissue under the injured tissue are measured. In this study, we investigated the validity of this method by an experiment using rat scald burn models. ⋯ SDBs, DDBs, and DBs can be differentiated by photoacoustic signals, suggesting that the method proposed is useful for diagnosing burn injuries.