scholarly journals Morphological changes in lung tissue in case of blunt abdominal trauma, massive blood loss, and ischemia-reperfusion of the limb

2020 ◽  
Vol 10 (8) ◽  
pp. 589
Author(s):  
O. V. Fedoseeva
Keyword(s):  
Blood Loss ◽  
Lung Tissue ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Morphological Changes ◽  
Ischemia Reperfusion ◽  
Massive Blood Loss

scholarly journals Study of morphological changes in the kidney during modeling of ischemic-reperfusion injuries of the limb and massive blood loss

2020 ◽  
pp. 5-10
Author(s):  
N. V. Volotovska
Keyword(s):  
Blood Loss ◽  
Blood Vessels ◽  
Structural Changes ◽  
Morphological Changes ◽  
Ischemia Reperfusion ◽  
Combat Trauma ◽  
Acute Ischemia ◽  
Massive Blood Loss ◽  
Ischemic Reperfusion ◽  
White Rats

The article presents the features of morphological disorders of liver tissue on the background of limb ischemia-reperfusion and massive blood loss. The aim of the work was to establish the presence of structural changes and the severity of morphological disorders of internal organs, remote from the primary place of ischemia-reperfusion during modeling the pathological process. The experiment was performed on 33 adult nonlinear white rats weighing 200-250 g, which were on the standard vivarium diet. Experimental animals were simulated with ischemic-reperfusion syndrome of the lower extremity and massive blood loss. Collection of materials was performed 1 h after intervention or release from the tourniquet and on the 1st, 3rd, 7th and 14th days. All interventions were performed under thiopental-sodium anesthesia (40 mg/kg body weight). Mostly structural violations were expressed as disturbance of blood supply of little and middle caliber blood vessels and also in initial dystrophic changes. During comparison of groups, depending on the severity, it was shown that both the isolated use of a tourniquet and massive blood loss had long-term, systemic consequences, however, more expressed in EG-2; single vascular glomeruli were shrunked, endothelial cells of arterioles were slightly damaged. On the 7th and 14th days changes in the structure of EG-1 were mostly absent, although in EG-2 the epitheliocytes of the outer layer of the capsule remained flattened, retained full blood vessels of the venous bed in the interstitium, and the vast majority of epitheliocytes of the excretory tubules were at different stages of hydropic dystrophy with partly desquamation of the epithelium in the gaps of the tubules. Also, the basal membranes of the tubules were not completely visualized, which indicates deep damage in the structures caused by acute ischemia as a result of bleeding. Thus, as combat trauma (blood loss) is in itself a life-threatening factor, the use of a tourniquet due to the development of ischemic-reperfusion process can complicate the course of the primary affection. Knowledge of the periodization of traumatic disease on the background of this pathology is important for the development of sanogenic effects in order to minimize this pathogenic factor.

scholarly journals Therapeutic effect of thiocetam on the manifestations of ischemia-reperfusion complicated by massive blood loss and mechanical trauma

2020 ◽  
Vol 10 (12) ◽  
pp. 382-393
Author(s):  
Nataliya Volotovska
Keyword(s):  
Blood Loss ◽  
Ischemia Reperfusion ◽  
White Male ◽  
Early Period ◽  
Male Rats ◽  
Antioxidant Defenses ◽  
Mechanical Trauma ◽  
Massive Blood Loss ◽  
Post Traumatic ◽  
Positive Effect

