Abstract：
INTRODUCTION:Our swine model of pulmonary contusion (PC) and hemorrhagic shock (HS) was initially complicated by renal failure, hyperkalemia, and premature death. To study the effects of novel therapies on organ failure, improved survival was necessary requiring the design of an aggressive treatment regimen. METHODS:Anesthetized swine sustained either PC or PC with grade V liver injury to induce HS (PC + HS). After injury, animals were resuscitated followed by either standard care (SC) with maintenance intravenous fluids (IVF) and treatment at potassium level of 6.0 mmol/L (n = 7; 3 PC, 4 PC + HS) or aggressive care (AC) with increased initial IVF, early and frequent potassium monitoring, and treatment at potassium level of 5.0 mmol/L (n = 15, 8 PC, 7 PC + HS). Hyperkalemia was treated with calcium, insulin, and glucose in both groups. RESULTS:Survival to 48 h was achieved in 13/15 (87%) in the AC group and 2/7 (29%) in the SC group (p = 0.014). Compared to SC, AC improved median survival (48 vs. 18 h, p = 0.008) and lowered potassium (5.0 vs. 7.5 mmol/L), creatinine (2.4 vs. 4.0 mg/dL), BUN (27.5 vs. 39.0 mg/dL), and lactate (0.97 vs. 3.57 mmol/L) at the last observed time-point prior to death. For PC + HS animals, survival to 48 h was achieved in 6/7 in the AC group and 0/4 in the SC group with an improved median survival in the AC group (48 vs. 18 h, p = 0.011) DISCUSSION: Aggressive and early hyperkalemia treatment prolongs survival while reducing kidney injury and potassium levels in a combat relevant injury model in swine.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Smith S,Behrens B,McCully B,Murphy J,Bommiasamy A,Goodman A,Dewey E,Pati S,Schreiber Mdoi
10.1016/j.amjsurg.2020.02.058subject
Has Abstractpub_date
2020-05-01 00:00:00pages
860-864issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30141-0journal_volume
219pub_type
杂志文章abstract：BACKGROUND:Medical students often experience difficulty comprehending anatomic relationships of complex operations to which they are exposed during surgical clerkship. Pancreaticoduodenectomy, the Whipple procedure, is one such operation. Although video recordings are available to facilitate the learning of the Whipple...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(98)00201-3
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Perihilar cholangiocarcinoma is usually unresectable at the time of diagnosis. Only few patients are candidates for a potential curative treatment. For those patients, prognosis is strongly related to negative resection margin and lymph node status. Thus, a certain benchmark of lymph node count is necessary ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2015.05.015
更新日期：2015-10-01 00:00:00
abstract：:Thrombosis and its major sequela, embolism, continue to contribute significantly to morbidity and mortality, both as primary disorders and as complications of other systemic systems. The understanding of the etiology of thromboembolism and the role of platelets, endothelium, and the plasma proteins in the development ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80743-3
更新日期：1990-12-01 00:00:00
abstract：:This laboratory study compared the biomechanical and biochemical healing of microvascular free skin flaps in irradiated and nonirradiated recipient areas. In the adult rat, the skin of the right groin region was exposed to a single fraction dose of 20 Gy, using a linear megavoltage accelerator. The left groin was shie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80730-5
更新日期：1992-12-01 00:00:00
abstract：BACKGROUND:Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility. METHODS:Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectiv...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.017
更新日期：2013-12-01 00:00:00
abstract：:This study is a retrospective review of 18 patients treated from 1964 to 1990 with inguinal lymph node metastases from rectal adenocarcinoma. Statistical analyses were performed to determine the effects of sex, disease-free interval, extent of inguinal lymph node metastases, and the presence of extranodal disease upon...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80204-1
更新日期：1994-09-01 00:00:00
abstract：BACKGROUND:Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS:The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The pre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.11.018
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND:Multivisceral resection is often required in the treatment of locally advanced rectal cancers. Such resections are relatively rare and oncologic outcomes, especially when sphincter preservation is performed, are not fully demonstrated. METHODS:A retrospective review was conducted of patients who underwent m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.10.014
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Mobile atheromas of the aortic arch are associated with otherwise unexplained strokes and transient ischemic attacks (TIA). They are associated with increased perioperative strokes in patients undergoing coronary artery bypass surgery. Peripheral embolization is an additional risk. Transesophageal echocardio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00115-4
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2004.08.066
更新日期：2005-04-01 00:00:00
abstract：:Angioaccess procedures at one institution over a 4-year period were retrospectively reviewed to ascertain the frequency of major limb- or life-threatening complications. A total of 435 angioaccess procedures were performed, including 81 Cimino-Brescia fistulas, 166 polytetrafluoroethylene grafts, and 111 thrombectomy/...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81076-1
更新日期：1992-09-01 00:00:00
abstract：:This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90191-7
更新日期：1987-08-01 00:00:00
abstract：:Inadequate attention has been paid to optimal closure of the postmastectomy incision in patients not desirous of breast reconstruction. Herein, we describe the use of a basic plastic surgical technique at the time of mastectomy to eliminate the dog-ear deformity at the axillary end of the incision. The technique is co...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80197-1
更新日期：1988-11-01 00:00:00
abstract：BACKGROUND:Surgical quality improvement (QI) is a global priority. We report the design and proof-of concept testing of a QI skills curriculum for urology residents. METHODS:'Umbrella review' of QI curricula (Phase-1); development of draft QI curriculum (Phase-2); curriculum review by Steering Committee of urologists ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2018.11.008
更新日期：2019-02-01 00:00:00
abstract：:This commentary identifies important differences in patient groups that affect the observations in the accompanying article. ...
