Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue最新文献

{"title":"[The study of continuous blood purification in severe asthma].","authors":"Lei Xu,&nbsp;Zhi-bo Li,&nbsp;Xin-jin Gao,&nbsp;Jun Li,&nbsp;Jie Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the mechanism that continuous blood purification (CBP) improve the lung mechanical ventilation parameters, cytokine levels and blood gas analysis results in severe asthma patients, and compare the differences in those parameters between bicarbonate and lactate displacement liquid.</p><p><strong>Methods: </strong>According to the random number table, 26 severe asthma patients were allocated into control group (n=10), bicarbonate group (n=8) and lactate group (n=8). Twenty-four hours treatment with mechanical ventilation (control group), mechanical ventilation + CBP (bicarbonate group) or mechanical ventilation + CBP (lactate group) were conducted respectively. Lung mechanical ventilation parameters, serum cytokine level and blood gas analysis results, arterial blood lactate, and electrolytes level were compared among groups.</p><p><strong>Results: </strong>After 24-hour CBP, the lung mechanical ventilation parameters were improved, cytokine levels were decreased, and pH value and partial pressure of oxygen were improved in bicarbonate group and lactate group. The two kinds of displacement liquid had no influence in arterial partial pressure of oxygen (PaO(2)), arterial blood lactate, and serum electrolytes level. The pH value in lactate group was higher than that in bicarbonate group (7.39±0.05 vs. 7.30±0.01, P<0.01). The arterial partial pressure of carbon dioxide (PaCO(2)) was lower in lactate group than that in bicarbonate group (57.14±5.04 mm Hg vs. 89.00±3.66 mm Hg, P<0.01).</p><p><strong>Conclusions: </strong>Combine CBP might improve the lung mechanical ventilation parameter, cytokine level and blood gas analysis more quickly in severe asthma treatment. The lactate displacement liquid improves the retention of carbon dioxide more.</p>","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"24 11","pages":"665-9"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31030187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Characteristics of the confined space accident and its medical rescue strategy].","authors":"Mao-xing Yue,&nbsp;Xi-yi Xia,&nbsp;Ying Li,&nbsp;Xiao-xing Bian,&nbsp;Qi-han Zheng,&nbsp;Jin-nan Yin,&nbsp;Xiao-cheng Zhao,&nbsp;Ai-min Cai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the characteristics of the confined space accident and its medical rescue strategy.</p><p><strong>Methods: </strong>Thirty-six patients with emergency rescue in the five confined space accident during June 2009 to July 2012 were retrospectively analyzed.</p><p><strong>Results: </strong>Twenty-nine people were caught in four confined space accidents caused by building collapse and 7 people were caught in one confined space accident caused by a tower of babel blast furnace damage which caused severe gas and hydrogen sulfide poisoning. For the 36 wounded, the shortest rescue time was 1.5 hours and the longest was 10.5 hours. Fourteen people were killed (mortality rate 38.89%). Characteristics of the confined space accident: the wounded activity environment was very harsh, the wounded were restricted particularly, the wounded injuries were diverse, the psychological depression was very common. The confined space environment and the complexity of wounded disease determined its medical rescue specificity and were very different from the usual trauma emergency.</p><p><strong>Conclusions: </strong>Confined space accident caused very painful casualties. The key reason is that the relevant personnel failed to clearly recognize the potential risks in the confined space or nearby, making the confined space into another \"quiet killer\". This problem needs to be paid highly attention.</p>","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"24 11","pages":"655-7"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31031322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical study of kidney injury molecule-1 in the treatment of sepsis patients].","authors":"Linliang Gao, Guo-fu Li, Yang Zhao, B. Zang","doi":"10.3760/CMA.J.ISSN.1003-0603.2012.