J Trauma
-
Over the past 30 years, efforts have been made to identify therapeutic targets in the host response to infection. ⋯ Trials of agents directed at altering the host's response during sepsis have had variable results, and it appears that several different factors may alter the efficacy of these agents.
-
Our recent experimental study showed that peripheral muscle tissue oxygen saturation (StO2), determined noninvasively by near-infrared spectroscopy (NIRS), was more reliable than systemic hemodynamics or invasive oxygenation variables as an index of traumatic shock. The purpose of this study was to establish the normal range of thenar muscle StO2 in humans and the relationship between shock state and StO2 in trauma patients. ⋯ Decreased thenar muscle tissue oxygen saturation reflects the presence of severe hypoperfusion and near-infrared spectroscopy may be a novel method for rapidly and noninvasively assessing changes in tissue dysoxia.
-
The diameter of the inferior vena cava in trauma patients may be useful for evaluating hypovolemia. ⋯ The diameter of the inferior vena cava was found to correlate with hypovolemia in trauma patients.
-
This retrospective study investigated the treatment of femoral shaft aseptic nonunions associated with broken distal locked screws and shortening. ⋯ The key to removal of broken screws is withdrawal of the nail slightly to release the incarcerated broken screw end. The screw end then is pushed out with a used Knowles' pin or a smaller screwdriver under image intensifier guidance. Concomitant one-stage femoral lengthening to treat nonunion with shortening has a high success rate.
-
Traumatic pneumorrhachis is extremely rare, and a review of the English literature has revealed only 31 reported cases. We review the cause and pathophysiology of this unique entity in trauma patients. We also discuss the significance of this entity to the trauma specialist, paying special attention to the differences between air in the subarachnoid space versus air in the epidural space.