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Hemorrhagic shock

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https://www.readbyqxmd.com/read/28817064/attenuation-of-multiple-organ-damage-by-continuous-low-dose-solvent-free-infusions-of-resveratrol-after-severe-hemorrhagic-shock-in-rats
#1
Tobias Müller, Michael Kirsch, Frank Petrat
Therapeutic effects of continuous intravenous infusions of solvent-free low doses of resveratrol on organ injury and systemic consequences resulting from severe hemorrhagic shock in rats were studied. Hemorrhagic shock was induced by withdrawing arterial blood until a mean arterial blood pressure (MAP) of 25-30 mmHg was reached. Following a shock phase of 60 min, rats were resuscitated with the withdrawn blood plus lactated Ringer's. Resveratrol (20 or 60 μg/kg × h) was continuously infused intravenously starting with the resuscitation phase (30 min) and continued until the end of the experiment (total treatment time 180 min)...
August 17, 2017: Nutrients
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#2
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28813523/et-26-hydrochloride-et-26-hcl-has-similar-hemodynamic-stability-to-that-of-etomidate-in-normal-and-uncontrolled-hemorrhagic-shock-uhs-rats
#3
Bin Wang, Shouming Chen, Jun Yang, Linghui Yang, Jin Liu, Wensheng Zhang
OBJECTIVE: ET-26 HCl is a promising sedative-hypnotic anesthetic with virtually no effect on adrenocortical steroid synthesis. However, whether or not ET-26 HCl also has a sufficiently wide safety margin and hemodynamic stability similar to that of etomidate and related compounds remains unknown. In this study, the effects of ET-26 HCl, etomidate and propofol on therapeutic index, heart rate (HR), mean arterial pressure (MAP), maximal rate for left ventricular pressure rise (Dmax/t), and maximal rate for left ventricular pressure decline (Dmin/t) were investigated in healthy rats and a rat model of uncontrolled hemorrhagic shock (UHS)...
2017: PloS One
https://www.readbyqxmd.com/read/28807216/early-resuscitation-with-exendin-4-alleviates-acute-lung-injury-after-hemorrhagic-shock-in-rats
#4
Xiang Song, Gan Chen, Xin Luo, Guoxing You, Yujing Yin, Ying Wang, Lian Zhao, Hong Zhou
BACKGROUND: Oxidative stress induced by hemorrhagic shock (HS) is known to initiate a systemic inflammatory response, which leads to subsequent acute lung injury. This study is aimed to assess the efficacy of exendin-4 (Ex-4) in attenuating lung injury in a rat model of HS and resuscitation (HS/R). METHODS: HS was induced in sodium pentobarbital-anesthetized adult male Wistar rats by withdrawing blood to maintain a mean arterial pressure of 30-35 mm Hg for 50 min...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28801841/the-use-of-aortic-balloon-occlusion-in-traumatic-shock-first-report-from-the-abo-trauma-registry
#5
M Sadeghi, K F Nilsson, T Larzon, A Pirouzram, A Toivola, P Skoog, K Idoguchi, Y Kon, T Ishida, Y Matsumara, J Matsumoto, V Reva, M Maszkowski, A Bersztel, E Caragounis, M Falkenberg, L Handolin, B Kessel, D Hebron, F Coccolini, L Ansaloni, J J Morrison, T M Hörer, M J Madurska
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014...
August 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28801344/frontline-science-macrophage-derived-exosomes-promote-neutrophil-necroptosis-following-hemorrhagic-shock
#6
Yang Jiao, Zhigang Li, Patricia A Loughran, Erica K Fan, Melanie J Scott, Yuehua Li, Timothy R Billiar, Mark A Wilson, Xueyin Shi, Jie Fan
Hemorrhagic shock (HS) renders patients susceptible to development of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) through mechanisms that are, as yet, unclear. Cell necroptosis, a form of regulated inflammatory cell death, is one of the mechanisms that controls cell release of inflammatory mediators from innate immune cells, such as polymorphonuclear neutrophils (PMNs), and critically regulates the progress of inflammation. In this study, we investigated the mechanisms of alveolar macrophage (AMϕ) effects on PMN necroptosis following HS...