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1003-0603.2012.11.003","url":null,"abstract":"OBJECTIVE\u0000To investigate the relationship between kidney injury molecule-1 (KIM-1) in urine and acute physiology and chronic health evaluation II (APACHEII) score, and the prognosis in the patients suffered from sepsis.\u0000\u0000\u0000METHODS\u0000In the perspective study, 56 patients in intensive care unit (ICU) from March 2010 to September 2011 suffered from sepsis were enrolled and treated according to the early goal-directed therapy (EGDT). The patients were divided into two groups according to the perform in EGDT or not within 6 hours (groupI, group II). Monitoring included APACHEII score, KIM-1, blood urea nitrogen (BUN) and creatinine (Cr) at before resuscitation (T0), 6 hours after resuscitation (T6 h), and 1 day (T1 d), 2 days (T2 d), 3 days (T3 d), 4 days (T4 d) and 5 days (T5 d) after ICU admission. According to the 28-day prognosis, all the patients were divided into survival group or death group.\u0000\u0000\u0000RESULTS\u0000The value of APACHEII score, urine KIM-1, BUN and Cr in groupI(n=30), decreased after fluid resuscitation and decreased to the lowest at T5 d. The value of APACHEII score, urine KIM-1, BUN and Cr in groupII(n=26), increased after failure of fluid resuscitation and increased to the highest at T5 d. The value of APACHEII score at T2 d and urine KIM-1 at T1 d in groupII were significantly higher than those in groupI (APACHEII score: 26.35±6.18 vs. 13.25±4.72, urine KIM-1: 4.721±1.432 μg/L vs. 0.909±0.325 μg/L, both P<0.05). The mortality in groupI was significantly lower than that in group II [10.0% (3/30) vs. 73.1% (19/26), P<0.05]. The value of APACHEII score, urine KIM-1, BUN and Cr in survival group (n=34) decreased with the clinical condition improved and decreased to the lowest at T5 d, while the value of APACHEII score, urine KIM-1, BUN and Cr in death group (n=22) increased and increased to the highest at T5 d. The value of APACHEII score at T1 d, and urine KIM-1 at T6 d in death group were significantly higher than those in survival group (APACHEII score:26.39±8.95 vs. 14.27±5.11, urine KIM-1:3.134±1.117 μg/L vs. 1.447±0.472 μg/L, both P<0.05).\u0000\u0000\u0000CONCLUSIONS\u0000KIM-1 in urine could be a good index for evaluation of sepsis, and it is helpful to understand the disease development by continuous surveillance. It is very important for the appraisal of prognosis, development and prognosis in sepsis, combined with APACHEII score.","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"103 1","pages":"647-50"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78642982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of PNU282987 on organ function and survival in dogs with lethal burn shock].","authors":"Ming-hua Du, Q. Hu, Hong-min Luo, Z. Lin, Li Ma, Huan Wang, Sen Hu","doi":"10.3760/CMA.J.ISSN.1003-0603.2012.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1003-0603.2012.11.004","url":null,"abstract":"OBJECTIVE\u0000To investigate the effects of PNU282987, a α7 nicotinic acetylcholine receptor agonist (α7nAChR), on organ function and survival rate in dogs with lethal burn shock.\u0000\u0000\u0000METHODS\u0000Twelve adult male Beagle dogs were subjected to 50% total body surface area (TBSA) full-thickness flame injury, and then they were randomly divided into a burn group and a PNU282987 group (PNU group), each n=6. The dogs in PNU group received PNU282987 (0.38 mg/kg, venous pumping) and the dogs in burn group received equal amount of normal saline solution as the control group. The mean arterial pressure (MAP) and the plasma levels of tumor necrosis factor-α (TNF-α), alanine aminotransferase (ALT), MB isoenzyme of creatine kinase (CK-MB), creatinine (Cr), blood urea nitrogen (BUN) were continuously determined before and 0.5, 2, 4, 8, 12, 24 hours after burn. All the above measurements were performed with animals in conscious and cooperative state. At the end of 24-hours-period experiment, the survival rate was recorded.