J Trauma
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To study hemodynamic effects of growth hormone (GH) and its main mediator, insulin-like growth factor-1, in a model of critical illness. ⋯ GH promoted metabolic acidosis in traumatized sepsis and impaired compensation of a subsequent hemorrhage.
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Comparative Study
Diaspirin cross-linked hemoglobin resuscitation improves cerebral perfusion after head injury and shock.
Shock associated with traumatic brain injury (TBI) doubles the mortality of TBI alone by inducing a secondary ischemic injury. Rapid correction of cerebral perfusion pressure (CPP) is thought to be essential to improving outcome. Diaspirin cross-linked hemoglobin (DCLHb) has been shown to improve cerebral blood flow, increase mean arterial pressure (MAP), and reduce lesion size in models of occlusive cerebral ischemia but has not been evaluated in a model of TBI combined with hemorrhagic shock. ⋯ These data suggest that DCLHb is beneficial in the early resuscitation of head injury and shock and that further investigation is warranted. Key Words: Diaspirin cross-linked hemoglobin, Head injury, Shock, Cerebral perfusion pressure.
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To review our experience with craniocerebral injuries caused by plastic bullets, and to delineate prognostic factors for outcome. ⋯ Plastic bullet-induced craniocerebral injuries carry a lower morbidity and mortality rate compared with other gunshot wounds. However, plastic bullets do incur a significant risk of injury. Their use should be carefully regulated.
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To identify preventable prehospital deaths, caused by trauma. ⋯ Upgrading of the emergency medical care service is required.