Double Blinded Randomized Controlled Trial: Does Hypertonic Saline Resuscitation in Trauma Following Damage Control Laparotomy
Abstract
Damage control laparotomy (DCL) has emerged as the standard of care for trauma patients requiring operative control of intra-abdominal and retroperitoneal injury. This advancement, which allows for the management of patients with previously lethal levels of hypothermia, acidosis, and coagulopathy, has also forced physicians to become comfortable with the management of an open abdomen. Despite advances in the recognition of IAH/ACS and implementation of a multitude of devices for temporary abdominal closure (TAC) as many as 30% of patients will fail to achieve primary fascial closure (PFC).While the morbidity associated with the management of an open abdomen poses one threat, the trauma patient that has received a DCL is also susceptible to the effects of a massive inflammatory reaction and associated multifactorial edema; a risk factor for developing multiple organ dysfunction syndrome (MODS). A variety of intravascular fluids have been investigated for their therapeutic effects against activation of neutrophils and the inflammatory cascade to improve clinical outcomes. From these investigations it has been shown that HTS is superior to lactated ringers solution (LR), and normal saline solution (NSS) at reducing neutrophil activation, apoptosis, bowel edema, and expression of inflammatory cytokines both in-vitro and in-vivo.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 23, 2019
- Accession Number
- AD1101279
Entities
People
- Valerie Sams
Organizations
- 59th Medical Wing