\u0000\u0000\u0000RESULTS\u0000The MAP significantly decreased after burn compared with the baseline data before-injury. The level of MAP in PNU group were significantly higher than those of the burn group from 4 hours after burn, and it returned to 83.6% of baseline level at 24 hours. In contrast, those in the burn group progressively decreased with time till death. The plasma levels of TNF-α in PNU group were significantly lower than those of burn group at each time points post injury. The ALT, Cr, BUN and CK-MB of the burn group increased persistently, while those of the PNU group increased at first and decreased subsequently except for ALT increased persistently, and they were all significantly lower than those of the burn group till to the time point of 12 hours (ALT:51.2±7.0 U/L vs. 104.8±7.4 U/L, Cr:42.7±5.4 μmol/L vs. 88.5±4.8 μmol/L, BUN:4.9±1.2 mmol/L vs. 14.7±1.4 mmol/L, CK-MB:564.0±39.1 U/L vs. 734.0±35.9 U/L, all P<0.05). At the end of 24-hours-period experiment, the survival rate of the PNU group was 50% (3/6) and significantly higher than that of the burn group 0(0/6).\u0000\u0000\u0000CONCLUSIONS\u0000The results indicated that PNU282987 decrease the levels of inflammatory cytokine, improve the organ functions and increase 24-hour survival rate in dogs with lethal burn injury. And PNU282987 may have potential clinical application.","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"10 1","pages":"651-4"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73956716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advance in the research of the relationship between novel gaseous signal molecule-hydrogen sulfide and hepatic fibrosis].","authors":"Xiu-fen Li,&nbsp;Yong-ping Zheng,&nbsp;Lin Wu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"24 11","pages":"703-4"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31030198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Plasma D-dimer changes and prognostic implication in severe acute pancreatitis].","authors":"Hong-jun Wu,&nbsp;Rong-xia Li,&nbsp;Yi Li,&nbsp;Xue-zhong Yu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To study the role of plasma D-dimer in human severe acute pancreatitis (SAP) and its relationship with disease severity.</p><p><strong>Methods: </strong>A prospective study was performed. From February 2010 to June 2011, plasma concentration of D-dimer and the results of other routine laboratory tests were measured in 32 SAP inpatients at admission immediately and 24, 48, 72 hours after admission. Ranson scores were also recorded. The relationship between plasma concentration of D-dimer and the results of other routine laboratory tests, Ranson scores were analyzed, and so did the relationship between plasma concentration of D-dimer and severity of patient's condition.</p><p><strong>Results: </strong>(1) There were no obvious changes for plasma concentration of D-dimer and the results of other routine laboratory index in 32 SAP inpatients at each time points after admission. (2) Plasma concentration of D-dimer of SAP was positively related to white blood count (WBC), creatinine (Cr), prothrombin time (PT) and activated partial thromboplastin time (APTT) and negatively related to hematocrit (Hct), albumin and calcium (P<0.05 or P<0.01). Plasma concentration of D-dimer of SAP at 48 hours after admission had positive relationship with Ranson scores (r=0.729, P=0.001). (3) Plasma concentration of D-dimer of SAP inpatients in CT grade D, E stage were significantly higher than that in CT grade B, C stage (1.18±0.02 mg/L, 1.23±0.01 mg/L vs. 0.90±0.02 mg/L, 0.93±0.01 mg/L, all P<0.05). (4) Plasma concentration of D-dimer of SAP in inpatients with multiple organ failure (MOF) at 24 hours and 48 hours were significantly higher than that in inpatients without MOF (24 hours: 1.26±0.02 mg/L vs. 0.93±0.02 mg/L, 48 hours:1.25±0.02 mg/L vs. 0.93±0.02 mg/L, both P<0.05).</p><p><strong>Conclusion: </strong>Plasma concentration of the D-dimer is significantly increased in SAP patients, and is related to the severity. The first plasma concentration of D-dimer of SAP after admission can well reflect severity of patient's condition.