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lactate in trauma

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https://www.readbyqxmd.com/read/29120938/fibrinogen-on-admission-in-trauma-score-early-prediction-of-low-plasma-fibrinogen-concentrations-in-trauma-patients
#1
Tobias Gauss, Sébastien Campion, Sébastien Kerever, Mathilde Eurin, Mathieu Raux, Anatole Harrois, Catherine Paugam-Burtz, Sophie Hamada
BACKGROUND: Early recognition of low fibrinogen concentrations in trauma patients is crucial for timely haemostatic treatment and laboratory testing is too slow to inform decision-making. OBJECTIVE: To develop a simple clinical tool to predict low fibrinogen concentrations in trauma patients on arrival. DESIGN: Retrospective cohort study. SETTING: Three designated level 1 trauma centres in the Paris Region, from January 2011 to December 2013...
November 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29117026/the-american-association-for-the-surgery-of-trauma-severity-grade-is-valid-and-generalizable-in-adhesive-small-bowel-obstruction
#2
Martin D Zielinski, Nadeem N Haddad, Asad Choudhry, Matthew C Hernandez, Daniel C Cullinane, David Turay, Ji-Ming Yune, Salina Wydo, Kenji Inaba, D Dante Yeh, Therese M Duane, Andrea Pakula, Ruby Skinner, Jill Watras, Carlos J Rodriguez, Kenneth A Widom, John Cull, Julie Dunn, Eric A Toschlog, Valerie G Sams, John C Graybill
INTRODUCTION: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma (EAST) multi-institutional SBO prospective observational study. METHODS: Adults (age≥18) with (ASBO) were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), labs (lactate, hemoglobin, creatinine, leukocytosis), imaging findings, operative details, length of stay, and Clavien-Dindo complications were collected...
November 7, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29102048/ethyl-pyruvate-reduces-acute-lung-damage-following-trauma-and-hemorrhagic-shock-via-inhibition-of-nf-%C3%AE%C2%BAb-and-hmgb1
#3
Borna Relja, Nils Wagner, Niklas Franz, Scott Dieteren, Katharina Mörs, Julia Schmidt, Ingo Marzi, Mario Perl
OBJECTIVE: After blunt thoracic trauma (TxT) and hemorrhagic shock with resuscitation (H/R) intense local inflammatory response and cell loss frequently impair the pulmonary function. Ethyl pyruvate (EP) has been reported to improve the pathophysiologic derangements in models of acute inflammation. Here, we studied the effects of EP on inflammation and lung damage after TxT+H/R. METHODS: Twenty four female Lewis rats (180-240g) were randomly divided into 3 groups: two groups underwent TxT followed by hemorrhagic shock (35±3mmHg) for 60min and resuscitation with either Ringers-Lactat (RL) alone or RL supplemented with EP (EP, 50mg/kg)...
October 16, 2017: Immunobiology
https://www.readbyqxmd.com/read/29094801/photoluminescence-intensity-ratio-of-eu-conjugated-lactates-a-simple-optical-imaging-technique-for-biomarker-analysis-for-critical-diseases
#4
Tarun Kakkar, Nikita Thomas, Eric Kumi Barimah, Gin Jose, Sikha Saha
Instant measurement of elevated biomarker such as lactic acid offers the most promising approaches for early treatment and prevention of many critical diseases including cardiac arrest, stroke, septic shock, trauma, liver dysfunction, and as well as for monitoring lactic acid level during intense exercise. In the present study a unique dependence of visible photoluminescence of Eu(3+) ions resulting from (5) D0 to (7) FJ(J=0,1,2,3,4) transitions, which can be exploited for rapid detection of biomarkers both in vitro and ex vivo has been reported...