August 11, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28799103/bleeding-recurrence-and-mortality-following-interventional-management-of-spontaneous-hcc-rupture-results-of-a-multicenter-european-study
#7
Lilian Schwarz, Michael Bubenheim, Johanna Zemour, Astrid Herrero, Fabrice Muscari, Ahmet Ayav, Romain Riboud, Christian Ducerf, J-Marc Regimbeau, Hadrien Tranchart, Emilie Lermite, Gheorghe Petrovai, Amal Suhol, Alexandre Doussot, Lorenzo Capussotti, Jean Jacques Tuech, Yves Patrice Le Treut
BACKGROUND: The incidence of spontaneous rupture of hepatocellular carcinoma (HCC) is low in Europe, at less than 3%. HCC rupture remains a life-threatening complication, with mortality reported between 16 and 30%. The risk of bleeding recurrence has never been clearly evaluated in such clinical situation. The objectives of this study were to evaluate the current risk of mortality related to HCC rupture and to focus on the risk of bleeding recurrence following interventional management...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28795328/severe-hemorrhagic-shock-leads-to-a-delayed-fracture-healing-and-decreased-bone-callus-strength-in-a-mouse-model
#8
Katrin Bundkirchen, Christian Macke, Janin Reifenrath, Luisa Marilena Schäck, Sandra Noack, Borna Relja, Philipp Naber, Bastian Welke, Michael Fehr, Christian Krettek, Claudia Neunaber
BACKGROUND: Multiple trauma is frequently associated with hemorrhagic shock and fractures of the extremities. Clinically, the rate of impaired fracture healing (delayed healing and nonunion) seems to be increased in patients with multiple injuries compared with patients with isolated fractures. As the underlying pathogenesis remains poorly understood, we aimed to analyze the biomechanical properties during fracture healing in a murine model. QUESTIONS: The aim of this study was to determine whether fracture healing after severe hemorrhagic shock results in (1) delayed bridging as determined by macroscopic and radiographic assessment, (2) altered conditions of callus components as determined by µCT, and (3) decreased maximum bending moment measured by a three-point-bending test compared with ordinary fracture healing...
August 9, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28794357/a-rare-case-of-gastric-ulcer-penetrating-the-pancreas-that-was-successfully-managed-by-conservative-therapy
#9
Narihiro Shibukawa, Shohei Ouchi, Shuji Wakamatsu, Yuhei Wakahara, Nobuyuki Tatsumi, Akira Kaneko
A 62-year-old woman was admitted to our hospital with septic shock due to left submandibular osteomyelitis and cellulitis. Her condition improved following tooth extraction, drainage, and the administration of antibiotics. However, on the 4th day of hospitalization, she went into hemorrhagic shock after defecating a massive tarry stool. Emergency esophagogastroduodenoscopy (EGD) was performed. We found a giant ulcer at the antral greater curvature of the stomach. Computed tomography (CT) revealed that the gastric ulcer had penetrated the pancreas...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28794110/involvement-of-connexin43-phosphorylation-and-gap-junctional-communication-in-vasopressin-induced-rock-dependent-vasoconstriction-after-hemorrhagic-shock
#10
Guangming Yang, Xiaoyong Peng, Yue Wu, Tao Li, Liangming Liu
We examined the roles played by gap junctions (GJs) and the GJ channel protein connexin43 (Cx43) in arginine vasopressin (AVP)-induced vasoconstriction after hemorrhagic shock, and their relationship to Rho kinase (ROCK) and protein kinase C (PKC). The results showed AVP induced an endothelium-independent contraction in rat superior mesenteric arteries (SMAs). Blocking the GJs significantly decreased the contractile response of SMAs and vascular smooth muscle cells (VSMCs) to AVP after shock and hypoxia. The selective Cx43-mimetic peptide inhibited the vascular contractile effect of AVP after shock and hypoxia...