</p>","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"24 11","pages":"658-61"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31031323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of dexmedetomidine assisted with brachial plexus block on stress in acute trauma patients].","authors":"Wen-li Miao,&nbsp;Yuan-xin Zhang,&nbsp;Shu-jian Hou,&nbsp;Hai-ping Tang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"24 11","pages":"683-4"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31030192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The correlation analysis between glucose level and its variability and prognosis in traumatic patients].","authors":"Zhaohui Liu, L. Su, Jingjing Wu, Jianfeng Tan, Y. Liao, Zhi-Feng Liu","doi":"10.3760/CMA.J.ISSN.1003-0603.2012.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1003-0603.2012.11.002","url":null,"abstract":"OBJECTIVE\u0000To investigate the effect of glucose level, variability on the prognosis of traumatic patients.\u0000\u0000\u0000METHODS\u0000A retrospective study involving 300 traumatic patients admitted to intensive care unit (ICU) was performed. The average glucose (GluAve), glucose standard deviation (GluSD) and glucose coefficient of variation (GluCV) during the first 72 hours were calculated. Patients were divided into survivor group (n=249) and non-survivor group (n=51) based on outcomes. The GluAve, GluSD and GluCV were compared between the two groups. Patients were allocated into five subgroups based on GluAve (3.9-5.5, 5.6-6.6, 6.7-7.7, 7.8-9.9, ≥10.0 mmol/L) as well as four subgroups on GluCV (<15%, 15%-30%, 30%-50%, >50%). The mortality in hospital was compared among the different subgroups and the different GluCV in the same level of GluAve subgroups, respectively. Multifactor logistic regression was used to determine the risk factor of hospital death.\u0000\u0000\u0000RESULTS\u0000The levels of GluAve, GIuSD, GluCV of non-survivor group were higher than those of survivor group [11.31±4.38 mmol/L vs. 8.50±3.40 mmol/L, 2.85±1.94 mmol/L vs. 1.87±1.67 mmol/L, (28.30±23.08)% vs. (20.90±13.70)%, all P<0.05]. With the gradual increment of GluAve and GluCV level, the mortality was raised accordingly (χ (2)(1)=26.332, P=0.000; χ (2)(2)=65.522, P=0.000). In the subgroup of GluAve 7.8-9.9 mmol/L, the mortality was 9.09% (3/33) with GluCV <15% versus 46.15% (6/13) with GluCV >50% (P<0.01) respectively, and in the subgroup of GluAve ≥10.0 mmol/L, the mortality corresponding rates were 21.05% (4/19) with GluCV < 15% and 61.54% (8/13) with GluCV > 50% (P<0.05). The multivariable logistic regression analysis demonstrated that GluAve and GluCV were risk factors of mortality[GluAve odds ratio (OR)=1.150, 95% confidence interval (95%CI) was 1.042 to 1.270, P=0.006; GluCV OR=1.022, 95%CI was 0.999 to 1.040, P=0.040], GluSD had no effect on mortality.\u0000\u0000\u0000CONCLUSIONS\u0000The increase in GluAve and GluCV in traumatic patients are significantly correlated with mortality. Control the level and the variability of blood glucose might be an important aspect of the multiple trauma death reduction.","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"27 1","pages":"643-6"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78503304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical study of value of transcranial Doppler ultrasonography in diagnosing brain death in severe craniocerebral injury].","authors":"Li Wang, Mu Li, Yong-qiang Wang, Xue-quan Feng, Rui Liu, Wei Li, Z. Feng","doi":"10.3760/CMA.J.ISSN.1003-0603.2012.11.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1003-0603.2012.11.010","url":null,"abstract":"OBJECTIVE\u0000To assess the clinical value of transcranial Doppler(TCD) ultrasonography in diagnosing brain death in patients with severe craniocerebral injury.\u0000\u0000\u0000METHODS\u0000Forty patients of severe craniocerebral injury defined by a scene Glasgow coma scale(GCS)≤8, admitted to Department of Neurosurgery of First Central Clinical Hospital of Tianjin Medical University, were divided into two groups based upon the prognosis: the death group(n=15) and the survival group (n=25). All patients were examined dynamically by TCD, and the occurrence of retrograde diastolic flow (RDF) and mean velocity (Vm) of middle cerebral arteries (MCA) were measured as well as the pulse index (PI).\u0000\u0000\u0000RESULTS\u0000In the survival group, 3 showed partial RDF which was found within 24 hours after injury, and the duration was short lasting for no more than 12 hours, and the RDF wave disappeared very quickly after treatment of drug or operation. These patients were in persistent vegetative state with Glasgow outcome score (GOS) 2, having been followed up for 6 months. In the death group, 12 showed fully RDF, 2 showed very small systolic spike. The characteristic change of 14 patients' cerebral hemodynamics took place 6-40 hours before clinical brain death. Compared with survival group, Vm of MCA was significantly decreased (20.07±13.97 cm/s vs. 56.72±16.87 cm/s), the value of PI was significantly increased (3.95±3.51 vs. 1.25±1.06), and the occurrence of RDF was also elevated (93.3% vs. 12.0%) in the death group, the differences were statistically significant (P<0.05 or P<0.01).\u0000\u0000\u0000CONCLUSION\u0000TCD with the advantages of easy and bedside operation, noninvasiveness, no disturbance from sedatives and repeatability in cerebral hemodynamic examination is of great clinic practical value in early diagnosing brain death in patients with severe cranial injury.","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"46 1","pages":"670-3"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72943607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of ulinastatin in traumatic brain injury with multiple injuries].","authors":"Yue Tu,&nbsp;Yun-feng Diao,&nbsp;Xi-ping Yang,&nbsp;Hong-tao Sun,&nbsp;Sai Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of ulinastatin (UTI) in traumatic brain injury (TBI) with multiple injuries.</p><p><strong>Methods: </strong>A prospective analysis of TBI patients with multiple injuries was performed. Sixty cases of cranial trauma with multiple injuries patients were randomly divided into two groups. There were 28 cases in control group while 32 cases in treatment group. Control group underwent conventional treatment while intravenous infusion of UTI was performed in treatment group. The dose of UTI was 200 kU every 8 hours. Patients' intracranial cerebral pressure (ICP) were monitored at admission and 10 days after treatment. At the same time levels of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), aspartate amino transfer enzymes (AST), creatinine (Cr), blood urea nitrogen (BUN), tumor necrosis factor-α (TNF-α), interleukin (IL-2, IL-6) were detected.</p><p><strong>Results: </strong>ICP was down trend after treatment in UTI group, but there was no statistical difference compared with the control group. Hepatic and renal function and inflammation factor levels were significantly decreased in both groups. WBC, CRP, PCT, ALT, AST, Cr, BUN, TNF-α, IL-2, IL-6 were significantly lower in UTI group than those in control group (WBC:12.3±4.5×10(9)/L vs. 15.9±6.3×10(9)/L, CRP:46.12±11.47 mg/L vs. 64.24±18.31 mg/L, PCT:4.51±1.27 μg/L vs. 10.51±4.27 μg/L, ALT:47.26±8.23 U/L vs. 60.94±8.39 U/L, AST:42.67±7.63 U/L vs. 68.51±10.17 U/L, Cr:79.62±15.36 μmol/L vs. 102.36±16.82 μmol/L, BUN:6.35±2.36 mmol/L vs. 8.39±1.67 mmol/L, TNF-α:93.6±31.5 μg/L vs. 195.8±23.9 μg/L, IL-2:12.3±4.5 μg/L vs. 15.9±6.3 μg/L, IL-6:52.36±12.46 μg/L vs. 69.34±26.13 μg/L, all P<0.05). The incidence of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in UTI group were significantly lower than those in control group (21.88% vs. 46.43%, 9.38% vs. 28.57%, both P<0.05).</p><p><strong>Conclusion: </strong>Application of UTI treatment in TBI with multiple trauma patients can potentially protect the brain, liver and other organ function, thus significantly reduce incidence rate of SIRS and MODS by reducing the release of inflammatory mediators and systemic reaction to the trauma invasion.</p>","PeriodicalId":23992,"journal":{"name":"Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue","volume":"24 11","pages":"677-9"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31030190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}