November 2, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/29049136/comparisons-of-traditional-metabolic-markers-and-compensatory-reserve-as-early-predictors-of-tolerance-to-central-hypovolemia-in-humans
#5
Alicia M Schiller, Jeffrey T Howard, Kristen R Lye, Christian G Magby, Victor A Convertino
Circulatory shock remains a leading cause of death in both military and civilian trauma. Early, accurate and reliable prediction of decompensation is necessary for the most efficient interventions and clinical outcomes. Individual tolerance to reduced central blood volume can serve as a model to assess the sensitivity and specificity of vital sign measurements. The compensatory reserve (CRM) is the measurement of this capacity. Measurements of muscle oxygen saturation (SmO2), blood lactate and end tidal CO2 (EtCO2) have recently gained attention as prognostic tools for early assessment of the status of patients with progressive hemorrhage, but lack the ability to adequately differentiate individual tolerance to hypovolemia...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29032876/clinical-value-of-triage-lactate-in-risk-stratifying-trauma-patients-using-interval-likelihood-ratios
#6
Bonny J Baron, Andrew Nguyen, Dimitre Stefanov, Amit Shetty, Shahriar Zehtabchi
Emergency physicians face the challenge of rapidly identifying high-risk trauma patients. Lactate (LAC) is widely used as a surrogate of tissue hypoperfusion. However, clinically important values for LAC as a predictor of mortality are not well defined. OBJECTIVES: 1. To assess the value of triage LAC in predicting mortality after trauma. 2. To compute interval likelihood ratios (LR) for LAC. METHODS: Retrospective chart review of trauma patients with a significant injury mechanism that warranted labs at an urban trauma center...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28955248/aicar-administration-attenuates-hemorrhagic-hyperglycemia-and-lowers-oxygen-debt-in-anesthetized-male-rabbits
#7
Yi Huang, Paul H Ratz, Amy S Miner, Victoria A Locke, Grace Chen, Yang Chen, Robert W Barbee
Background: Many strategies have been utilized to treat traumatic shock via improved oxygen delivery (DO2), while fewer have been used to in an attempt to reduce oxygen demand (VO2). The cellular energy sensor 5' adenosine monophosphate-activated protein kinase (AMPK) has the potential to modulate both whole-body DO2 and VO2. Therefore, we determined the effect of the AMPK activator AICAR (5-aminoimidazole-4-carboxamide 1-β-D-ribonucleoside) given acutely or chronically on key metabolites, hemodynamics, and oxygen consumption/delivery before and during hemorrhage in anesthetized male rabbits...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28954004/independent-early-predictors-of-mortality-in-polytrauma-patients-a-prospective-observational-longitudinal-study
#8
Luiz Guilherme V da Costa, Maria José C Carmona, Luiz M Malbouisson, Sandro Rizoli, Joel Avancini Rocha-Filho, Ricardo Galesso Cardoso, José Otávio C Auler-Junior
OBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population...
August 2017: Clinics
https://www.readbyqxmd.com/read/28930961/impact-of-a-novel-phosphoinositol-3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#9
George Edward Black, Kyle K Sokol, Donald M Moe, Jon D Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhaylo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental phosphoinositol-3 kinase (PI3-K) inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage-associated molecular patterns (DAMPs)...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930955/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#10
COMPARATIVE STUDY
Michael Craig Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian J Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene before decompensation is paramount to survival. Lactate is extremely sensitive to shock, and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The compensatory reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930937/administration-of-hypertonic-solutions-for-hemorrhagic-shock-a-systematic-review-and-meta-analysis-of-clinical-trials
#11
REVIEW
Meng-Che Wu, Tin-Yun Liao, Erica M Lee, Yueh-Sheng Chen, Wan-Ting Hsu, Meng-Tse Gabriel Lee, Po-Yang Tsou, Shyr-Chyr Chen, Chien-Chang Lee
BACKGROUND: Several clinical trials on hypertonic fluid administration have been completed, but the results have been inconclusive. The objective of this study is to summarize current evidence for treating hypovolemic patients with hypertonic solutions by performing a systematic review and meta-analysis. METHODS: Major electronic databases were searched from inception through June 2014. We included only randomized controlled trials involving hemorrhagic shock patients treated with hypertonic solutions...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28869098/measurement-of-blood-lactate-d-dimer-and-activated-prothrombin-time-improves-prediction-of-in-hospital-mortality-in-adults-blunt-trauma
#12
Rimako Umebachi, Takayuki Taira, Shinjiro Wakai, Hiromichi Aoki, Hiroyuki Otsuka, Yoshihide Nakagawa, Sadaki Inokuchi
No abstract text is available yet for this article.
August 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28855773/effectiveness-and-safety-of-polygeline-in-patients-with-hypovolemia-due-to-trauma
#13
Ajai Singh, Sabir Ali, Rohita Shetty
BACKGROUND: This retrospective study examined the effectiveness and safety of polygeline in adult patients with hypovolemia due to traumatic injury. MATERIALS AND METHODS: Polygeline was administered after evaluating the amount of blood loss and estimating hematological and biochemical parameters. Changes in vital signs, serum electrolytes, arterial pH, and serum lactate were evaluated. The safety was evaluated by recording the adverse events if any. RESULTS: Sixty patients with the mean age 37...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28855769/correlation-of-venous-lactate-and-time-of-death-in-emergency-department-patients-with-noncritical-lactate-levels-and-mortality-from-trauma
#14
Ashika Jain, Adam Aluisio, Bonny J Baron, Richard Sinert, Saman Sarraf, Eric Legome, Valery Roudnitsky, Leon Boudourakis, Shahriar Zehtabchi
BACKGROUND: Serum venous lactate (LAC) levels help guide emergency department (ED) resuscitation of patients with major trauma. Critical LAC level (CLAC, ≥4.0 mmol/L) is associated with increased disease severity and higher mortality in injured patients. The characteristics of injured patients with non-CLAC (NCLAC) (<4.0 mmol/L) and death have not been previously described. OBJECTIVES: (1) To describe the characteristics of patients with venous NCLAC and death from trauma...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28844961/mitochondrial-dysfunction-in-rat-splenocytes-following-hemorrhagic-shock
#15
Marie Warren, Kumar Subramani, Richard Schwartz, Raghavan Raju
The regulation of mitochondrial function is critical in cellular homeostasis following hemorrhagic shock. Hemorrhagic shock results in fluid loss and reduced availability of oxygen and nutrients to tissues. The spleen is a secondary lymphoid organ playing a key role in 'filtering the blood' and in the innate and adaptive immune responses. To understand the molecular basis of hemorrhagic shock, we investigated the changes in splenocyte mitochondrial respiration, and concomitant immune and metabolic alterations...