August 9, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/28790290/-postoperative-intrathoracic-hemorrhage-perioperative-prevention-and-management
#11
Yoshimasa Maniwa
Postoperative intrathoracic hemorrhage is sometimes diagnosed in the thoracic cavity, while the patient is in the recovery room after undergoing thoracic surgery such as lung resection with thoracotomy or mediastinal surgery with a median sternotomy. The information from the chest tube is important to identify this kind of postoperative complication. When the condition becomes severe, the patient may develop hemorrhagic shock due to hemothorax and re-exploration to assess for bleeding and hemostasis may be required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28768294/measurement-of-metabolic-fluxes-using-stable-isotope-tracers-in-whole-animals-and-human-patients
#12
Julie A Reisz, Angelo D'Alessandro
PURPOSE OF REVIEW: Metabolic flux analysis using stable isotope labeled substrates allows for the tracing of carbon, nitrogen, and hydrogen atoms through metabolic pathways and is an invaluable tool for investigating dynamic metabolic changes occurring in health and disease. Studies of flux analysis in vivo are more technically challenging than in vitro or ex vivo but provide a highly detailed view of organ and/or systemic metabolism. We review here recent efforts in studies of diet and nutrition, non-small cell lung cancer, ischemia/reperfusion injury, and hemorrhagic shock where in vivo flux analysis was utilized to analyze metabolic modulation...
September 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28762583/case-of-spontaneous-splenic-rupture-caused-by-ectopic-pregnancy-in-the-spleen
#13
Bao-Qiang Wu, Feng Zhu, Yong Jiang, Dong-Lin Sun
Splenic ectopic pregnancy refers to the implantation of the oosperm in the spleen. If not diagnosed early, the results of this phenomenon would almost certainly be splenic rupture, which is equivalent to the spontaneous rupture of the spleen. If the patient has no history of trauma, it is difficult to diagnose this condition early and an explicit diagnosis is often obtained by exploratory laparotomy. We report the case of a 27-year-old woman who was admitted to the hospital due to abdominal pain and hemorrhagic shock...
August 1, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28762448/comparison-of-warm-fluid-and-cold-fluid-resuscitation-during-uncontrolled-hemorrhagic-shock-model-in-rats
#14
Serkan Dilmen, Mehmet Eryılmaz, Salih Müjdat Balkan, Muhittin Serdar, Murat Durusu, Ali Osman Yıldırım, Sanem Aslıhan Dilmen
BACKGROUND: This study was designed to compare the effects of resuscitation with cold and warm fluid on survival time, rate and volume of hemorrhage, hemodynamics, hypothermia, coagulopathy, acid-base balance, hematocrit, lactate, and base deficit during uncontrolled hemorrhagic shock (HS) model in rats. METHODS: HS model was created with splenic vascular and parenchymal injury in 29 rats under ketamine and xylazine anesthesia. Thirty minutes after the hemorrhage, the rats were randomized to receive 14...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28757293/economic-cost-and-burden-of-dengue-during-epidemics-and-non-epidemic-years-in-taiwan
#15
Dih-Ling Luh, Cheng-Chieh Liu, Yun-Ru Luo, Szu-Chieh Chen
BACKGROUND: Determining the disease and economic burden of dengue is critical for the allocation of public health resources. Several studies have used disability-adjusted life-years (DALYs) to estimate the disease burden of dengue in different regions. However, there are no published studies discussing the estimates of dengue-related economic and disease burden specifically in Taiwan. OBJECTIVES: We assessed the economic cost and disease burden of dengue infections in Taiwan for the period 1998-2014, and compared these during epidemic and non-epidemic years...
