Damage control reanimation

As yet, no cure exists for upper-limb paralysis resulting from the damage to motor pathways after spinal cord injury or stroke. Recently, neural activity from the motor cortex of paralyzed individuals has been used to control the movements of a robot arm but restoring function to patients' actual limbs remains a considerable challenge. Previously we have shown that electrical stimulation of the cervical spinal cord in anesthetized monkeys can elicit functional upper-limb movements like reaching and grasping...

In 91 injured persons, suffering severe closed combined abdominal trauma, the staged surgical treatment was conducted, in 41 of them the operation was performed during one narcosis, but with surgical pause after temporary stopping of hemorrhage, in 50 the "damage control surgery" was applied. Unstable critical state of the injured persons, "unfavorable" prognosis of course of an acute period of the traumatic disease served as indications for the staged surgical treatment conduction. While the urgent laparotomy performance the surgical manipulations were conducted in minimal volume, surgical pause was applied with the patient's state reestimation...

AIM: Despite successful resuscitation, cardiac arrest (CA) often has a poor clinical prognosis. Different diagnostic tools have been established to predict patients' outcome. However, their sensitivity remains low. Assessment of cerebral perfusion by duplex ultrasound might provide additional information regarding the extent of neuronal damage. The aim of the present study was to analyse the changes of global cerebral blood flow (CBF) and intracranial blood flow parameters in the acute stage after CA and its correlation with patients' outcome...

OBJECTIVES: Advanced donor age is one of the risk factors for graft failure and is the leading cause of early death after heart transplantation. Better myocardial preservation methods should reduce graft failure. The purpose of this study was to determine if adenosine, which is known to enhance cardioplegic protection, enhances myocardial preservation during heart transplantation using older donors. METHODS: We used a rat heterotopic heart transplantation model with Lewis rats that were at least 60 weeks old as donors...

UNLABELLED: Stress-damage of upper gastro-intestinal tract (GIT) mucous membrane and gastro-intestinal hemorrhage (GIH) increase the lethality of patients in the departments of reanimation and intensive care unit. The purpose of this study is to evaluate effectiveness and safety of pantoprazole use in patients with at least one risk factor of upper GIT mucosa stresses-damage and GIH. An important part of this study was examination of 24-hour intragastric pH - control results in patients during 1-st day after the surgery...

BACKGROUND AND PURPOSE: Commonly used classic hypoglossal (CN XII) to facial nerve (CN VII) anastomosis has the disadvantage of tongue hemiatrophy. Thus, various attempts have been made to modify this method to reduce the tongue damage. The aim of this report was to present the results of hemihypoglossal-facial nerve anastomosis (HHFA) technique in relation to facial muscles reanimation and hemitongue atrophy. MATERIAL AND METHODS: The first 7 consecutive patients who underwent CN VII anastomosis with half of the CNXII, for which the follow-up period exceeded 12 months, were analysed...

Abdominal pressure, abdominal hypertension and abdominal compartment syndrome are not synonyms but well-differentiated entities which have been studied over the last century in patients who have medical or surgical problems and in those who have undergone laparotomies to control abdominal damage. There are numerous bibliographical references and studies which have been carried out in this field by medical personnel to provide evidence of a tight relationship among abdominal hypertension and secondary physio-pathological alterations related to abdominal hypertension; therefore, it is important to monitor patients which will help to prevent abdominal compartment syndrome...

Facial nerve palsy affects individuals of all ages, races, and sexes. Psychological and functional implications of the paralysis present a devastating management problem to those afflicted, as well as the carriers. Since Sir Charles Bell's original description of facial palsy in 1821, our understanding and treatment options have expanded. It is essential that a multidisciplinary approach, encompassing ophthalmologists; Ear, Nose, and Throat surgeons; plastic surgeons; and psychologists work closely to optimize patient management in a staged approach...

