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traumatic shock

Kuan-Ho Lin, Chien-Liang Liu, Wei-Wen Kuo, Catherine Reena Paul, Wei-Kung Chen, Su-Ying Wen, Cecilia Hsuan Day, Hsi-Chin Wu, Vijaya Padma Viswanadha, Chih-Yang Huang
Cardiac trauma has been recognized as a complication associated with blunt chest trauma involving coronary artery injury, myocardium contusion and myocardial rupture. Secondary cardiac injuries after trauma supposed to be a critical factor in trauma patients, but the mechanism is not fully explored. Overproduction of TNF-alpha had been reported in multiple trauma animals, this induces oxidative stress resulting in cardiac apoptosis. Apoptosis gradually increases after trauma and reaches to a maximum level in 12 h time...
2016: PloS One
Ronald Chang, Lindley E Folkerson, Duncan Sloan, Jeffrey S Tomasek, Ryan S Kitagawa, H Alex Choi, Charles E Wade, John B Holcomb
BACKGROUND: Plasma-based resuscitation improves outcomes in trauma patients with hemorrhagic shock, while large-animal and limited clinical data suggest that it also improves outcomes and is neuroprotective in the setting of combined hemorrhage and traumatic brain injury. However, the choice of initial resuscitation fluid, including the role of plasma, is unclear for patients after isolated traumatic brain injury. METHODS: We reviewed adult trauma patients admitted from January 2011 to July 2015 with isolated traumatic brain injury...
October 13, 2016: Surgery
Christos Lazaridis
Shock is a systemic form of acute circulatory failure leading to cellular dysoxia and death. Such a state of aerobic metabolism failure also underlies neuronal cell death in severe traumatic brain injury. It is becoming increasingly recognized that ischemic hypoxia is not the sole mechanism and that multiple alternate cooperating mechanisms may be responsible for compromising neuronal oxidative metabolism. These different mechanisms can be usefully understood via analysis of the classic subdivisions of tissue hypoxia...
October 11, 2016: Journal of Critical Care
Lai Yee Leung, Ying Deng-Bryant, Katherine Cardiff, Megan Winter, Frank Tortella, Deborah Shear
BACKGROUND: Energy metabolic dysfunction is a key determinant of cellular damage following traumatic brain injury and may be worsened by additional insults. This study evaluated the acute/subacute effects of combined hypoxemia (HX) and hemorrhagic shock (HS) on cerebral interstitial levels of glucose, lactate, and pyruvate in a rat model of penetrating ballistic-like brain injury (PBBI). METHODS: Rats were randomly assigned into the sham control, PBBI, and combined injury (P + HH) groups...
November 2016: Journal of Trauma and Acute Care Surgery
V P Novoselov, S V Savchenko, O A Sakovchuk
The objective of the present study was the expert assessment of the morphological signs of renal lesions depending on the type of deformation associated with a blunt trauma. The authors proposed the algorithm for the description of a kidney damage taking into consideration the specific morphological features associated with a blunt trauma. The pathomorphological changes in the kidney tissue under the normal hemodynamic conditions and in the case of hemorrhagic shock at different times after the injury taking into account its organ specificity make it possible to reliably predict the duration of the post-traumatic period...
2016: Sudebno-meditsinskaia Ekspertiza
Sebastian Zabierek, Jakub Zabierek, Adam Kwapisz, Marcin E Domzalski
BACKGROUND AND PURPOSE: The patella plays an important role in knee biomechanics and provides anterior coverage of the knee joint. One to two percent of the population has an anatomical variant of patella called a bipartite patella that usually does not case pain. However, occasionally after injury or overuse during sport it can be a source of anterior knee pain. The purpose of this case report was to present a rare variant of bipartite patella and highlight conservative treatment of this condition...
October 2016: International Journal of Sports Physical Therapy
Eric M Janezic, Swetha Uppalapati, Stephanie Nagl, Marco Contreras, Edward D French, Jean-Marc Fellous
Post-traumatic stress disorder (PTSD) is in part due to a deficit in memory consolidation and extinction. Oxytocin (OXT) has anxiolytic effects and promotes prosocial behaviors in both rodents and humans, and evidence suggests that it plays a role in memory consolidation. We studied the effects of administered OXT and social co-housing in a rodent model of PTSD. Acute OXT yielded a short-term increase in the recall of the traumatic memory if administered immediately after trauma. Low doses of OXT delivered chronically had a cumulating anxiolytic effect that became apparent after 4 days and persisted...
