Resuscitative Strategies in the Trauma Patient: The Past, the Present, and the Future

Eick, B; Denke, Nancy J.

doi:10.1097/jtn.0000000000000383

Cited by 11 publications

(18 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, effective resuscitation strategies have become the key in the efforts to reduce mortality and to improve outcomes based on timely surgical hemostasis. 2…”

Section: Introductionmentioning

confidence: 99%

Effect of peritoneal dialysis solution with different pyruvate concentrations on intestinal injury

Zhang

Shen

Deng

et al. 2020

Exp Biol Med (Maywood)

View full text Add to dashboard Cite

To investigate the effects of direct peritoneal resuscitation with pyruvate-peritoneal dialysis solution (Pyr-PDS) of different concentrations combined with intravenous resuscitation on acid–base imbalance and intestinal ischemia reperfusion injury in rats with hemorrhagic shock. Sixty rats were randomly assigned to group SHAM, group intravenous resuscitation, and four direct peritoneal resuscitation groups combined with intravenous resuscitation: group NS, LA, PY1, and PY2, that is, normal saline, lactate-PDS (Lac-PDS), lower concentration Pyr-PDS (Pyr-PDS1), and higher concentration Pyr-PDS (Pyr-PDS2), respectively. Two hours after hemorrhagic shock and resuscitation, the pH, oxygen partial pressure, carbon dioxide partial pressure (PCO2), base excess, and bicarbonate ion concentration (HCO3−) of the arterial blood were measured. The intestinal mucosal damage index and intercellular adhesion molecule 1 (ICAM-1), tumor necrosis factor-α, interleukin-6, zonula occludens-1, claudin-1, and occludin levels in intestinal issues were detected. Two hours after resuscitation, group PY2 had higher mean arterial pressure, pH, oxygen partial pressure, and base excess and lower PCO2 of arterial blood than group PY1 ( P < 0.05). Tumor necrosis factor-α and interleukin-6 levels in group PY2 were significantly lower than those in group PY1 ( P < 0.05). Zonula occludens-1, claudin-1, and occludin expression levels were significantly higher in group PY2 than in group PY1 ( P < 0.05). Direct peritoneal resuscitation with Pyr-PDS2 combined with intravenous resuscitation enhanced the hemodynamics, improved the acid–base balance, and alleviated intestinal ischemia reperfusion injury from hemorrhagic shock and resuscitation in rats. The mechanisms might include correction of acidosis, inhibition of inflammatory response, enhancement of systemic immune status, regulation of intestinal epithelial permeability, and maintenance of intestinal mucosal barrier function. Impact statement Hemorrhagic shock is a life-threatening condition after trauma or during surgery. Acid–base imbalance and intestinal ischemia reperfusion injury are two significant causes in the pathogenetic process and multiple organ dysfunction. As a result, it is urgent and necessary to find an effective method of resuscitation in order to reverse the acid–base imbalance and protect organ function. This current study confirmed the protection against hypoxic acidosis and intestinal ischemia reperfusion injury by peritoneal resuscitation with pyruvate combined with intravenous resuscitation in rats with hemorrhagic shock. And the peritoneal dialysis solution with pyruvate of high concentration plays a crucial role in the process. It provided a new idea and possible direction of fluid resuscitation for alleviating organ injuries, protecting organ functions, and improving clinical prognosis after hemorrhagic shock and resuscitation.

show abstract

“…Therefore, effective resuscitation strategies have become the key in the efforts to reduce mortality and to improve outcomes based on timely surgical hemostasis. 2…”

Section: Introductionmentioning

confidence: 99%

Effect of peritoneal dialysis solution with different pyruvate concentrations on intestinal injury

Zhang

Shen

Deng

et al. 2020

Exp Biol Med (Maywood)

View full text Add to dashboard Cite

show abstract

“…Durante los últimos años se ha investigado respecto al tratamiento más adecuado que se puede ofrecer a los pacientes con shock hemorrágico debido a trauma con el propósito de disminuir la mortalidad por este tipo de lesiones. Históricamente se ha reanimado a los pacientes con grandes cantidades de líquidos, pero se ha observado que, a pesar de los esfuerzos realizados, hay un riesgo de muerte considerablemente alto y las complicaciones han sido evidentes (5).…”

