European Journal of Trauma and Emergency Surgery最新文献

{"title":"Cardiopulmonary collapse in frail patients treated with cemented and uncemented hemiarthroplasty.","authors":"Thomas P Bosch, Max P L van der Sijp, Pieta Krijnen, Arthur H P Niggebrugge, Rachid Mahdad, Inger B Schipper","doi":"10.1007/s00068-025-02856-0","DOIUrl":"https://doi.org/10.1007/s00068-025-02856-0","url":null,"abstract":"<p><strong>Background: </strong>Peri-operative cardiopulmonary collapse (CPC) poses an increased risk of in-hospital mortality, especially in frail patients. Bone Cement Implantation Syndrome (BCIS) is CPC following, cemented, arthroplasty, characterized by hypoxia and/or hypotension. The main objective of this study was to evaluate the association between cemented hemiarthroplasty and CPC, in patients with a femoral neck fracture (FNF) and increased pre-operative risk, and identify other risk factors for cardiopulmonary collapse.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with a FNF treated with a cemented or uncemented hemiarthroplasty, aged ≥ 80 years, with ASA score ≥ 3 and ≥ 1 cardiac or pulmonal comorbidity. CPC was defined as hypoxia/hypotension grade ≥ 2 according to Donaldson's criteria. Multivariable logistic regression analysis was used to adjust for confounding in the relation between cemented hemiarthroplasty and CPC, and to identify other risk factors for CPC in patients with a cemented hemiarthroplasty.</p><p><strong>Results: </strong>The incidence of CPC was 51.1% in 221 cemented hemiarthroplasty patients compared to 23.3% in 73 uncemented hemiarthroplasty patients (p < 0.001). The use of cement increased the risk for CPC almost threefold (adjusted odds ratio [aOR] 2.87, 95% confidence interval [CI] 1.46-5.64). Preoperative reduced left ventricle ejection fraction (aOR 3.03, 95% CI 1.50-6.14) was another independent risk factor for CPC.</p><p><strong>Conclusion: </strong>Cementation increases the risk of CPC in frail FNF patients treated with hemiarthroplasty. Emphasis on euvolemia and avoidance of excessive pressurization, and careful consideration of an indicated cemented hemiarthroplasty in frail hip fracture patients may be advised for patients with an increased preoperative risk for BCIS.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"181"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into orthopedic and trauma emergency care and current challenges in Germany.","authors":"Jonas Roos, Sophia Helm, Amadeo Touet, Davide Cucchi, Kristian Welle, Leonie Weinhold, Ingo Graeff, Martin Gathen","doi":"10.1007/s00068-025-02829-3","DOIUrl":"https://doi.org/10.1007/s00068-025-02829-3","url":null,"abstract":"<p><strong>Background: </strong>The reform of emergency and acute care in Germany focuses on efficiently managing patient flows to reduce overcrowding in emergency departments, primarily caused by a rise in patients with low urgency and a lack of alternative care options. The aim of this work was to analyze the emergency care of orthopedic and trauma surgery patients in a Level I trauma center in order to improve patient care and manage resources more effectively.</p><p><strong>Material and methods: </strong>In this retrospective study, the data of orthopaedic and trauma surgery patients from the emergency department of a university in 2022 were analyzed. Data included demographics, triage levels, transport modes, diagnoses, and treatment outcomes. Process metrics like length of stay and time to medical contact were also evaluated. Descriptive and statistical analyses were conducted to examine patient distribution and resource use.</p><p><strong>Results: </strong>A total of 9414 patients (47.5% females; mean age 42.4 ± 24.1 years) were included, with 7500 treated for trauma and 1914 for orthopedic diagnoses. Most patients (79.6%) received outpatient care, while 21.3% were admitted as inpatients. Manchester Triage System distribution revealed 48.5% green, 31.0% yellow, 14.8% orange, and 0.8% red. The most common MTS flowcharts were limb problems (38.3%), falls (19.7%), and back pain (11.1%). Ambulance transport accounted for 33.7% of arrivals, while 65.1% presented independently. The average length of stay in the ED was 213 min, varying significantly across triage categories and working hours.