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Identifying predictors of nosocomial pneumonia in trauma patients admitted to a level-1 trauma center.
Arch Orthop Trauma Surg
December 2024
Department of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Background: Nosocomial pneumonia is common in trauma patients and associated with an adverse prognosis. We recently externally validated and recalibrated an existing formula to predict nosocomial pneumonia risk. Identifying more potential predictors could aid in a more accurate prediction of nosocomial pneumonia risk in level-1 trauma patients.
View Article and Find Full Text PDFBeyond the Barriers of Ex Vivo Lung Perfusion Through an Emblematic Case: A New Way Forward to Expand the Donor Pool.
J Clin Med
December 2024
Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy.
Lung transplantation is the most effective treatment for end-stage respiratory diseases, but its application is limited by the shortage of organs. Ex vivo lung perfusion (EVLP) has emerged as a promising technique to evaluate and recondition donor lungs previously deemed unsuitable for transplantation. However, limitations such as lung contusions, air leaks, and perfusate extravasation, especially in portable EVLP systems, hinder the procedure.
View Article and Find Full Text PDF[Delayed Cardiac Tamponade After Blunt Chest Trauma].
Kyobu Geka
October 2024
Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Delayed cardiac tamponade following blunt chest trauma is a rare incident, and we provide a report including a literature review for further discussion. The patient is a 56-year-old male. He fell off a motorcycle and sustained contusions to the left side of his chest.
View Article and Find Full Text PDFModulation of the hepatic RANK-RANKL-OPG axis by combined C5 and CD14 inhibition in a long-term polytrauma model.
Front Immunol
December 2024
Institute of Clinical and Experimental Trauma Immunology, Ulm University Medical Center, Ulm, Germany.
Background: Polytrauma and hemorrhagic shock can lead to direct and indirect liver damage involving intricate pathophysiologic mechanisms. While hepatic function has been frequently highlighted, there is minimal research on how the receptor activator of the NF-κB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) system is regulated in the liver following trauma. Furthermore, cross-talking complement and toll-like-receptor (TLR) systems can contribute to the posttraumatic response.
View Article and Find Full Text PDFLung contusion complicated by pneumonia worsens lung injury via the inflammatory effect of alveolar small extracellular vesicles on macrophages and epithelial cells.
J Trauma Acute Care Surg
January 2025
From the Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery (K.N., W.C., W.J., K.P., D.P., J.W., B.E., T.C.), UC San Diego School of Medicine, San Diego; Comparative Effectiveness and Clinical Outcomes Research Center (R.C.), Riverside University Health System, Loma Linda University School of Medicine, Riverside, California; and Trauma and Acute Critical Care Center (K.N.), Tokyo Medical and Dental University Hospital, Bunkyo-ku, Tokyo, Japan.
Background: Lung contusion (LC) complicated by pneumonia is associated with a higher risk of acute lung injury (ALI) mediated by activation of immune cells and injury to the lung epithelium. Small extracellular vesicles (sEVs) are essential mediators of cellular crosstalk; however, their role in the development of postinjury ALI remains unclear. We hypothesized that LC complicated by pneumonia increases the pro-inflammatory effect of alveolar sEVs on macrophages and the cytotoxicity of alveolar sEVs to pulmonary epithelial cells, worsening the severity of ALI.
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