The Journal of surgical research
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Prolonged elevated blood lactate levels strongly correlate with poor outcomes in a variety of critically ill patients. We hypothesized that the dynamic postoperative changes in blood lactate levels during the first 24 h were significantly associated with postoperative morbidity and mortality in patients undergoing elective major abdominal surgery. ⋯ The dynamic changes in blood lactate levels during the first 24 postoperative h were significantly associated with complications after major elective abdominal surgery. This result warrants a "golden hour and silver day" perspective of early resuscitation in this patient cohort.
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Mild traumatic brain injury (TBI) is a serious public health concern affecting more than 1.7 million people in the United States annually. Mild TBI is difficult to diagnose and is clinically associated with impaired motor coordination and cognition. ⋯ The current study provides a reproducible model of mild TBI in mice that exhibits pathologic features of mild TBI in humans. Furthermore, our data suggest that serum cytokines, such as IL-6, may be effective biomarkers for severity of head injury.
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Hemodynamic status and coagulation capacity affect blood loss after injury. The most advantageous fluid and blood pressure to optimize resuscitation and minimize perturbation of coagulation are unclear. We investigated interactions of isovolumic hemodilution on hemodynamics, coagulation, and blood loss after injury. ⋯ In this rat model of liver injury, blood loss was associated with baseline MAP and type of fluid used for dilution. Hemodilution with LR did not produce coagulopathy based on laboratory values. When controlling baseline MAP, dilution with LR increased bleeding, confirming a functional coagulopathic state.
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Preexisting cirrhosis usually leads to an inadequate and delayed regeneration of the future liver remnant (FLR) after portal vein embolization (PVE). Bone marrow-derived mesenchymal stem cells (BMSC) are promising candidates for therapeutic applications in liver diseases. In this study, the efficacy of autologous BMSCs transplantation to promote FLR regeneration was investigated in a rat cirrhotic model. ⋯ Autologous BMSCs can differentiate into hepatocyte and promote FLR regeneration after PVE in cirrhotic liver, which may be through improving local microenvironment by decreasing cirrhosis, up-regulating the gene expressions of VEGF, HGF, IL-10, and MMP-9.
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Meta Analysis
A meta-analysis of the effectiveness and safety of using tranexamic acid in primary unilateral total knee arthroplasty.
To evaluate the effectiveness and safety of tranexamic acid (TEA) treatment in reducing perioperative blood loss and transfusion for patients receiving primary unilateral total knee arthroplasty (TKA) and to explore the most effective and safe protocol. ⋯ Intravenous TEA could significantly reduce perioperative blood loss and blood transfusion requirements following primary unilateral TKA. Its application is not associated with increased risk of venous thromboembolisms or other adverse events.