</p><p><strong>Conclusion: </strong>This study highlights key challenges in orthopedic and trauma emergency care, emphasizing the prevalence of low-urgency cases contributing to overcrowding. Enhancing outpatient care capacity and implementing reforms like integrated emergency centers and optimized triage systems are crucial to improving efficiency and aligning resources with patient needs.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"180"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influencing factors for fragility fractures of the pelvis on length of stay and complication rate.","authors":"Andreas Termer, Olga Ruban, Anica Herlyn, Tim Fülling, Philip Gierer","doi":"10.1007/s00068-025-02861-3","DOIUrl":"https://doi.org/10.1007/s00068-025-02861-3","url":null,"abstract":"<p><strong>Purpose: </strong>Increasing incidence of fragility pelvic ring fractures (FFP) is driven by demographic. An analysis of the patient population, along with the factors influencing total length of stay (LoS), and endpoints such as complications is essential for a better understanding and treatment of FFP injuries.</p><p><strong>Methods: </strong>This retrospective data analysis includes all inpatients treated from January 2018 to December 2022, with an FFP. Excluded were patients < 65 years, high-energy trauma, acetabular fractures, or pathological fractures. Collected data included demographics as well as information about comorbidities, diagnostics, therapy, LoS and complications.</p><p><strong>Results: </strong>A total of 363 patients were included, of which 14% (n = 52) were male and 86% (n = 311) female. The average age was 84.4 ± 6.6 years. While 31.1% (n = 113) were mobile without aid before onset of symptoms there was a significant (p < 0.01) decrease to 5.2% (n = 19) at discharge. Only 43.8% (n = 159) remained self-dependent at discharge, compared to 62.3% (n = 226) before injury (p < 0.01). Significantly longer LoS was found with higher FFP types (p < 0.01), higher number of complications (p < 0.01) as well as operative treatment (p < 0.01) and MRI diagnostics (p < 0.01). A significant increase on the number of complications was found with FFP IV (p = 0.02) and operative treatment (p < 0.01).</p><p><strong>Conclusion: </strong>Higher FFP types, higher number of complications, as well as operative treatment and MRI diagnostics prolonged the total LoS. FFP IV and operative treatment were associated with higher number of complications. By identifying specific factors influencing the inpatient stay, further prospective studies may show improved complication/ mortality rates by optimizing those factors.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"179"},"PeriodicalIF":1.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunomodulatory and cardio-protective effects of differentially originated multipotent mesenchymal stroma cells during polymicrobial sepsis in mice.","authors":"Anna Kanewska, Ina Lackner, Anne Friedrich, Martina Winkelmann, Markus Rojewski, Birte Weber, Jochen Preßmar, Mario Perl, Hubert Schrezenmeier, Miriam Kalbitz","doi":"10.1007/s00068-025-02862-2","DOIUrl":"https://doi.org/10.1007/s00068-025-02862-2","url":null,"abstract":"<p><strong>Purpose: </strong>Sepsis is a life-threatening condition with cardiac complications being an independent predictor of poor outcome. Although their mechanisms have been widely investigated, therapeutic options remain limited. One promising therapeutic tool are mesenchymal stromal cells (MSCs). The aim of this study is to investigate the immunomodulatory effects of human MSCs from two different sources (bone marrow/BMMSC and adipose tissue/ASC) and to evaluate their cardioprotective potential.</p><p><strong>Methods: </strong>60 adult male C57BL/6 mice were divided into sham, sepsis (cecal ligation puncture (CLP)) and two i.v. treatment groups CLP + human BMMSC and CLP + human ASC with 5 animals in each group. The observation periods were 8, 24 and 72 h. Left ventricular tissue was analyzed histologically, by qPCR (C3ar, C5ar1, Il-1b, Il-6, Il-10, Tlr2, Tlr4, Tnfa, and Nlrp3) and western blot. Cardiac damage markers troponin I and heart fatty acid binding protein (HFABP) were detected in serum by ELISA.</p><p><strong>Results: </strong>Troponin I and HFABP were significantly increased in CLP group after 8 h compared to sham. In cardiac tissue the expression of C3ar, C5ar1, Il-1b, Il-6, Il-10, Tlr2, Tlr4, Tnfa and Nlrp3 inflammasome was upregulated up to 24h after CLP compared to sham. After BMMSC treatment, C3ar as well as C5ar, Tlr2 and Il-10 mRNA expression in left ventricle was downregulated compared to CLP, whereas ASC treatment was associated with the downregulation of Il-6 and Nlrp3.