Among the current medical and social problems, injuries and blood loss occupy a prominent place, causing stress on the antioxidant defenses. Hypoxia, which underlies the pathogenesis of the post-traumatic period of both diseases, leads to a significant imbalance in the work of internal organs. Scientists are increasingly attracted by the need to use a tourniquet or intraoperative ligatures, as reperfusion local and systemic damage develops. Antioxidants are considered a promising means of correction.The aim of the study was to investigate the features of metabolic disorders in the liver in the early post-traumatic period on the background of the use of a tourniquet and the effectiveness of thiocetam correction.Materials and methods. The experiment was perfomed on 130 white male rats (200-250 g), which were divided into 4 groups: control – the CG, the EG-1 – combination of limb ischemia-reperfusion (IR) with blood loss, the EG-2 – combination of limb IR with blood loss and mechanical trauma of the thigh; the EG-3 combination of limb IR, blood loss, mechanical injury and thiocetam administration. The Malonic dialdehide level catalase activity were estimated in the liver.Results. The use of thiocetam, which is able to struggle against of ischemia and lipid peroxidation by reactivating antiradical enzymes: superoxide dismutase, catalase and glutathione peroxidase, had a positive effect on the state of antioxidant and prooxidant units in the organ, located far from the place of primary ischemia-reperfusion. If in the group of untrated animals (the EG-2, where massive blood loss was combined with a thigh fracture and the use of hemostatic tourniquet) in the early period, the MDA level exceeded the CG data in 5,4 times, and on the 7th and 14th days remained high – being higher on 2,1 times and on 2,7 times, then in the EG-3 (group of treated animals) on the 1st day the level of MDA exceeded the CG data in 4,3 times, but on the 7th and 14th days was higher by 90,5 % and 64 % respectively. The supportive effect of thiocetam on the activity of catalase in the liver was also noted. Thus, in EG-2 the level of antioxidant enzyme on the 1st day decreased by 71,7 %, and remained almost at this level throughout the all post-experimental period. As for the group of treated animals, the level of activity on the 1st day after the intervention decreased by 44,7%, and was so for almost the entire period. On the 14th day, it remained reduced compared to the CG by 35,1 %, while in EG-2 this index was lower compared to the CG by 70,5 %.Conclusion. Having the positive effect of the introduction of thiocetam in the ischemic area, we can eventually add new complex, given the world experience, which would affect the development of the inflammatory response and the rheological properties of blood.

Myth And Facts About The Evolving Role of Laparoscopic Splenectomy In Isolated High Grades Splenic Injuries In Hemodynamically Stable Patients With Blunt Abdominal Trauma. Randomized Controlled Trial.

2021 ◽  
Author(s):  
Tamer.A. A.M. Habeeb ◽  
Gamal Osman ◽  
Amr Ibrahim ◽  
Mohamed Riad ◽  
Abd-Elrahman M. Metwalli ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Laparoscopic Splenectomy ◽  
Splenic Injury ◽  
Laparoscopic Group ◽  
Open Group ◽  
High Grade ◽  
Significant Difference

Abstract Background: Spleen is the most common intra-abdominal organ injury in blunt abdominal trauma. Splenectomy (open or laparoscopic) is the role in treatment of severe injuries of spleen or after failure of conservative treatment.Aim of the work: Compare the outcomes between open versus laparoscopic in high grade splenic injuries.Methods: This study includes 70 patients with various grades of splenic injuries in abdominal trauma. The patients were 15 years and older. They were categorized into two groups: open splenectomy group (35 patients) and laparoscopic splenectomy group (35 patients). The study was performed from January, 2012 to July 2017. Variables included demographics data, splenic injury graded by computerized tomography, duration of operation (in minutes), intra-operative blood loss (in ml), and intraoperative blood transfusion, length of hospital stay (in days), complications and mortality.Results: There was no significant difference or association between groups as regard age, sex and causes of splenic injury (p=0.374, 0.41, 0.38).Most cases were under 35 years old male patients exposed to motor car accidents. As regard intraoperative data, no statistically significant difference between both groups except for blood loss and transfusion that were statistically significant to the open group (p=0.039*).In the laparoscopic group, operational time was longer than open but no statistically significant (p=0.11).as regard conversion, we found that 14% of laparoscopic group (5 cases) had conversion. Most cases operated by laparoscopic approach were in grade III, IV with no cases tried in grade V (p=0.06). No statistically significant difference between both groups as regard postoperative variables except Pain (p=0.0003), and hospital stay(p=0.00) that were significantly longer among open group.The immediate postoperative complications showed that Wound infection, Missed injuries, pancreatic fistula and ileus were significantly higher among open group (p=0.00, 0.006, 0.02, 0.0004).The delayed postoperative complications where Incisional hernia (p=0.001) and Adhesive intestinal obstruction (p=0.00) were significantly associated with open group.Conclusion: In high-grade splenic injuries patients, this study found that laparoscopic splenectomy is safe.

scholarly journals Peculiarities of cytolytic syndrome development with associated injury of the abdominal organs and massive blood loss in the experiment

2021 ◽  
Vol 11 (5) ◽  
pp. 229-236
Author(s):  
I. V. Kuzminskyi ◽  
V. K. Grodetskyi ◽  
H. Yu. Thymbalyuk
Keyword(s):  
Blood Loss ◽  
Research Group ◽  
Considerable Increase ◽  
Ischemia Reperfusion ◽  
Massive Bleeding ◽  
Abdominal Injury ◽  
Research Groups ◽  
Massive Blood Loss ◽  
Abdominal Organs ◽  
Thiopental Sodium

