J Trauma
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Hemorrhage is a common cause of death despite the recent advances in resuscitation and critical care. Conventional resuscitation fluids are designed to reestablish tissue perfusion, but they fail to prevent systemic inflammation. Indeed, resuscitation can promote inflammatory responses, which can be more dangerous than the original hemorrhage. This consideration is relevant in critical care where hemorrhage is normally associated with collateral trauma that can exacerbate the inflammatory responses during resuscitation. Here, we analyzed whether ethyl pyruvate could provide a therapeutic anti-inflammatory potential during resuscitation in experimental hemorrhage with trauma. ⋯ Ethyl pyruvate may attenuate systemic inflammatory responses during resuscitation and improve survival in experimental models of hemorrhage with trauma.
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Surgical approach to acute Rockwood grade III acromioclavicular (AC) joint injuries demands satisfying and reliable treatment results of shoulder function in the long term. This study investigates the operative outcome of acute grade III AC joint separations after temporary K-wire transfixation of the AC joint over the years. We hypothesize, that the well-established temporary articular transfixation of acute Rockwood grade III AC joint dislocations with K-wires provides good and consistent functional outcome at long term. ⋯ Temporary K-wires fixation of acute Rockwood grade III AC joint separations enable good long-term results in shoulder function. The achieved functional outcome parameters reveal a high consistency in the long run over the years.
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To evaluate the use of the bone injection gun to obtain vascular access in the prehospital setting by an Helicopter-Transported Emergency Medical Team. ⋯ The bone injection gun is an effective and safe device for the resuscitation of patients in a prehospital setting. It seems to be equivalent in success rate as intraosseous needles in children, but it seems to be more successful in adults.
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In critically injured patients with multiple injuries and unstable pelvic fracture, late mortality almost invariably results from sepsis. ⋯ In critically injured patients with multiple injuries and unstable pelvic fracture, peripelvic soft tissue infections occasionally cause sepsis. Peripelvic infections are often accompanied by necrotic changes and easily develop into severe sepsis or multiple organ failure. Identifying high-risk patients and early diagnosis with prompt surgical treatment are indispensable for the patients' survival.
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Inflammatory mediators in postshock mesenteric lymph have been causally linked to systemic polymorphonuclear cells (PMNs) priming resulting in acute lung injury (ALI) and multiple organ failure. Earlier human and animal studies demonstrated ALI after lower limb ischemia/reperfusion (I/R) injury. As hemorrhagic shock (HS) is in essence a systemic I/R insult, we postulated that systemic lymph after HS would exhibit PMN priming and this was studied in vitro. ⋯ Exposure with systemic lymph after HS resulted in PMN priming. These results question the unique properties attributed to post-HS lymph from the splanchnic bed in causing PMN priming and ALI after shock. The causal agent(s) for these effects are unclear.