</p><p><strong>Conclusions: </strong>CLP-induced polymicrobial sepsis in mice was associated with cardiac damage and increased inflammation in left ventricular tissue. Therapeutic systemic application of human BMMSC and ASC ameliorated damage and inflammation in the heart.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"178"},"PeriodicalIF":1.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracostomy for removal of excess fluid in surgical stabilization of rib fractures: the T-REX trial.","authors":"Sarah Majercik, Scott Gardner, Evert A Eriksson, Joseph D Forrester, Joshua A Villarreal, Zachary M Bauman, Lindsey Cavlovic, Andrew R Doben, Gregory R Semon, Fredric M Pieracci, Theresa Morin, Kelley Mancine, Zachary D Warriner, Caroline Neff, SarahAnn S Whitbeck, Thomas W White","doi":"10.1007/s00068-025-02845-3","DOIUrl":"https://doi.org/10.1007/s00068-025-02845-3","url":null,"abstract":"<p><strong>Background: </strong>Management of the pleural space during and after SSRF is a matter of debate. Tube thoracostomy (TT), intra-operative pleural lavage (PL) and video assisted thoracoscopic surgery (VATS) use varies between surgeons. The purpose of this study is to describe differences in practice patterns of pleural space management (TT, PL, VATS) after SSRF at institutions with extensive experience in chest wall reconstruction.</p><p><strong>Methods: </strong>Prospective data from adult SSRF patients at eight U.S. trauma centers between January 1, 2020 and September 1, 2022 was collected. Patients were managed according to institutional protocols. Outcome measures included hospital and ICU length of stay, 30-day readmission rate, infectious complications, and incidence of procedural re-intervention. Discrete variables are reported as median (IQR). P-values for continuous variables were obtained using Kruskal-Wallis, and for categorical variables using Chi-square.</p><p><strong>Results: </strong>273 patients from 8 centers were included. Median age was 60 (46-68), 70% were male, and 99% suffered blunt trauma. ISS was 17 (13-26), ranging from a low of 14 (10-19) to 26 (18-35) (p = 0.002). Median operative time was 2.5 (1.9-3.3) hours, with 5 (4-6) plates placed. VATS ranged from 2 to 78% at each center and PL ranged from 25 to 100% (p < 0.001). Almost all patients received TT. TT remained in place for 3 (2-4) days, few (2%) had any complication related to the TT, nor did they require drain replacement (7%) or reoperation (2%). ICU and hospital lengths of stay were 3 (2-6) and 8 (6-13) days (P < 0.001). Readmission rates were low (4%), and did not differ between centers.</p><p><strong>Conclusion: </strong>At centers experienced in SSRF, there is variation in management of the pleural space. While ICU and hospital lengths of stay are different between centers, rates of reoperation and readmission are similar. Further study is needed to delineate optimal management of the pleural space after SSRF.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"174"},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting mechanical complications in proximal femoral nailing for elderly patients: a radiological scoring system based on a single-centre retrospective cohort with 586 cases.","authors":"Cafer Özgür Hançerli, Halil Büyükdoğan","doi":"10.1007/s00068-025-02850-6","DOIUrl":"https://doi.org/10.1007/s00068-025-02850-6","url":null,"abstract":"<p><strong>Background: </strong>Proximal femoral nailing (PFN) is a preferred treatment for intertrochanteric femoral fractures in elderly patients due to its minimally invasive nature and early mobilisation benefits. However, mechanical complications such as implant failure, cutout, and reduction collapse remain significant challenges. This study introduces the targeted surgical score (TSS), a novel scoring system designed to predict and mitigate mechanical complications by evaluating modifiable surgical factors.