Damage control reanimation

In Germany per year approximately 60,000 and in Austria 5,000 adult patients suffer from out-of-hospital cardiac arrest. Only 10-15% of these patients survive without neurological damage. For decades hypothermic temperature control has been a central component of post-resuscitation treatment, but is controversial due to recently published studies.

Damage Control Resuscitation (DCR) is a strategy designed to prioritize hemostasis procedures, from the point of injury to surgical management, whether faced with an influx of bleeding casualties or a single casualty with severe hemodynamic instability. Widely disseminated, it provides clear objectives for prioritizing physiological restoration to the anatomy required for short-term survival. Initially applied to surgery, DCR has now been extended to the entire upstream care chain, including first aid and emergency medicine...

BACKGROUND: In the absence of a viable proximal nerve stump, damaged after surgical procedures around the skull base, numerous techniques for facial reanimation have been developed over time, aiming to restore baseline symmetry and active mimicry. OBJECTIVE: To report experience using the masseteric nerve as a direct transfer to the facial nerve rerouted after intratemporal translocation. This paper illustrates the main steps of the technique and the quality of results...

A 48-year-old female presented to the emergency department with chest pain and collapsed at the front desk. She was reanimated with mechanical chest compression, and after coronary angiography, a left anterior descending/diagonal bifurcation mini-crush stenting was performed. Few hours after the procedure, the patient showed severe hypotension. Abdominal ultrasound and computed tomography (CT) scan evidenced a massive subcapsular liver hematoma (Grade IV, American association for the surgery of trauma (AAST) liver injury scale) of the right lobe with extrahepatic blushing...

Melanie Klein and André Green offer competing descriptions of primitive mental development. The former emphasizes the need to control internal objects through splitting and projective identification, while the latter emphasizes a narcissistic retreat from objects through progressive deadening of the self. To bridge these theoretical differences a spectrum of fantasies is proposed ranging from reanimation (bringing deadness back to life) to reparation (healing damage caused by paranoid attack). Clinically, alternations between these two defensive patterns occur, acting together to avoid painful anxieties...

While the donation after circulatory death (DCD) heart transplantation is an emerging clinical practice, the primary source of donor hearts for transplantation remains donation after brain death (DBD) donors. DCD process induces formation of NOD-like receptor family pyrin domain containing-3 (NLRP3) inflammasome, a key mediator of inflammation-driven damage to heart. Inhibition of NLRP3 inflammasome formation could be protective to DCD hearts. Five groups (n = 8 each) of mice were studied-control beating heart donor (CBD) wild-type (WT), DCD WT, CBD NLRP3 knockout (KO), DCD NLRP3 KO, and DCD WT NLRP3 inhibitor group...

Hypoglossal-facial nerve anastomosis (HFA) aims to reanimate denervated mimic muscles with hypoglossal axons when the transected facial nerve is not accessible. The aim of this study was to evaluate the recovery of HFA using a "Y" tube in two variants: (1) the proximal stump of the hypoglossal nerve was entubulated to the "Y" tube (classic "Y" tube HFA) and (2) the "Y" tube was sutured to an epineurial window of a slightly damaged hypoglossal nerve (end-to-side "Y" tube HFA). A total of 48 adult female rats were divided into four groups: intact controls (group 1), sham operated (group 2), classic "Y" tube HFA (group 3) and end-to-side "Y" tube HFA (group 4)...

PURPOSE: Heart transplantation is commonly considered to be the only option available for patients with congenital heart defects and/or individuals with terminal heart failure. Myocardial ischemia-reperfusion injury (IRI) can damage the heart and prolong recovery. Common complications of IRI include graft rejection, cardiac allograft vasculopathy, graft dysfunction, and chronic kidney disease. Solutions of omega-3/omega-6 fatty acids and bear bile acids have been found to attenuate IRI...

OBJECTIVE: To develop French guidelines on the management of patients with severe abdominal trauma. DESIGN: A consensus committee of 20 experts from the French Society of Anaesthesiology and Critical Care Medicine (Société française d'anesthésie et de réanimation, SFAR), the French Society of Emergency Medicine (Société française de médecine d'urgence, SFMU), the French Society of Urology (Société française d'urologie, SFU) and from the French Association of Surgery (Association française de chirurgie, AFC), the Val-de-Grâce School (École du Val-De-Grâce, EVG) and the Federation for Interventional Radiology (Fédération de radiologie interventionnelle, FRI-SFR) was convened...

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)...