July 27, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28756909/gastroduodenal-artery-coiling-to-curb-upper-gastrointestinal-bleeding
#16
Krishnamurti A Rao, Ramsey Al-Hakim, Thomas Scagnelli, George Sanchez, William Munios, Erick Hernandez, Juan E Sola, Holly Neville, Anthony Hogan, Eduardo A Perez
BACKGROUND: Peptic ulcers in pediatric populations are uncommon and can present with upper gastrointestinal bleeding and shock on presentation. An endoscopy is done initially to identify bleeding source. However, definitive treatment is achieved with angiography. The use of coiling is effective in achieving hemorrhagic control in duodenal ulcers or gastric ulcers, particularly in adults. However, the use in pediatric populations is unknown. We present a case of peptic ulcer disease treated with a gastroduodenal artery coil in a pediatric patient that has never been reported in the literature...
July 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28756036/spontaneous-rupture-of-the-iliac-vein
#17
Ryan Joseph, Jimie Owsley
Spontaneous iliac vein rupture is a rare diagnosis with less than 40 cases documented worldwide. There are certain similarities between many of the previously reported cases described in the literature and there are various proposed theories as to why patients develop a spontaneous rupture. A delay in diagnosis is not uncommon and the mainstay of treatment is laparotomy. Here, we report a case of a 51-year-old female with lower extremity swelling for 2days who subsequently developed hemorrhagic shock and had to be taken emergently to surgery, where a rupture of the common and external iliac veins was identified...
July 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28751369/wearable-technology-for-compensatory-reserve-to-sense-hypovolemia
#18
Victor A Convertino, Michael N Sawka
Traditional monitoring technologies fail to provide accurate or early indications of hypovolemia-mediated extremis because physiological systems (as measured by vital signs) effectively compensate until circulatory failure occurs. Hypovolemia is the most life-threatening physiological condition associated with circulatory shock in hemorrhage or sepsis, and it impairs one's ability to sustain physical exertion during heat stress. This review focuses on the physiology underlying the development of a novel non-invasive wearable technology that allows for real-time evaluation of the cardiovascular system's ability to compensate to hypovolemia, or its compensatory reserve, which provides an individualized estimate of impending circulatory collapse...
July 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28742815/il33-mediated-ilc2-activation-and-neutrophil-il5-production-in-the-lung-response-after-severe-trauma-a-reverse-translation-study-from-a-human-cohort-to-a-mouse-trauma-model
#19
Jing Xu, Jesse Guardado, Rosemary Hoffman, Hui Xu, Rami Namas, Yoram Vodovotz, Li Xu, Mostafa Ramadan, Joshua Brown, Heth R Turnquist, Timothy R Billiar
BACKGROUND: The immunosuppression and immune dysregulation that follows severe injury includes type 2 immune responses manifested by elevations in interleukin (IL) 4, IL5, and IL13 early after injury. We hypothesized that IL33, an alarmin released early after tissue injury and a known regulator of type 2 immunity, contributes to the early type 2 immune responses after systemic injury. METHODS AND FINDINGS: Blunt trauma patients admitted to the trauma intensive care unit of a level I trauma center were enrolled in an observational study that included frequent blood sampling...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742775/estimation-of-stroke-volume-and-stroke-volume-changes-by-electrical-impedance-tomography
#20
Fernando José da Silva Ramos, André Hovnanian, Rogério Souza, Luciano C P Azevedo, Marcelo B P Amato, Eduardo L V Costa
BACKGROUND: Electrical impedance tomography (EIT) is a noninvasive imaging method that identifies changes in air and blood volume based on thoracic impedance changes. Recently, there has been growing interest in EIT to measure stroke volume (SV). The objectives of this study are as follows: (1) to evaluate the ability of systolic impedance variations (ΔZsys) to track changes in SV in relation to a baseline condition; (2) to assess the relationship of ΔZsys and SV in experimental subjects; and (3) to identify the influence of body dimensions on the relationship between ΔZsys and SV...
July 24, 2017: Anesthesia and Analgesia
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