</p><p><strong>Methods: </strong>A retrospective analysis of 586 patients aged 65 and older treated with PFN between 2015 and 2022 was conducted. Data on demographic characteristics, fracture classifications, and surgical parameters were collected. Radiographic assessments included tip-apex distance (TAD) and lag screw positioning for implant placement quality, medial and anterior cortical support (MCS and ACS), and fracture alignment in both AP and lateral planes for reduction quality. Each parameter was scored, resulting in a cumulative TSS ranging from 0 to 8. Logistic regression and ROC curve analysis were performed to evaluate the predictive capacity of TSS.</p><p><strong>Results: </strong>The average TSS was 4.06 ± 2.22 in the complication group and 6.14 ± 1.56 in the non-complication group (p < 0.001). A one-point increase in TSS was associated with a 44.9% reduction in complication risk (OR 0.551; p < 0.001). Independent risk factors included lag screw placement (non-central superior quadrants), inadequate cortical support in AP and lateral planes (MCS and ACS), and TAD (≥ 25 mm). The TSS demonstrated relatively good discriminative ability with an AUC of 0.768.</p><p><strong>Conclusion: </strong>TSS may aid in predicting and mitigating mechanical complications while potentially guiding surgical applications in PFN, but further prospective multicentre validation is required. While certain parameters of TSS could be considered intraoperatively, its full implementation may be more practical for postoperative risk assessment.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"172"},"PeriodicalIF":1.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESTES recommendations for the treatment of polytrauma-a European consensus based on the German S3 guidelines for the treatment of patients with severe/multiple injuries.","authors":"Cristina Rey Valcarcel, Dan Bieler, Gary A Bass, Christine Gaarder, Frank Hildebrand","doi":"10.1007/s00068-025-02852-4","DOIUrl":"10.1007/s00068-025-02852-4","url":null,"abstract":"<p><strong>Introduction: </strong>Considerable heterogeneity exists in the configuration and implementation maturity of trauma systems across European healthcare settings, and the opportunities for guideline-informed high-quality care varies considerably. Therefore, the European Society of Trauma and Emergency Surgery (ESTES), with its constituent national societies, has developed comprehensive consensus recommendations for care-context appropriate treatment of polytrauma patients in Europe, from the pre-hospital setting to the first surgical phase.</p><p><strong>Methods: </strong>Adhering to the RAND/UCLA Appropriateness Method (RAM), ESTES conducted a three-round modified Delphi consensus. National society expert delegates assessed Grade of Recommendation (GoR) A and Good Clinical Practice Points (GPP) elements of the German Society of Trauma Surgery (DGU) \"S3 guidelines for polytrauma/severe injury management\" for appropriateness and implementability within their respective healthcare systems.</p><p><strong>Results: </strong>In the first consensus round, 82 GoR A and 57 GPP recommendations were analysed. Of these, seven GPP were rephrased for clarity and four were removed due to redundancy or conflicting content. Consequently, 135 recommendations (82 GoR A and 53 GPP) remained, with 128 (77 GoR A and 51 GPP) deemed appropriate and necessary, and seven as uncertain due to expert disagreement.</p><p><strong>Conclusion: </strong>These ESTES recommendations constitute the first cohesive Europe-wide framework for managing the polytrauma patient from the prehospital setting to the end of the first surgical phase. They serve as a foundational tool for the development of national guidelines, particularly in regions with evolving trauma systems, and promote alignment towards a uniform standard-of-care across Europe.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"171"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timely enteral nutrition of ventilated polytrauma patients: current standards and room for improvements.","authors":"Ottavio de la Vega, Saskia Ridley-Smith, Howard Huang, Daniel Hali, Simone Meakes, Cino Bendinelli, Zsolt J Balogh","doi":"10.1007/s00068-025-02849-z","DOIUrl":"10.1007/s00068-025-02849-z","url":null,"abstract":"<p><strong>Purpose: </strong>Polytrauma patients in intensive care units (ICUs) face significant risks of morbidity and mortality, with nutrition playing a crucial role in mitigating energy deficits and complications such as multi-organ failure (MOF). This study aimed to evaluate adherence to enteral nutrition (EN) guidelines in ventilated polytrauma patients and explored correlations between EN timing and clinical outcomes.