Section: Introductionunclassified

Hipotensión Permisiva en Trauma

Berrío

́ánchez

Ramírez

et al. 2021

Rev. Médica Risaralda

View full text Add to dashboard Cite

Introducción: El shock hemorrágico es una de las causas más comunes de muerte en pacientes con trauma debido a que pone en marcha un círculo vicioso de mecanismos que incluyen hipotermia, acidosis y coagulopatía. Para mitigar estos efectos, se han propuesto estrategias de control de daños, incluido el aporte controlado de líquidos con hipotensión permisiva contemplando metas en la presión arterial sistólica para mantener una adecuada perfusión de los tejidos. Objetivo: Conocer información actualizada acerca del manejo de la hipotensión permisiva en pacientes con trauma. Metodología: Se buscó información en las bases de datos Web-of-Science y Scopus de los últimos cinco años. El resultado arrojó un total de 118 artículos de los cuales se tomaron 30, según los criterios de inclusión y exclusión. Resultados: Todos los artículos consideran el uso de la hipotensión permisiva como una buena opción para el manejo de los pacientes con trauma e hipotensión, sin embargo, difieren en qué momento es adecuado utilizarlo y en qué condiciones se debe realizar. Conclusiones: Si bien la hipotensión permisiva se ha convertido en uno de los pilares fundamentales en el manejo prehospitalario del paciente con trauma, se requieren estudios investigativos en humanos para soportar cuándo y cómo debe utilizarse.

show abstract

“…The products of decay of tissues, specific and nonspecific toxins are a trigger mechanism for burn infections, and, subsequently, the development of septicotoxemia [8,9]. Therefore, from the theoretical and practical point of view, it is important to conduct studies to study the changes of the testis germinal epithelium, the course of compensatory adjustment and regenerative processes in them at the closure of the burn wound after the early necrectomy of the affected skin sections with crushed cryo-lyophilized xenograft skin substrate [2,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…Submicroscopic state of the spermatogenic cells of the testicle of the animal for 7 days after a thermal trauma. Primary spermatocyte (1), spermatids(2). х13000.…”

mentioning

confidence: 99%

Electron microscopic changes of the testis germinal epithelium after an experimental thermal trauma in the application of cryo-lyophilized xenograft skin substrate

Волков

Muha

2018

Rep. of Morph.

View full text Add to dashboard Cite

Deep, large area of thermal trauma of the skin leads to significant morphofunctional changes in organs in the composition of the burned organism. However, condition of the central organ of the male reproductive system - testicle after burns and, especially, in the treatment of thermally damaged areas of the skin remain poorly understood. The purpose of this study was to establish an ultrastructural re-organization of testis germinal epithelium cells in the stages of toxemia and septicotoxemia following an experimental thermal trauma when using xenograft skin substrate. The studies were carried out on 35 sexually mature white male rats, which were divided into three groups: 1 - intact animals (5 rats), 2 - animals with burn injury (15 rats), 3 - animals with burn injury, for which were used xenograft skin substrate (15 rats). The burn was applied under ketamine anesthesia with copper plates, heated in boiling water, on 1820% shaved body surface of animals. Early necrectomy of the damaged areas of skin was carried out 1 day after the thermal burn. The formed wounds were covered with cryo-lyophilized xenograft skin substrate. Experimental animals were decapitated at 7, 14 and 21 days of the experiment (early, late toxemia and septicotoxemia). The material sampling for electron microscopy was carried out in accordance with a generally accepted methodology. It is established that in the stage of early toxemia (7 days of experiment) there are adaptive-compensatory changes and signs of destruction of spermatogenic cells of testis. In the stages of late toxemia and septicotoxemia (14 and 21 days of the trial), significant destructive changes occur in all components of the seminiferous tubules of the organ. Electron microscopically found that the closure of the burn wound after the early necrectomy of cryo-lyophilized xenograft skin substrate in severe experimental burn injury in the early stages of the experiment significantly reduces the damage of testis germinal epithelium of experimental animals and activates regenerative processes. This contributes to a significant improvement in the ultrastructure of the components of the convoluted tubules of the organ in the late stages of the experiment.

show abstract

Resuscitative Strategies in the Trauma Patient: The Past, the Present, and the Future

Cited by 11 publications

References 38 publications

Effect of peritoneal dialysis solution with different pyruvate concentrations on intestinal injury

Effect of peritoneal dialysis solution with different pyruvate concentrations on intestinal injury

Hipotensión Permisiva en Trauma

Electron microscopic changes of the testis germinal epithelium after an experimental thermal trauma in the application of cryo-lyophilized xenograft skin substrate

Contact Info

Product

Resources

About