J Trauma
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Much controversy exists over the fluid composition for hypotensive resuscitation. We previously showed that addition of 6% Dextran-70 or hetastarch to 7.5% NaCl led to heart instability and mortality. Our aim was to examine the early resuscitative effects of 7.5% NaCl with adenosine, lidocaine, and magnesium (ALM) on hemodynamics and mortality in a rat model of severe hemorrhagic shock. ⋯ Ultra-small intravenous bolus of 7.5% NaCl with ALM led to a significantly higher MAP, higher diastolic rescue, and higher rate-pressure product compared with other treatment groups. The possible clinical and military applications for permissive hypotensive resuscitation are discussed.
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In our previous studies, antioxidant transcription factor, nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway has been shown to play an important role in protecting traumatic brain injury (TBI)-induced acute lung injury (ALI). This study was designed to explore whether recombinant human erythropoietin (rhEPO) administration modulates pulmonary Nrf2 signaling pathway in a murine TBI model. ⋯ The results of this study suggest that post-TBI rhEPO administration may induce Nrf2-mediated cytoprotective response in the lung, and this may be a mechanism whereby rhEPO reduces TBI-induced ALI.
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Multicenter Study
Derivation of a decision instrument for selective chest radiography in blunt trauma.
To derive a decision instrument (DI) that identifies patients who have virtually no risk of significant intrathoracic injury (SITI) visible on chest radiography and, therefore, no need for chest imaging. ⋯ We derived a DI consisting of seven clinical criteria that can identify SITI in blunt trauma patients with extremely high sensitivity. If validated, this instrument will allow for safe, selective chest imaging with potential resource savings.
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The purpose of this study was to test the effect of (1) titanium versus stainless steel metal and (2) locked unicortical versus bicortical shaft fixation on stiffness of Less Invasive Stabilization System (LISS) constructs in a mechanically unstable nonosteoporotic distal femur fracture model. ⋯ Unstable distal femur fracture constructs, created in sawbone specimens, fixed with stainless steel and titanium LISS implants, with or without bicortical locking screws proximally, show similar biomechanical properties under loading. Although there are numerous considerations when selecting implants for these fractures, our results indicate that stiffness is not a significant factor in choosing between the constructs tested.