Journal of Trauma and Acute Care Surgery最新文献

{"title":"Re: Elevated cell-free hemoglobin: A novel early biomarker following traumatic injury.","authors":"İbrahim Eker, Soner Yılmaz, Aytekin Ünlü","doi":"10.1097/TA.0000000000004636","DOIUrl":"https://doi.org/10.1097/TA.0000000000004636","url":null,"abstract":"","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-limited association between plasma transfusion and mortality in pediatric traumatic brain injury.","authors":"Leah Furman, Erin V Feeney, Barbara A Gaines, Christine M Leeper","doi":"10.1097/TA.0000000000004694","DOIUrl":"https://doi.org/10.1097/TA.0000000000004694","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a predominant cause of pediatric mortality. While prehospital plasma administration has been associated with lower mortality in adults with TBI, the impact of early plasma in children is unknown.</p><p><strong>Methods: </strong>In this retrospective cohort study, we examined the impact of plasma transfusion within 4 hours of arrival on 4-hour, 24-hour, and 30-day mortality in children aged 1 to 17 years with severe TBI (head Abbreviated Injury Scale scores 4 and 5) using the National Trauma Data Bank from 2020 to 2022. We excluded subjects with mild-moderate or nonsurvivable TBI or missing plasma or weight data. Cox proportional hazard models, clustered by facility, assessed the effect of early plasma on mortality, adjusting for: age; sex; trauma mechanism; interfacility transfer; shock; total Glasgow Coma Scale; Injury Severity Score; trauma center level; insurance; binary whole blood, red blood cell, and platelet administration; and weight-adjusted total 4-hour transfusion volumes.</p><p><strong>Results: </strong>Of 367,065 children in the National Trauma Data Bank from 2020 to 2022, 14,691 met the inclusion criteria, of whom 1,594 (10.9%) received early plasma. Subjects were mostly male (67.8%), with a median (interquartile range) age of 12 (5-15) years, Glasgow Coma Scale score of 11 (3-15), Injury Severity Score of 25 (17-29), and 28.7% presenting in shock. The adjusted hazard ratio (HR) for the effect of plasma administration on mortality was 0.610 (95% CI, 0.430-0.864; p = 0.005) at 4 hours, 0.894 (95% CI, 0.706-1.131; p = 0.350) at 24 hours, and 1.132 (95% CI, 0.961-1.334; p = 0.138) at 30 days.</p><p><strong>Conclusion: </strong>This study reports a significant association between early plasma administration and a lower risk of 4-hour mortality among children with severe TBI that does not persist at or beyond 24 hours. While these data suggest that plasma resuscitation may extend the window for lifesaving intervention, additional prospective data are needed.</p><p><strong>Level of evidence: </strong>Therapeutic/Care Management; Level III.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary repair versus resection for American Association for the Surgery of Trauma grades I and II colon injuries: Does the management approach really matter? An Eastern Association for the Surgery of Trauma multicenter trial.","authors":"Caitlin A Fitzgerald, Christopher Barnes, Erika K Bisgaard, Bryant J McLafferty, Kevin N Harrell, Matthew M Fleming, Jonathan P Meizoso, James Walker, Jason D Sciarretta, Bahaa E Succar, Mingyuan Cheng, Richard H Lewis, Greggory R Davis, Odessa Puli, Tanya Egodage, Jennifer Mooney, Stacy Nguyen, Jordan M Kirsch, Anna Mary Jose, Derek Lumbard, Andreana Finn, Kyle Sheppard, Korey S Shively, Caleb Butts, Alaina M Lasinski, Nicholas G Beattie, Mary N Noory, Sejul A Chaudhary, William Irish, Pak Leung, Karla Luketic, Matthew Noorbakhsh, Khalid Almahmoud, Alison Cash, Andrew C Bernard, Arathi Kumar, Anthony J DeSantis, Rosemary A Kozar, Ajay Prasad, Anaar E Siletz, Thomas J Schroeppel, Jennifer Rodriquez, Nichole Tackett, Caleb Mentzer, Anna Sabu-Kurian, Brittany K Bankhead, Bishwajit Bhattacharya, Adrian A Maung, Grace Chang, Uma Ramoutar, Michael S Farrell, Marah Hamdan, Yee M Wong, Ryan T Deci, Luis Fernandez, Brandi Pero, Carlos H Palacio, Juan J Rendon Garcia, James J Myall, Andrew J Riggle, Simin Golestani, Joshua Dilday, April Miller, Luis Taveras, Payton Grande, Stephanie Scott, Ryan P Dumas","doi":"10.1097/TA.0000000000004649","DOIUrl":"https://doi.org/10.1097/TA.0000000000004649","url":null,"abstract":"<p><strong>Background: </strong>The management of traumatic low-grade (American Association for the Surgery of Trauma [AAST] grades I and II) colon injuries has evolved. Recent data suggest that primary repair (PR) or resection over colostomy decreases morbidity and mortality. However, data comparing patients undergoing PR versus resection with anastomosis (RWA) are lacking. We hypothesized that patients presenting with low-grade colon injuries undergoing PR would have fewer postoperative complications than patients undergoing RWA.</p><p><strong>Methods: </strong>This was a retrospective, multicenter analysis of all patients presenting with AAST grades I and II colon injuries to 32 Level 1 trauma centers from 2011 to 2021. Based on operative documentation, patients were dichotomized into two groups, those who underwent PR or RWA. Outcomes included length of stay, infectious complications, and mortality. Multivariate logistic regression was performed to determine the independent effect of operative technique on outcomes.</p><p><strong>Results: </strong>A total of 2,022 patients met the inclusion criteria for this study. Most were young (36 [24-44] years), male (79.6%), and presented after penetrating trauma (58.2%). A total of 1,013 patients presented with a grade I injury, while 1,009 patients presented with a grade II injury. Furthermore, 1,314 patients underwent PR, and 708 underwent RWA. While there was no difference in Injury Severity Score between PR and RWA, RWA was associated with more adverse outcomes including surgical site infections, suture line failure/leak, fascial dehiscence, and a longer hospital length of stay (all p < 0.001). When controlling for mechanism of injury, AAST grade, Injury Severity Score, and number of intra-abdominal injuries RWA were independently associated with more infectious complications including superficial, deep, and organ space surgical site infections.</p><p><strong>Conclusion: </strong>Resection with anastomosis was independently associated with more adverse outcomes including multiple infectious complications and longer hospital length of stay compared with PR, suggesting that low-grade colon injuries can be safely managed with PR alone.</p><p><strong>Level of evidence: </strong>Multicenter Retrospective Comparative Study; Level III.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of efficacy of helmet use and helmet laws to reduce mortality and cervical spine injury in adult motorcycle riders: A practice management guideline from the Eastern Association for the Surgery of Trauma.","authors":"Asanthi M Ratnasekera, Sirivan S Seng, Stuart K Gardiner, Caroline Butler, Anna Goldenberg-Sandau, Ning Lu, Hiba Abdel Aziz, Rachel D Appelbaum, Hassan Mashbari, Shabnam Hafiz, Sharfuddin Chowdhury, Hahn Soe-Lin, John M Reynolds, Amanda L Teichman, Susan Kartiko, Elinore J Kaufman, Patrick Murphy, Lisa Kodadek, Rishi Rattan","doi":"10.1097/TA.0000000000004607","DOIUrl":"10.1097/TA.0000000000004607","url":null,"abstract":"<p><strong>Background: </strong>Motorcycle crash fatalities remain a significant public health concern. Traumatic brain injury is a leading cause of death following motorcycle crash. We aim to provide evidence-based guidelines pertaining to helmet use and helmet laws with respect to important outcomes including mortality, cervical spine injury, and discharge disposition.</p><p><strong>Methods: </strong>An evidence-based systematic review was performed to answer the following Population, Intervention, Comparator, Outcomes (PICO) questions: PICO 1-Should adult motorcycle riders wear helmets or not wear helmets to improve mortality, brain injury-related mortality, cervical spine injury, and discharge disposition from the hospital? PICO 2-Should motorcycle universal helmet laws (UHLs) or no UHLs be enacted to improve mortality, brain injury-related mortality, cervical spine injury, and discharge disposition from the hospital? An academic medical librarian searched Medline, Cochrane CENTRAL, CINAHL, Embase, Engineering Village, Health and Safety Science Abstracts, Scopus, SPORTDiscus, TRID, the VHL Regional Portal, and Elsevier. The Grading of Recommendations Assessment, Development, and Evaluation methodology was used to assess the quality of the evidence and create recommendations. The working group reached consensus on the final evidence-based recommendations. The study was registered in PROSPERO (CRD42020172705).