TITLE

Splanchnic Hypoperfusion-Directed Therapies in Trauma: A Prospective, Randomized Trial

PUB. DATE
March 2005
SOURCE
American Surgeon;Mar2005, Vol. 71 Issue 3, p252
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Splanchnic hypoperfusion as reflected by gastric intramucosal aeidosis has been recognized as an important determinant of outcome in shock. A comprehensive splanchnic hypoperfusion-ischemia reperfusion (IRP) protocol was evaluated against conventional shock management protocols in critical trauma patients. The study was a prospective randomized trial comparing three therapeutic approaches to hypoperfusion after severe trauma in 151 trauma patients admitted to the intensive care unit. Group 1 patients received hemodynamic support based on conventional indicators of hypoperfusion. In group 2, resuscitation was further guided by gastric tonometry-derived estimates of splanchnic hypoperfusion and included more invasive hemodynamic monitoring and additional administration of colloid or crystalloid solutions, or inotropic support. Group 3 patients additionally received therapies specifically aimed at optimizing splanchnic perfusion and minimizing oxidant-mediated damage from reperfusion. The three groups were similar based on age, Injury Severity Score, and Acute Physiology and Chronic Health Evaluation II Scores. There were no statistically significant differences in mortality rates, organ dysfunction, ventilator days, or length of stay between any of the interventions. Techniques of optimization of splanchnic perfusion and minimization of oxidant-mediated reperfusion injury evaluated in this study were not advantageous relative to standard resuscitation measures guided by conventional or lonometric measures of hypoperfusion in the therapy of occult and clinical shock in trauma patients.
ACCESSION #
16671097

 

Related Articles

  • Erratum to: The IMPACT prognosis calculator used in patients with severe traumatic brain injury treated with an ICP-targeted therapy. Olivecrona, Magnus; Koskinen, Lars-Owe // Acta Neurochirurgica;Sep2012, Vol. 154 Issue 9, p1739 

    Corrections to the article "The IMPACT prognosis calculator used in patients with severe traumatic brain injury treated with an ICP-targeted therapy," by Magnus Olivecrona and colleague that was published online on August 12, 2012 is presented regarding cerebral perfusion pressure (CPP).

  • The coagulopathy of trauma. Maegele, M. // European Journal of Trauma & Emergency Surgery;Apr2014, Vol. 40 Issue 2, p113 

    Trauma is a leading cause of death, with uncontrolled hemorrhage and exsanguination being the primary causes of preventable deaths during the first 24 h following trauma. Death usually occurs quickly, typically within the first 6 h after injury. One out of four patients arriving at the Emergency...

  • Reduced pulmonary inflammatory response during cardiopulmonary bypass: effects of combined pulmonary perfusion and carbon monoxide inhalation Goebel, Ulrich; Siepe, Matthias; Mecklenburg, Anne; Doenst, Torsten; Beyersdorf, Friedhelm; Loop, Torsten; Schlensak, Christian // European Journal of Cardio-Thoracic Surgery;Dec2008, Vol. 34 Issue 6, p1165 

    Abstract: Objective: Pulmonary inflammation induced by cardiopulmonary bypass (CPB) is one of the main causes for lung injury after cardiac surgery. Pulmonary perfusions as well as carbon monoxide (CO) inhalation are known to reduce the inflammatory reaction of the lung. We hypothesized that a...

  • Effect of Defocused CO2 Laser on Equine Tissue Perfusion. Bergh, A.; Nyman, G.; Lundeberg, T.; Drevemo, S. // Acta Veterinaria Scandinavica;2006, Vol. 47, p33 

    Treatment with defocused CO2 laser can have a therapeutic effect on equine injuries, but the mechanisms involved are unclear. A recent study has shown that laser causes an increase in equine superficial tissue temperature, which may result in an increase in blood perfusion and a stimulating...

  • Appropriate use of topical haemoglobin in chronic wound management: consensus recommendations. CHADWICK, PAUL; MCCARDLE, JOANNE; MOHAMUD, LUXMI; TICKLE, JOY; VOWDEN, KATH; VOWDEN, PETER // Wounds UK;2015 Special Issue, p30 

    Oxygen has a crucial role in wound healing; 97% of chronic, non-healing wounds have been shown to have low oxygen levels (Hauser, 1987). Topical oxygen therapy has been shown to be effective in treating non-healing wounds, but is still underutilised. A working group of key opinion leaders met in...

  • Comparison of Pre- and Post-treatment Pain Scores of Twenty One Horses with Laminitis Treated with Acupoint and Topical Low Level Impulse Laser Therapy. Petermann, Uwe // American Journal of Traditional Chinese Veterinary Medicine;Feb2011, Vol. 6 Issue 1, p13 

    Low-level impulse lasers have been applied focally to stimulate acupoints (laser acupuncture) and topically over wounds, joints and other tissues to increase circulation and promote healing. Laser acupuncture has been used to treat neck and back pain, tendonitis, osteoarthritis, injuries,...

  • RESEARCH ALERT. Hobday, Erin // Men's Health;Oct2005, Vol. 20 Issue 8, p44 

    Presents updates on several research regarding health as of October 2005. Information on the Band-Aid-size sensor developed by British researchers for heart-attack patients; Possibility of a treatment for injured spinal-cord tissue; Correlation of smoking with sperm production in men;...

  • Trauma-Induced Coagulopathy. KATRANCHA, ELIZABETH D.; GONZALEZ III, LUIS S. // Critical Care Nurse;Aug2014, Vol. 34 Issue 4, p54 

    Coagulopathy is the inability of blood to coagulate normally; in trauma patients, it is a multifactorial and complex process. Seriously injured trauma patients experience coagulopathies during the acute injury phase. Risk factors for trauma-induced coagulopathy include hypothermia, metabolic...

  • Effects of intravascular perfusion of cooled crystalloid solution on cold-induced brain injury using an extracorporeal cooling-filtration system. Furuse, M.; Ohta, T.; Ikenaga, T.; Liang, Y. M.; Isono, N.; Kuroiwa, T.; Preul, M. C. // Acta Neurochirurgica;Nov2003, Vol. 145 Issue 11, p983 

    Summary ¶Background. We evaluated cerebral metabolic change during brain hypothermia with intravascular perfusion of cooled crystalloid solution using an extracorporeal cooling-filtration system and cerebroprotective effects of this hypothermia on brain injury in an animal model. Method....

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics