J Trauma
-
Comparative Study
Comparison of the Airway Scope and Macintosh laryngoscope with in-line cervical stabilization by the semisolid neck collar: manikin study.
The usefulness of Airway Scope (AWS) and Macintosh direct laryngoscope (ML) for patients with trauma requiring intubation with in-line cervical stabilization for protection of the cervical spine was compared. ⋯ The usefulness of AWS may be comparable with or greater than that of ML for oral intubation in trauma patients with in-line cervical stabilization.
-
The homodigital reverse vascular island flap-a regional, axial-patterned skin flap elevated with a vascular pedicle from the proximal digit-is a one-step procedure used to replace skin and soft tissue loss or destruction in the distal finger. The purpose of this study was to evaluate the clinical outcome. ⋯ The homodigital reverse island flap is an ideal surgical treatment for distal digital defects with a lower complication rate and good functional result, and the indication of age can be extended for older patients with a good preoperative evaluation.
-
Because platelet CD40 ligand (CD40L) expression plays an important role in inflammatory conditions, reduction of CD40L expression may be beneficial for patients with sepsis. Although hypertonic saline, mannitol, and hydroxyethyl starch (HES) solutions have been shown to modulate inflammatory responses, their effects on platelet CD40L expression are unclear. We assessed the effects of hypertonic saline, mannitol, and HES solutions on platelet CD40L expression. ⋯ Our data show that resuscitation fluids, such as hypertonic saline, mannitol, and HES, inhibit agonist-induced CD40L expression on platelets. These resuscitation fluids may have an anti-inflammatory action when administered to septic patients.
-
In previous animal studies, induction of therapeutic hypothermia (HT) in hemorrhagic shock (HS) had beneficial effects on the hemodynamic and metabolic parameters and on the survival. However, the effect of induced HT on acute lung injury (ALI) in HS has not been investigated. We sought to determine the effects of HT on ALI in HS. ⋯ HT attenuates HS-induced ALI in rats by the modulation of GSK, HSP 72, iNOS, and NF-kappaB.
-
In 2007, a potent procoagulant mineral called WoundStat (WS), consisting of smectite granules, received clearance from the Food and Drug Administration for marketing in the United States for temporary treatment of external hemorrhage. Previously, we found that microscopic WS particles remained in the injured vessels that were treated, despite seemingly adequate wound debridement. Thus, we investigated the thromboembolic risk of using WS when compared with kaolin-coated gauze, Combat Gauze (CG); or regular gauze, Kerlix (KX) to treat an external wound with vascular injuries in pigs. ⋯ WS granules caused endothelial injury and significant transmural damage to the vessels that render them nonviable for primary surgical repair. The granules can enter systemic circulation and cause distal thrombosis in vital organs. More relevant in vitro and in vivo safety tests should be required for clearance of new hemostatic agents.