</p><p><strong>Results: </strong>A total of 28 studies were identified for analysis for PICO 1, and 10 studies were identified for PICO 2. Helmet use was associated with a lower incidence of mortality (odds ratio, 0.48; 95% confidence interval, 0.41-0.56; p < 0.001) and lower incidence of cervical spine injury (odds ratio, 0.66; 95% confidence interval, 0.58-0.76; p < 0.001). Although a meta-analysis for PICO 2 was not possible because of significant methodological heterogeneity, the vast majority of studies demonstrated large improvements in outcomes with a UHL. Overall certainty of evidence was deemed low for PICO 1 and PICO 2 because of risk of bias.</p><p><strong>Conclusion: </strong>We strongly recommend that individual motorcycle riders wear helmets and that universal helmet legislation be enacted and enforced to decrease mortality, to decrease the incidence of cervical spine injury, and to improve discharge disposition from the hospital.</p><p><strong>Level of evidence: </strong>Systematic Review and Meta-analysis; Level II.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical and pharmacostability of 15 essential medications in cold and ultracold environments.","authors":"Jason McMullan, Christopher Droege, Thomas Blakeman, John-Michael Fowler, Eric Mueller, Maia Smith, Madeline Foertsch","doi":"10.1097/TA.0000000000004648","DOIUrl":"https://doi.org/10.1097/TA.0000000000004648","url":null,"abstract":"<p><strong>Background: </strong>Medications require storage and use at room temperature but are largely untested in extreme temperature environments. Deep freezing and frequent freeze-thaw cycling may be expected in Artic and Polar missions. We hypothesize that medications have variable tolerance to exposure of up to 90 days of deep freezing or freeze-thaw cycling.</p><p><strong>Methods: </strong>With military stakeholder input, 15 essential medications were placed in programmed environmental chambers to maintain -60°F (-51°C, deep freeze) or cycle between 12 hours at -40°F (-40°C) and 68°F (20°C), mimicking possible operational scenarios. Controls were stored at room temperature. Six vials of each medication were placed in each environment for 30, 60, and 90 days of exposure. After exposure, each vial was examined for physical/visual abnormality and sent for concentration testing via high-performance liquid chromatography. Changes from labeled concentration >10% were considered significant, consistent with Food and Drug Administration guidance.</p><p><strong>Results: </strong>Amiodarone, phenylephrine, norepinephrine, haloperidol, dexamethasone, rocuronium, and metoprolol show physical and pharmacostability through 90 days in both environments. Propofol shows disruption of the emulsion and significant degradation after 30 days in both environments. Sodium bicarbonate, tranexamic acid, calcium chloride, and succinylcholine vials frequently shattered by 30 days of exposure. One naloxone vial experienced degradation. At 30 days, all epinephrine vials had physical change with separation of protective caps from the vials, and two had breakage; unbroken vials showed no degradation in either environment. Atropine experienced limited breakage and no degradation.</p><p><strong>Conclusion: </strong>Some critical medications experience physical failure and chemical degradation when exposed to up to 90 days of deep freeze or freeze-thaw cycles. Studied formulations of propofol, tranexamic acid, epinephrine, calcium chloride, succinylcholine, and sodium bicarbonate should not be deployed unless these temperature extremes can be avoided. Alternative formulations, packaging, and environmental mitigation solutions should be considered.