October 12, 2016: Behavioural Pharmacology
Martin Sillesen, Theodore Bambakidis, Simone Dekker, Yongqing Li, Hasan B Alam
BACKGROUND: Resuscitation with Fresh Frozen Plasma (FFP) decreases brain lesion size and swelling in a swine model of Traumatic Brain Injury (TBI) and hemorrhagic shock (HS). We hypothesized that brain gene expression profiles following TBI+HS would be modulated by FFP resuscitation. STUDY DESIGN: 15 swine underwent a protocol of TBI and HS, two hours of shock followed by resuscitation with FFP, Normal Saline (NS) or hetastarch (Hextend, HEX, 5/group). After 6 hours, brain RNA was isolated and hybridized onto a Porcine Gene ST 1...
October 7, 2016: Journal of the American College of Surgeons
Melvin E Stone, Stanley Kalata, Anna Liveris, Zachary Adorno, Shira Yellin, Edward Chao, Srinivas H Reddy, Michael Jones, Carlos Vargas, Sheldon Teperman
BACKGROUND: Critical administration threshold (≥3 units of packed red blood cells/h or CAT+) has been proposed as a new definition for massive transfusion (MT) that includes volume and rate of blood transfusion. CAT+ has been shown to eliminate survivor bias and be a better predictor of mortality than the traditional MT (>10 units/24h). End-tidal CO2 (ET CO2) negatively correlates with lactate and is an early predictor of shock in trauma patients. We conducted a pilot study to test the hypothesis that low ET CO2 on admission predicts CAT+...
July 5, 2016: Injury
Yun Zhang, Jian Zhang, Tao Xu, Wei Wu, Fang-Fang Huang, Wen-Qiao Yu, Shao-Yang Zhang, Ting-Bo Liang
BACKGROUND: Intestinal dendritic cells play important roles in regulating the function of the intestinal immune barrier and the intestinal bacterial translocation. In this study, we aim to investigate the effects of allicin on the function of mesenteric lymph node-dendritic cells after trauma/hemorrhagic shock. METHODS: One hundred and eight-four Sprague-Dawley rats were randomly assigned into a sham group (n = 46), sham + allicin group (n = 46), trauma/hemorrhagic shock group (n = 46), and trauma/hemorrhagic shock + allicin group (n = 46)...
October 3, 2016: Surgery
Nissar Shaikh, M A Rhaman, Ali Raza, Adel Shabana, Mahommad Faisal Malstrom, Ghanem Al-Sulaiti
BACKGROUND: High spinal cord injury (HSCI) is one of the devastating traumatic injuries. 80% of these patients are young male, and 93% will have major neurological disabilities. There is a paucity of literature about prolonged bradycardia in HSCI patients. The aim of this study was to know the prevalence, risk factors, precipitating factors for prolonged bradycardia in the HSCI patients. MATERIALS AND METHODS: All patients who were admitted to the Intensive Care Unit (ICU) of a tertiary hospital, with spinal cord injury above level of dorsal (D4) were enrolled in this study prospectively...
October 2016: Asian Journal of Neurosurgery
Joseph A Posluszny, Lena M Napolitano
INTRODUCTION: Treatment of severe hemorrhagic shock due to acute blood loss from traumatic injuries in a Jehovah's witness (JW) trauma patient is very challenging since hemostatic blood product resuscitation is limited by refusal of the transfusion of allogeneic blood products. CASE PRESENTATION: We describe a multifaceted approach to the clinical care of a severely anemic JW trauma patient including the early administration of a bovine hemoglobin-based oxygen carrier (HBOC) as a bridge to resolution of critical anemia (nadir hemoglobin 3...
June 2016: Archives of Trauma Research
Dublu Lal Gupta, Sanjeev Bhoi, Teena Mohan, Sagar Galwnkar, D N Rao
INTRODUCTION: Multiple organ dysfunction syndrome (MODS) developed due to the insult of trauma is a leading cause of death. The high mortality rate in these patients with and without sepsis has been reported up to 50%, throughout the world and thus required an urgent insight to overcome this problem. OBJECTIVE: The aim of this study is to examine the differential changes in subsets of T cells, imbalance in cytokine profile, immune-paralysis (T cell anergy) in Trauma hemorrhagic shock (THS) and post traumatic sepsis patients...