The function of the organs responsible for detoxification processes, in particular the liver, deserves a special role in the conditions of combined trauma. It is proved that ischemia-reperfusion of the limb caused by the imposition of a tourniquet, is the cause of significant toxemia. Under such conditions, it becomes clear that the detoxification function may be impaired, especially against the background of blunt combined trauma to the abdominal organs complicated by massive bleeding. Changes in the detoxification function of the liver are indicated by markers of the cytolytic syndrome. However, there is no clear understanding of how ischemia - limb reperfusion affects the development of cytolytic syndrome.Objective of research: to study the effect of massive blood loss associated with ischemia-reperfusion of the limb on the cytolytic syndrome indicators in case of injury of the abdominal organs.  Materials and methods. 100 mature albino male Wistar rats with the body weight of 190-220 grams kept on standard vivarium forage were used in the experiment. The animals were divided into the control and 3 research groups (containing 10 animals each). Arresting bleeding tourniquet was applied proximally on the lower limbs of rats from the first research group for 120 minutes under thiopental-sodium anesthesia (40 mg/kg-1), which caused development of ischemic-reperfusion.  Closed abdominal injury was simulated by means of delivering two dosed blows in the region of the abdominal cavity in the second research group; massive blood loss was simulated by means of cutting the femoral vessels and bloodletting from 25 to 30 % of the circulating blood volume in the group. Injuries from the first two groups were combined in the third group. The control group of animals received anesthesia without formation of any injuries. With the aim to determine alterations of cytolytic syndrome the activity of enzymes – markers of cytolytic syndrome ALT and AST were determined by means of a unified method.  The animals of the research groups were removed from the experiment under thiopental-sodium anesthesia by means of the total bloodletting from the heart.Results. Analysis of the results of the study found that cytolytic syndrome develops irrespective of the kind of injuries simulated. Thus, even during a day of post-traumatic period ALT and AST activity increases which is clearly registered in all the three research groups. Further destruction of cellular membranes increases till the 3rd day, which is manifested by a considerable increase of ALT and AST activity in the blood serum. This process continues till the 7th day. A tendency to ALT and AST decrease is observed only in the 1st group on the 7th day. Comparison of the 2nd and 3rd research groups within the time interval enables to understand that application of tourniquets on the limbs of animals with closed abdominal injury and massive bleeding deteriorates cytolytic processes.Conclusions: Simulated injuries in the research groups were associated with the occurrence of cytolytic processes possessing a tendency to develop in the period of early signs of traumatic disease.  Ischemic-reperfusion syndrome of the limbs accelerates considerably the development of systemic changes with abdominal injuries and hypovolemic shock, which was manifested by a considerable increase of ALT and AST parameters in the group with abdominal trauma and massive blood loss and becoming higher than that of the control in end of the experiment.

scholarly journals The role of laparoscopy in optimization of blunt abdominal trauma treatment in children and adolescents

2020 ◽  
pp. 52-54
Author(s):  
A. N. Shapkina ◽  
M. V. Kozlova
Keyword(s):  
Children And Adolescents ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Fatal Outcome ◽  
Trauma Treatment ◽  
Internal Organs ◽  
Study Objective ◽  
Massive Blood Loss ◽  
Results Of Treatment

Objective. The study objective is to analyze the results of blunt abdominal trauma treatment in children and adolescents with an emphasis on the possibilities of minimally invasive surgery.Methods: The results of treatment of 129 patients aged from 3 to 17 with injured internal organs due to blunt abdominal trauma were retrospectively analyzed.Results: Medical therapy was effective in 74.6% of cases. Surgery was limited to a laparoscopy access in 13 cases (10.7%), open surgery was required to 18 patients (14.7%). One fatal outcome associated with the massive blood loss was registered.Conclusions: The algorithm of treatment of blunt abdominal traumas, used over the last years and including laparoscopy in hemodynamically stable patients, allowed avoiding laparotomy in 85.3% of cases. 

scholarly journals Methylene Blue Attenuates Lung Injury Induced by Hindlimb Ischemia Reperfusion in Rats