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to the Editor: \"A trauma expert consensus: Capabilities are required early to improve survivability from traumatic injury\".","authors":"Jennifer M Gurney, Russ S Kotwal, John B Holcomb","doi":"10.1097/TA.0000000000004662","DOIUrl":"https://doi.org/10.1097/TA.0000000000004662","url":null,"abstract":"","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care utilization after operative versus nonoperative appendicitis management using an administrative claims database.","authors":"Pawan J Mathew, Miranda Moore, Bishwajit Bhattacharya, Eric Schneider, Kimberly Davis, Kevin M Schuster","doi":"10.1097/TA.0000000000004682","DOIUrl":"https://doi.org/10.1097/TA.0000000000004682","url":null,"abstract":"<p><strong>Background: </strong>Use of nonoperative management for uncomplicated appendicitis is increasing. Recurrent appendicitis is only one measure of successful nonoperative management. We examined health care utilization and exposure to medical imaging between patients postappendectomy and those with an in situ appendix over the year after initial diagnosis. We hypothesized that nonoperative management would result in greater health care utilization than operative management in the year following index diagnosis.</p><p><strong>Methods: </strong>Using MarketScan, a commercial and fee-for-service Medicare claims database, we extracted patients presenting to the emergency department (ED) with acute appendicitis and without perforation from 2017 to 2021, and either underwent appendectomy during index presentation or nonoperative treatment. We examined differences in abdominal pain related health care utilization within 1-year including ED visits, hospitalizations, and abdominal computed tomography (CT) scans associated with the most common causes of ED presentation for abdominal pain.</p><p><strong>Results: </strong>Of 26,588 patients presenting with uncomplicated appendicitis (female, 50.4%; mean [SD] age, 37.9 [15.3] years; mean [SD] Elixhauser comorbidity index, 0.8 [1.2]), 24,102 (90.6%) underwent appendectomy. At 1 year, 2,544 (9.6%) represented to the ED with an abdominal pain and/or appendicitis related diagnosis. Of nonoperatively managed patients, 78 (3.1%) underwent appendectomy for recurrent appendicitis at a median of 70 days, and 396 (15.9%) represented to the ED but did not undergo appendectomy. Emergency department visits, subsequent hospitalization, and abdominal CT scans were more common in the nonoperative group. After adjusting for patient sex, age, and Elixhauser comorbidity index, patients managed nonoperatively were approximately twice as likely (relative risk [RR], 2.10 [1.90-2.31]) to represent to the ED, be hospitalized (RR, 2.32 [1.94-2.76]), or undergo a CT scan (RR, 1.87 [1.68-2.08]) within 1 year.</p><p><strong>Conclusion: </strong>After adjusting for baseline characteristics, nonoperative management of uncomplicated appendicitis was associated with representation to the ED, rehospitalization, and repeat CT imaging.</p><p><strong>Level of evidence: </strong>Therapeutic/Care Management; Level III.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor: Does the injury pattern drive the surgical treatment strategy in multiply injured patients with major fractures?","authors":"Sascha Halvachizadeh, Hans-Christoph Pape","doi":"10.1097/TA.0000000000004580","DOIUrl":"https://doi.org/10.1097/TA.0000000000004580","url":null,"abstract":"","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attenuated interferon-γ following injury is associated with chronic critical illness.","authors":"Joseph Cuschieri, Lucy Z Kornblith, Hashem Kalthoum, Sophia Cuschieri, Shibani Pati, Adrian Piliponsky","doi":"10.1097/TA.0000000000004671","DOIUrl":"https://doi.org/10.1097/TA.0000000000004671","url":null,"abstract":"<p><strong>Objective: </strong>Altered genomic expression of interferon (IFN)-γ has been demonstrated to be associated with the development of organ failure following severe injury. Altered expression of IFN-γ on innate immunity and long-term outcomes have not been previously examined. The purpose of this study was to determine the effect that IFN-γ plays on monocyte function and development of chronic critical illness (CCI).</p><p><strong>Methods: </strong>Severely injured patients were prospectively evaluated in a development cohort (n = 124). Blood was drawn within 12 hours of injury. Plasma IFN-γ was determined by immune-assay. Clinical and outcome data were prospectively obtained for 1 year. Within this development cohort, a plasma IFN-γ level associated with CCI was determined. This IFN-γ level was analyzed within a separate prospective validation cohort (n = 78). Blood samples in this validation cohort underwent analysis for monocyte activation.