Traumatic brain injury: patterns of failure of nonoperative management.

Objective: The circumstances of failure for nonoperative management of blunt traumatic brain injury have been poorly defined. In this study, all trauma patients identified over a 12-year period with progression of neurologic injury requiring craniotomy were retrospectively reviewed.

Methods: Data collected included demographic information, mechanism of injury, field and admission vital signs, and Glasgow Coma Scale score, medications, associated injuries, and coagulopathy.

Serum lactate is not predicted by anion gap or base excess after trauma resuscitation.

Objective: The inability to normalize lactate predicts death after trauma, but lactate may not be immediately available in every center. We postulated that, in a normal acid-base environment, lactate would correlate with the anion gap and the base excess of an arterial blood gas.

Methods: We studied 52 consecutive, invasively monitored patients with trauma admitted directly to the intensive care unit (ICU) from the emergency department or operating room in our level I center to determine whether base excess and anion gap could predict lactate.

Pulmonary fibroblast function in an acute lung injury model.

The role of pulmonary fibroblasts (PFBs) in early adult respiratory distress syndrome is poorly understood. To investigate PFB cellular function in acute lung injury, New Zealand rabbits (2 to 3 kg) were given either three daily doses of phorbol myristate acetate (PMA; 65 micrograms/kg, IV), a potent stimulator of oxygen radical formation, or saline (control). On day 4, the lungs were harvested, subjected to enzymatic digestion, and PFBs isolated via serial subculture.

Effects of a platelet-activating factor antagonist, CV-3988, on different shock models in the rat.

Research in recent years has implicated many vasoactive mediators in causing or maintaining the shock process. One of the newer mediators to be considered is platelet-activating factor (PAF). The present group of experiments examined the effects of a PAF antagonist, CV-3988, on PAF, endotoxin, and hemorrhagic hypotension in rats.