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Liangrong Wang ◽  
Baihui Chen ◽  
Bi Lin ◽  
Yuzhu Ye ◽  
Caiying Bao ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Lung Injury ◽  
Lung Tissue ◽  
Morphological Changes ◽  
Ischemia Reperfusion ◽  
Lavage Fluid ◽  
Sprague Dawley ◽  
Sod Activity ◽  
Sprague Dawley Rats ◽  
Healthy Adult Male

Objective. This study was aimed to investigate the protective effect of methylene blue against lung injury induced by reperfusion of ischemic hindlimb in a rat model. Methods. Twenty-four healthy adult male Sprague-Dawley rats were equally randomized into three groups: sham (SM) group, ischemia reperfusion (IR) group, and methylene blue (MB) group. Rats in both IR and MB groups were subjected to 4 h of ischemia by clamping the left femoral artery and then followed by 4 h of reperfusion. Treatment with 1% methylene blue (50 mg/kg) was administrated intraperitoneally at 10 min prior to reperfusion in the MB group. After 4 h of reperfusion, malondialdehyde (MDA) level, myeloperoxidase (MPO), and superoxide dismutase (SOD) activities in lung tissue were detected; inflammatory cytokines, including IL-1β and IL-6, were measured in bronchoalveolar lavage fluid (BALF); correspondingly, the morphological changes and water content in both gastrocnemius muscle and lung samples were evaluated. Results. Hindlimb IR caused remarkable morphological abnormalities and edema in both muscle and lung tissues. SOD activity was decreased, both the MPO activity and MDA level in lung tissue, as well as IL-1β and IL-6 levels in BALF, were increased in the IR group (p<0.05). Compared with the IR group, SOD activity was increased, whereas MPO activity and MDA level in lung tissue and IL-1β and IL-6 levels in BALF were decreased in the MB group (p<0.05). Also, the histological damage and edema in both lung and muscle tissues were significantly attenuated by the treatment of methylene blue. Conclusion. Methylene blue attenuates lung injury induced by hindlimb IR in rats, at least in part, by inhibiting oxidative stress.

scholarly journals INFLUENCE ISCHEMIA-REPERFUSION ON THE MORPHOLOGICAL CHANGES LARGE JOINTS OF THE LOWER EXTREMITIES UNDER COMBINED ABDOMINO-SKELETAL INJURY

2019 ◽  
Vol 85 (4) ◽  
pp. 4-8
Author(s):  
V.O. Kryliuk ◽  
S.V. Garian
Keyword(s):  
Blood Loss ◽  
Morphological Changes ◽  
Ischemia Reperfusion ◽  
Abdominal Cavity ◽  
White Male ◽  
Lower Extremities ◽  
Standard Diet ◽  
Skeletal Trauma ◽  
Circulating Blood Volume ◽  
Reactive Changes

To study the effect of limb reperfusion in a model of combined abdominal-skeletal trauma and massive blood loss on histological changes of the knee joints. The experiment used 40 adult white male Wistar rats weighing 190-220 g, which were on a standard diet of vivarium. The experimental animals who modeled closed abdominal trauma, skeletal trauma, massive external blood loss, and ischemia-reperfusion of the lower extremities. The studies were performed 21 days after trauma modeling. All trauma experiments were performed under thiopental sodium (40 mg·kg-1 mass). The closed femoral bone fracture was modeled by applying a single metered blow to a specially designed thigh device. Closed trauma to the abdominal organs was modeled by applying two metered blows to the abdominal cavity with a specially designed device. Massive external blood loss was modeled by blood flow from 20 to 22 % of circulating blood volume from the femoral vessels on the opposite side of the femur fracture. Lower limb ischemia­reperfusion was simulated by imposing hemostatic plaits on the proximal portions of the lower legs of the test animals for two hours. In the preparations of the tissues of the hip and knee joint tissue reactive changes characteristic of inflammatory processes was found: pronounced changes in the hyaline cartilage of the metepiphyseal plate of the joints, edema of the connective tissue, disruption of the ordered arrangement of the insert plates of the compact part of the bone, significant vascular disorders in the form of arteries, edema of the adventitious sheath of vessels was noted. Thus, it was determined that combined trauma combined with ischemia reperfusion of the lower extremities in the later periods after the traumatic period can cause reactive changes in the large joints of the lower extremities.

BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Dhawal Panchal ◽  
Firdaus Dekhaiya ◽  
Harin Tailor
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Blunt Injury ◽  
Abdominal Drainage ◽  
Duration Of Hospital Stay ◽  
Considerable Morbidity ◽  
Injured Patients

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied  which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords:  Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

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