December 2016: Cytokine
Stephen C Gale, Jurek F Kocik, Robert Creath, Jessica S Crystal, Viktor Y Dombrovskiy
BACKGROUND: After injury, base deficit (BD) and lactate are common measures of shock. Lactate directly measures anaerobic byproducts, whereas BD is calculated and multifactorial. Although recent studies suggest superiority for lactate in predicting mortality, most were small or analyzed populations with heterogeneous injury severity. Our objective was to compare initial BD with lactate as predictors of inhospital mortality in a large cohort of blunt trauma patients all presenting with hemorrhagic shock...
October 2016: Journal of Surgical Research
Graham Martin
OBJECTIVE: The physical events of the first 15 milliseconds of a traumatic brain injury are reviewed from computer simulations using finite element calculations and applied to observed pathology. METHODS: The impact creates two shock waves; one through the brain, another through the skull, both injure the brain separately. Two accelerations, anteroposterior and rotary, distort or stretch the brain, because of inertia. The two shockwaves are reflected many times within in the brain, from boundaries where the density or elasticity changes...
September 23, 2016: Brain Injury: [BI]
Michael J Beltran, Tyson E Becker, Richard K Hurley, Jennifer M Gurney, Roman A Hayda
Hemorrhage continues to be the most common cause of death among service members wounded in combat. Injuries that were previously nonsurvivable in previous wars are now routinely seen by combat surgeons in forward surgical units, the result of improvements in body armor, the universal use of field tourniquets to control extremity hemorrhage at the point of injury, and rapid air evacuation strategies. Combat orthopaedic surgeons remain a vital aspect of the forward surgical unit, tasked with assisting general surgical colleagues in the resuscitation of patients in hemorrhagic shock while also addressing traumatic amputations, open and closed long bone fractures, and mechanically unstable pelvic trauma...
October 2016: Journal of Orthopaedic Trauma
Gustav Folmer Genét, Peter Bentzer, Sisse Rye Ostrowski, Pär Ingemar Johansson
Traumatic brain injury and hemorrhagic shock is associated with blood-brain barrier (BBB) breakdown and edema formation. Recent animal studies have shown that fresh frozen plasma (FFP) resuscitation reduces brain swelling and improves endothelial function compared to isotonic NaCl (NS). The aim of this study was to investigate whether pooled and pathogen-reduced plasma (OctaplasLG(®) [OCTA]; Octapharma, Stockholm, Sweden) was comparable to FFP with regard to effects on brain water content, BBB permeability, and plasma biomarkers of endothelial glycocalyx shedding and cell damage...
October 13, 2016: Journal of Neurotrauma
Richard J Servatius, Christine E Marx, Swamini Sinha, Pelin Avcu, Jason D Kilts, Jennifer C Naylor, Kevin C H Pang
Exposure to lateral fluid percussion (LFP) injury consistent with mild traumatic brain injury (mTBI) persistently attenuates acoustic startle responses (ASRs) in rats. Here, we examined whether the experience of head trauma affects stress reactivity. Male Sprague-Dawley rats were matched for ASRs and randomly assigned to receive mTBI through LFP or experience a sham surgery (SHAM). ASRs were measured post injury days (PIDs) 1, 3, 7, 14, 21, and 28. To assess neurosteroids, rats received a single 2.0 mA, 0.5 s foot shock on PID 34 (S34), PID 35 (S35), on both days (2S), or the experimental context (CON)...
2016: Frontiers in Neuroscience
Michael J Poellmann, Tobin R Sosnick, Stephen C Meredith, Raphael C Lee
Aggregation of denatured or unfolded proteins establishes a large energy barrier to spontaneous recovery of protein form and function following traumatic injury, tissue cryopreservation, and biopharmaceutical storage. Some tissues utilize small heat shock proteins (sHSPs) to prevent irreversible aggregation, which allows more complex processes to refold or remove the unfolded proteins. It is postulated that large, amphiphilic, and biocompatible block copolymers can mimic sHSP function. Reduced and denatured hen egg white lysozyme (HEWL) is used as a model aggregating protein...
September 12, 2016: Macromolecular Bioscience
B Tettenborn, S Mehnert, I Reuter
Peripheral nerve injuries due to sports are relatively rare but the exact incidence is not known due to a lack of epidemiological studies. Particular sports activities tend to cause certain peripheral nerve injuries including direct acute compression or stretching, repetitive compression and stretching over time, or another mechanism such as ischemia or laceration. These nerve lesions may be severe and delay or preclude the athlete's return to sports, especially in cases with delayed diagnosis. Repetitive and vigorous use or overuse makes the athlete vulnerable to disorders of the peripheral nerves, and sports equipment may cause compression of the nerves...
September 2016: Fortschritte der Neurologie-Psychiatrie
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