Abdominal Trauma in Combat

Singh, KJ; Galagali, Ashwin

doi:10.1016/s0377-1237(10)80011-5

Cited by 2 publications

(2 citation statements)

References 25 publications

(21 reference statements)

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“…Hyperenzymemia in this case is considered as a non-specific reaction of the body to the influence of the compression factor of excessive intensity with impaired permeability of biomembranes and ischemia under traumatic injury, which indicates an increase in liver failure. It is believed that the main mechanisms of cytolytic hyperenzymemia are direct cell damage, as well as the result of systemic membranopathy with increased permeability of cell membranes due to hypoxia and activation of free radical processes [3,4].…”

Section: Resultsmentioning

confidence: 99%

“…Terroristic acts and the use of explosive devices in everyday life both on purpose and by accident take a special position among emergency situations [1]. Peculiarities of such situations are occurrence of injuries caused by high energy associated with massive bleeding, damage of a considerable part of the soft tissues [3]. Such cases require special attention of clinical workers since ischemic-reperfusion syndrome of the limbs due to application of arresting bleeding tourniquets is also involved to unfavorable factors of such victims [4].…”

Section: Introductionmentioning

confidence: 99%

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Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

Kuzminskyi¹,

Grodetskyi

Thymbalyuk

2021

J Educ Health Sport

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The function of the organs responsible for detoxification processes, in particular the liver, deserves a special role in the conditions of combined trauma. It is proved that ischemia-reperfusion of the limb caused by the imposition of a tourniquet, is the cause of significant toxemia. Under such conditions, it becomes clear that the detoxification function may be impaired, especially against the background of blunt combined trauma to the abdominal organs complicated by massive bleeding. Changes in the detoxification function of the liver are indicated by markers of the cytolytic syndrome. However, there is no clear understanding of how ischemia - limb reperfusion affects the development of cytolytic syndrome.Objective of research: to study the effect of massive blood loss associated with ischemia-reperfusion of the limb on the cytolytic syndrome indicators in case of injury of the abdominal organs. Materials and methods. 100 mature albino male Wistar rats with the body weight of 190-220 grams kept on standard vivarium forage were used in the experiment. The animals were divided into the control and 3 research groups (containing 10 animals each). Arresting bleeding tourniquet was applied proximally on the lower limbs of rats from the first research group for 120 minutes under thiopental-sodium anesthesia (40 mg/kg-1), which caused development of ischemic-reperfusion. Closed abdominal injury was simulated by means of delivering two dosed blows in the region of the abdominal cavity in the second research group; massive blood loss was simulated by means of cutting the femoral vessels and bloodletting from 25 to 30 % of the circulating blood volume in the group. Injuries from the first two groups were combined in the third group. The control group of animals received anesthesia without formation of any injuries. With the aim to determine alterations of cytolytic syndrome the activity of enzymes – markers of cytolytic syndrome ALT and AST were determined by means of a unified method. The animals of the research groups were removed from the experiment under thiopental-sodium anesthesia by means of the total bloodletting from the heart.Results. Analysis of the results of the study found that cytolytic syndrome develops irrespective of the kind of injuries simulated. Thus, even during a day of post-traumatic period ALT and AST activity increases which is clearly registered in all the three research groups. Further destruction of cellular membranes increases till the 3rd day, which is manifested by a considerable increase of ALT and AST activity in the blood serum. This process continues till the 7th day. A tendency to ALT and AST decrease is observed only in the 1st group on the 7th day. Comparison of the 2nd and 3rd research groups within the time interval enables to understand that application of tourniquets on the limbs of animals with closed abdominal injury and massive bleeding deteriorates cytolytic processes.Conclusions: Simulated injuries in the research groups were associated with the occurrence of cytolytic processes possessing a tendency to develop in the period of early signs of traumatic disease. Ischemic-reperfusion syndrome of the limbs accelerates considerably the development of systemic changes with abdominal injuries and hypovolemic shock, which was manifested by a considerable increase of ALT and AST parameters in the group with abdominal trauma and massive blood loss and becoming higher than that of the control in end of the experiment.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

Kuzminskyi¹,

Grodetskyi

Thymbalyuk

2021

J Educ Health Sport

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Use of a local hemostatic agent based on chitosan and external compression of the abdominal area to control intra-abdominal bleeding

Golovko

Samokhvalov

Grishin

et al. 2022

Bulletin of the Russian Military Medical Academy

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The paper presents the intermediate results of an experimental study of three samples of chitosan-based local hemostatic agent in a model of intense intra-abdominal bleeding in an average-sized experimental animal (a Soviet Chinchilla rabbit) with a standard wound on the parenchymal organ (liver) in combination with external compression of the abdominal area to achieve hemostasis in the acute phase of the experiment. At the first stage, nine experimental groups and one control group, with three biological objects each, were involved (n = 30). The composition and properties of laboratory preparations of hemostatics were different from the concentration of the main component. To select the optimal sample of a local hemostatic agent with the least local irritant effect on the organs and structures of the abdominal cavity, three experimental groups with three animals each were formed at the second stage, without modeling blood loss (n = 9) with follow-up from 24 to 72 h. The studied drugs have high hemostatic activity in the model of intense intra-abdominal bleeding with follow-up periods from several hours to 3 days. Moreover, intraperitoneal administration of hemostatic agent samples does not lead to a pronounced local irritant effect. However, during the first 180 min of the experiment, only one fatal outcome was recorded in a group of animals with 15% chitosan in the studied drug because of a technical error in modeling the source of bleeding. External compression of the abdominal area demonstrated its effectiveness as an auxiliary technique for temporary control of the intra-abdominal source of bleeding in the experimental model. The objectification of the obtained results was achieved through a control sectional study and laboratory screening of peripheral blood indicators of experimental animals at different stages of the experiment. To further evaluate the hemostatic activity of chitosan-based drugs, creating an experimental model using a large experimental animal is necessary.

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Abdominal Trauma in Combat

Cited by 2 publications

References 25 publications

Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

Use of a local hemostatic agent based on chitosan and external compression of the abdominal area to control intra-abdominal bleeding

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