journal_title：American journal of surgery
pub_type： 评论,杂志文章
doi：10.1016/j.amjsurg.2007.11.014
更新日期：2008-07-01 00:00:00
abstract：:Massive venous thromboses of the extremities, although uncommon, are responsible for many of the long-term sequelae associated with venous disease. The charts of all patients with a diagnosis of iliofemoral venous thrombosis or subclavian vein thrombosis over a 6-year period were reviewed. There were 59 patients with ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90361-9
更新日期：1989-08-01 00:00:00
abstract：BACKGROUND:The upper thigh is an alternative but infrequently used site to the forearm for placement of subcutaneous polytetrafluoroethylene (PTFE) arteriovenous conduits in patients requiring hemodialysis for end stage renal failure. This site has the great advantage of easier accessibility for self-cannulation. METH...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00405-9
更新日期：1997-04-01 00:00:00
abstract：:Mean fasting preoperative pancreatic polypeptide levels in a group of 18 patients with duodenal ulcer disease were 462 +/- 88 pg/ml, with 13 patients having markedly elevated levels (mean 600 +/- 106 pg/ml) and 5 patients having normal or minimally elevated levels (mean 112 +/- 32 pg/ml). Mean fasting postoperative pa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90040-1
更新日期：1986-06-01 00:00:00
abstract：BACKGROUND:Several nationwide reports show lower female participation in colon cancer screening. We therefore assessed for outcome differences in women of screening age presenting for surgical treatment of colon cancer patients. METHODS:All patients over 50 years undergoing surgery for first-onset colon cancer at Mass...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.09.033
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:We hypothesize that medical centers that prioritize altruism can also deliver superior quality care. METHODS:Data were obtained from California's Office of Statewide Health Planning and Development, Medicare Hospital Compare, and the Joint Commission US Census Bureau's American Community Survey. Outcomes we...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2014.10.016
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:The prognostic significance of the platelet (PLR) and neutrophil (NLR) to lymphocyte ratios for patients with resectable colorectal cancer liver metastases (CLM) was evaluated. METHODS:Clinicopathologic data from patients who underwent hepatectomy for CLM at two tertiary care hospitals between 1995 and 2017...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2020.05.003
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：:Fifty-three patients with upper gastrointestinal bleeding and proven esophageal varices were treated by intravascular injection sclerotherapy of the varices using a mixture of ethanolamine oleate, bovine thrombin and cephalothin. An intraesophageal balloon was used to impede craniad flow during the injection. Except i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90191-x
更新日期：1982-04-01 00:00:00
abstract：:Twenty-five patients with ulcerative colitis were treated between 1959 and 1986 at the Mount Sinai Hospital, with severe gastrointestinal hemorrhage as their major complaint. Twenty-two patients required operation, while three patients were treated medically. Total proctocolectomy with ileostomy was carried out in 5 p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(06)80064-4
更新日期：1990-06-01 00:00:00
abstract：BACKGROUND:Antibiotic prophylaxis during placement of implanted central venous access ports (CVAP) has not been studied. This retrospective review compared the rate of catheter-related infections (CRIs) with and without perioperative antibiotics. METHODS:This was a single-center study that compared patients treated wi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.023
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to investigate the relationship between perforated appendicitis and patient with diabetes using a population-based data set. METHODS:This study used data from the Longitudinal Health Insurance Database 2005 in Taiwan. We identified 4,806 patients hospitalized with acute appendi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.08.041
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. METHODS:A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. RESULTS:19 (14%) of 136 anal cancer patients wer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.08.011
更新日期：2020-01-01 00:00:00
abstract：:From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80438-6
更新日期：1993-05-01 00:00:00
abstract：:Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90089-8
更新日期：1979-06-01 00:00:00
abstract：:Recently, the role and timing of surgery for treating secondary and tertiary hyperparathyroidism (HPT) have been questioned. In order to delineate the indications for surgery in these patients, a retrospective analysis of 53 consecutive patients treated with parathyroidectomy was conducted. Subtotal thyroidectomy was ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80537-9
更新日期：1990-10-01 00:00:00