</p><p><strong>Methods: </strong>A four-year retrospective (2019-2022) analysis of ventilated polytrauma patients (abbreviated injury scale > 2 in ≥ 2 body regions) admitted to a level 1 trauma centre. Collected data included demographics, injury characteristics and EN patterns. Early EN was defined as started withing 24 h. Statistical analysis assessed associations between EN, injury severity, and outcomes such as ICU length of stay (LOS), mortality, and MOF.</p><p><strong>Results: </strong>Of 182 patients (median age 41, male 77%, median ISS 34), 41 did not receive EN and were excluded. Of the remaining 141, 64% received early EN, with a median time to EN of 17.8 h. Early EN was associated with reduced ICU LOS (p = 0.016). Delaying EN initiation correlated with higher injury severity (p = 0.008). Each one-hour delay to EN increased MOF odds by 1.47% (OR: 1.0147, p = 0.07). EN interruptions (> 6 h) occurred 354 times.</p><p><strong>Conclusion: </strong>Investigations into current EN standards in polytrauma patients demonstrated an average of 2.5 interruptions in EN exceeding 6 h per patient, with 40% not fed within 24 h. Combined with inconsistent dietician input, this offers room for improvement as early EN is associated with better outcomes, with a reduced ICU LOS established through this study.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"169"},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding the Alvarado and AIR score in pregnant women.","authors":"Roland E Andersson, Elin Moltubak, Kalle Landerholm","doi":"10.1007/s00068-025-02851-5","DOIUrl":"10.1007/s00068-025-02851-5","url":null,"abstract":"<p><p>This letter to the Editor is a comment to the report by Kahana N et al. evaluating the diagnostic properties of the Alvarado and AIR score in pregnant women. The AIR score is not correctly described. This has important implications for the interpretation of the study results.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"168"},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of adenosine A₃ receptor and endothelial nitric oxide synthase in patients with traumatic hemorrhagic shock.","authors":"Yasin Öztaş, Yusuf Ertuğrul Aslan, Elif Funda Şener, Halime Dana, Emre Tuğhan, Nurullah Günay, Abdullah Tuncay Demiryürek","doi":"10.1007/s00068-025-02853-3","DOIUrl":"10.1007/s00068-025-02853-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of this research is to access the expression of adenosine A3 receptor (ADORA3) and nitric oxide synthase 3 (NOS3) genes and serum levels of ADORA3 and NOS3 in patients with multiple trauma with hemorrhagic shock.</p><p><strong>Materials and methods: </strong>The study was performed at Erciyes University between November 2022 and March 2024, in a prospective and controlled manner. Patients diagnosed with traumatic hemorrhagic shock and requiring transfusion in the emergency department were selected as the patients group. Gene expressions were analyzed using quantitative real-time PCR analysis in total RNA samples and serum levels of NOS3 and ADORA3 were detected using ELISA measurements.</p><p><strong>Results: </strong>In patients with multiple trauma, adenosine A3 receptor (ADORA3) gene expression showed a significant increase at discharge when compared to healthy controls (P < 0.05). However, serum levels of ADORA3 showed significant decreases at all stages (i.e. at admission, at 24 h, and at discharge) of patients. Although no significant changes were detected in NOS3 gene expression, marked decreases in serum NOS3 levels were observed at admission and at 24 h in multiple trauma patients (P < 0.05). ADORA3 and NOS3 gene expressions were found to be significantly diminished in nonsurvivors.</p><p><strong>Conclusion: </strong>The study emphasizes the importance of ADORA3 and NOS3 gene expressions in influencing shock progression in multiple trauma patients. The increase in ADORA3 gene expression may play a role in restoring vascular reactivity after traumatic shock. Decreased serum NOS3 and ADORA3 levels can contribute to the shock progression in the pathophysiology of multiple trauma.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"167"},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}