</p><p><strong>Results: </strong>In the development cohort, an IFN-γ ≤ 50 pg/mL was associated with the development of CCI. This IFN-γ level was independently associated with CCI in the developmental cohort after adjusting for age, Injury Severity Score, lactate concentration, and blood transfusions. An IFN-γ ≤ 50 pg/mL within the validation cohort was associated with a statistically significant increase in CCI, nosocomial infection, poor discharge disposition, and 1-year mortality (25% vs. 4%, p = 0.005). Consistent with the development of CCI, attenuated IFN-γ was associated with decreased monocyte activation and surface human leukocyte antigen-DR expression.</p><p><strong>Conclusion: </strong>Decreased IFN-γ is predictive of CCI development. This reduction in IFN-γ is associated with a reduction in human leukocyte antigen-DR and monocyte activation, which may result in the development of CCI, increased nosocomial infections, and poor long-term outcomes. Interferon-γ levels early following injury may be useful as a biomarker for prognosis and to serve to identify patients who could benefit from IFN-γ administration or other novel therapeutic interventions to prevent long-term complications.</p><p><strong>Level of evidence: </strong>Prognostic and Epidemiological; Level III.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-22 as a novel therapy for trauma relevant acute kidney injury.","authors":"Sharven Taghavi, Carson Mills, Farhana Shaheen, David Engelhardt, Allison Newell, John Dasinger, Jay Kolls, Heddwen Brooks, Olan Jackson-Weaver","doi":"10.1097/TA.0000000000004655","DOIUrl":"https://doi.org/10.1097/TA.0000000000004655","url":null,"abstract":"<p><strong>Background: </strong>Treatment for acute kidney injury (AKI) after trauma remains primarily supportive. While interleukin (IL)-22 is known to decrease cell death and stimulate regeneration in the kidney, its potential as a therapeutic in trauma-relevant AKI is unknown. IL-22:Fc is a recombinant human IL-22 protein combined with a human Fc immunoglobulin to increase serum half-life. We hypothesized that IL-22:Fc would mitigate AKI in a trauma-relevant rat model of hemorrhagic shock and resuscitation (H/R).</p><p><strong>Methods: </strong>Sprague-Dawley rats were anesthetized, and femoral arteries were cannulated. Mean arterial pressure was reduced to 40 mm Hg by withdrawing blood and kept there for 30 minutes. Animals were then resuscitated with intravenous lactated Ringer's solution to a mean arterial pressure of 60 for an additional 30 minutes. Treated animals (n = 8) received 150 μg/kg of IL-22:Fc at the start of resuscitation and compared with sham injected. Laboratories were drawn at baseline and end of resuscitation.</p><p><strong>Results: </strong>Both groups demonstrated AKI as measured by blood urea nitrogen and serum creatinine, while treated animals had lower blood urea nitrogen and creatinine at the end of H/R. In addition, IL-22:Fc-treated animals had lower urinary albumin concentration (0.39 vs. 0.12 μg/mL, p = 0.02). Furthermore, neutrophil gelatinase-associated lipocalin levels, a marker of AKI, measured in the outer medulla were lower in treated animals. Neutrophil gelatinase-associated lipocalin levels measured in the cortex glomeruli (1,005 vs. 1,457 AU, p = 0.41) and inner medulla (5,670 vs. 5,885 AU, p = 0.16) were not different. Neutrophil gelatinase-associated lipocalin levels were higher in the tubular cortex for treated rats (2,420 vs. 3,541 AU, p = 0.02). Phosphorylated signal transducer and activator of transcription 3 levels were not higher in the kidney of treated rats.</p><p><strong>Conclusion: </strong>IL-22:Fc protects the kidneys after H/R and appears to act selectively on the outer medulla. This beneficial effect does not appear to be mediated by signal transducer and activator of transcription 3, as shown in other organ systems. IL-22:Fc may be a novel therapy for AKI in trauma patients.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}