OBJECTIVE: To investigate the effect of chronic infection of Toxoplasma gondii on the spatial learning and memory capability in mice. METHODS: Toxoplasma tachyzoites (RH strain) were reanimated at 37 degrees C after 15 days' storage at -20 degrees C, and injected intraperitoneally to mice of the experimental group each with 7.7 x 10(5). Normal saline was given to the control group, 0.5 ml per mouse. Two months later, all mice were tested in the Morris Water Maze...

The authors evaluated ten years of surgical reanimation in the University Centre of Lausanne (CHUV). Irreversible coagulopathy (IC) is the predominant cause of death for the polytraumatized patient. Acidosis, hypothermy, and coagulation troubles are crucial elements of this coagulopathy. The authors looked for a criterion allowing the identification of dying of IC. In a retrospective study, laboratory results of pH, TP, PTT, thrombocyte count and the need for blood transfusion units were checked for each major step of the primary evaluation and treatment of the polytraumatized patients...

BACKGROUND: In addition to the hippocampus, the dorsolateral caudate nucleus (CN) and the pars reticularis of the substantia nigra (SNr) are among the most vulnerable brain areas to ischemia. A possible association of the neuronal injury in these two subcortical nuclei has been proposed, the primary damage affecting the CN GABAergic neurons innervating the SNr, and secondarily the SNr neurons as a result of an imbalance of GABAergic and glutamatergic input to the SNr. Progesterone (P(4)) exerts a GABAergic action on the central nervous system (CNS) and is known to protect neurons in the cat hippocampus from the damaging effect of acute global cerebral ischemia (AGCI)...

Life saving surgery is the surgery which has to be performed during the acute or reanimation period (1 to 3 h) and during the primary or stabilisation period (first day surgery). During the reanimation period lifethreatening conditions are identified and management is begun simultaneously. Many trauma surgeons talk about the first "golden hours" as the time interval starting immediately after the injury when rapid intervention will save lives and a lack of intervention will result in life loss. Most common, these critical conditions are exsanguinating hemorrhage, acute pump failure, obstruction of airways, mechanical failure of ventilation or severe brain damage with tentorial herniation...

The complex approach to both restoration and maintenance of vital functions in patients with severe nervous system diseases is described in this article. The respiratory reanimation is thought to be the main problem of neuroreanimatology. The long-term experience of the Institute of Neurology of Rus. Acad. Med. Sci. in this field is presented. It was concerned with the arbitrary respiratory control disorders, automatic respiratory regulation disturbances, the damages of peripheral centers associated with respiratory function...

BACKGROUND: The aim of this study was to evaluate the viability of arrested pig hearts harvested after animal death. METHODS: Hearts (n = 25) were preserved for 2 hours by cold storage (4 degrees C) with St. Thomas' cardioplegic solution no warm ischemia (0 minutes; control) or 10, 20, 30, or 60 minutes of in situ warm ischemia (animal exsanguination). Hearts were then reperfused for 1 hour with whole blood with an in vitro functional testing system. Left ventricular developed pressure and coronary flow were measured during reperfusion...

Cardiovascular arrest may be followed by severe respiratory insufficiency due to an increase in the pressure in the pulmonary vascular system, an alteration in capillary permeability, or both. Extracorporeal circulation (ECC), on the other hand, can lead to a change in capillary integrity ('capillary leakage') caused by the unphysiologic perfusion patterns and/or activation of various mediator systems. Pulmonary hyperhydration (increased extravascular lung water [EVLW]) seems to be the most important factor limiting pulmonary function in this situation...

The Wiktor stent, a new coronary balloon-expandable tantalum stent, was implanted in 17 patients for other wise nonmanageable occlusion after balloon angioplasty (n = 11) and for recurrent restenosis (n = 6). Stents of 3.0 to 4.0 mm were implanted (right coronary artery: n = 10, left anterior descending artery: n = 4, left circumflex artery: n = 2, venous graft: n = 1). All patients were fully anticoagulated initially with heparin followed by coumadin for 3 months and were treated with acetylsalicylic acid indefinitely...