J Trauma
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The reduced vascular reactivity after severe trauma or shock played an important role in the development and outcome of shock. Our previous study showed that protein kinase C (PKC) took part in the regulation of vascular reactivity after hemorrhagic shock. The objective of this study was to investigate the protective effects of activation of PKC on hemorrhagic shock and its related mechanism. ⋯ Activation of PKC has protective effects on hemorrhagic shock. The mechanism is related not only to its hemodynamic stabilization effect via improving vascular reactivity and calcium sensitivity but also to its effect on improving the perfusion and mitochondrial function of vital organs.
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Letter Case Reports
Intra-abdominal hypertension, prone ventilation, and abdominal suspension.
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Multicenter Study Retracted Publication
Delay in diagnosis and treatment of blunt intestinal perforation does not adversely affect prognosis in the pediatric trauma patient.
Blunt intestinal injury (BII) requiring surgical intervention in the pediatric trauma population remains difficult to diagnose. We sought to analyze whether delay in treatment in the event of perforation had an adverse affect on patient outcome. ⋯ These data suggest that delay in operative intervention does not have a significant effect on prognosis after pediatric blunt intestinal perforation. Appropriate observation and serial examination rather than repeat computed tomography and/or urgent exploration would appear adequate when the diagnosis is in question.
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Multicenter Study
Prophylaxis for venous thromboembolism during rehabilitation for traumatic brain injury: a multicenter observational study.
Deep venous thrombosis (DVT) is a major cause of mortality and morbidity after traumatic brain injury (TBI). There is no consensus regarding appropriate screening, prophylaxis, or treatment during acute rehabilitation. ⋯ Prophylactic anticoagulation during rehabilitation seemed safe for TBI patients whose physicians deemed it appropriate, but did not conclusively reduce venous thromboembolism. Given the number of DVTs present before rehabilitation, screening and prophylaxis during acute care may be more important.
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Randomized Controlled Trial
Intensive insulin therapy in severe traumatic brain injury: a randomized trial.
Intensive insulin therapy (IIT) has been shown to reduce morbidity and mortality in critically ill patients. Little investigation has been done to find out whether it improves the prognosis of patients with severe traumatic brain injury (STBI). ⋯ In our study, IIT did not improve the neurologic outcome of patients with STBI but did increase the risk of hypoglycemia compared with CGT.