October 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28843717/variables-associated-with-pulmonary-thromboembolism-in-injured-patients-a-systematic-review
#16
Ryan Shuster, Joseph Mathew, Alexander Olaussen, Dashiell Gantner, Dinesh Varma, Jim Koukounaras, Mark C Fitzgerald, Peter A Cameron, Biswadev Mitra
BACKGROUND: Pulmonary thromboembolism (PTE) is a dangerous complication of traumatic injury, with varied risk profiles and treatment options. This review aims to describe reported incidence and variables associated with PTE among severely injured patients. METHODS: Searches were conducted using PubMed, Cochrane and MEDLINE. Relevant studies were identified by two independent reviewers based on predetermined inclusion criteria. Incidence of PTE was the primary outcome measure...
August 18, 2017: Injury
https://www.readbyqxmd.com/read/28842902/measuring-mitochondrial-substrate-utilization-in-skeletal-muscle-stem-cells
#17
C Hai Ly, James G Ryall
Skeletal muscle stem cells (MuSCs) derived from the somatic mesoderm play a critical role in successful muscle regeneration following injury and trauma. MuSCs have been found to undergo rapid changes in metabolism following a change in cell state, such as that which occurs during the transition from quiescence to an actively proliferating state. There is mounting evidence that metabolism is critically important in the regulation of quiescence, activation, and differentiation and thus the development of new techniques that aim to further probe the metabolism of MuSCs is essential...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28830477/hyperfibrinolysis-in-severe-isolated-traumatic-brain-injury-may-occur-without-tissue-hypoperfusion-a-retrospective-observational-multicentre-study
#18
Mineji Hayakawa, Kunihiko Maekawa, Shigeki Kushimoto, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matsuoka, Toshifumi Uejima, Naoto Morimura, Hiroyasu Ishikura, Akiyoshi Hagiwara, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Daisuke Kudo, Takashi Kanemura, Takayuki Shibusawa, Shintaro Furugori, Yoshihiko Nakamura, Atsushi Shiraishi, Kiyoshi Murata, Gou Mayama, Arino Yaguchi, Shiei Kim, Osamu Takasu, Kazutaka Nishiyama
BACKGROUND: Hyperfibrinolysis is a critical complication in severe trauma. Hyperfibrinolysis is traditionally diagnosed via elevated D-dimer or fibrin/fibrinogen degradation product levels, and recently, using thromboelastometry. Although hyperfibrinolysis is observed in patients with severe isolated traumatic brain injury (TBI) on arrival at the emergency department (ED), it is unclear which factors induce hyperfibrinolysis. The present study aimed to investigate the factors associated with hyperfibrinolysis in patients with isolated severe TBI...
August 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28827507/presentation-coagulopathy-and-persistent-acidosis-predict-complications-in-orthopaedic-trauma-patients
#19
Benjamin R Childs, Daniel R Verhotz, Timothy A Moore, Heather A Vallier
OBJECTIVES: To evaluate the ability of measures of coagulopathy and acidosis to predict complications. We hypothesize that increased coagulopathy and acidosis over the first 60 hours of hospitalization will result in increased rates of infection and mortality. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred and seventy-six skeletally mature patients with an Injury Severity Score (ISS) greater than 16 who were surgically treated for high energy fractures of the femur, pelvic ring, acetabulum, and/or spine...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28814248/pediatric-abdominal-trauma
#20
Tim Lynch
Abdominal trauma is present in approximately 25% of pediatric patients with major trauma and is the most common cause of unrecognized fatal injury in children. Pediatric abdominal trauma is typically blunt in nature with the spleen being the most common organ injured. Non-operative management is employed in over 95% of patients. Penetrating injuries are less common but often require operative management. Knowledge of specific mechanisms of injury aids the clinician in the diagnosis of specific injuries. Computed tomography (CT) is the gold standard in the identification of intra-abdominal injury...
August 14, 2017: Current Pediatric Reviews
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