Blood transfusion.
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Blood Loss, Surgical↗
Biomedical subjects
Narong Kulvatunyou
Publications and source records attributed to Narong Kulvatunyou.
Care of the injured Jehovah's Witness patient: case report and review of the literature.
Care for the Jehovah's Witness patient can be a challenge and often a dilemma to clinicians because of the patient's religious beliefs and teachings against receiving blood and blood products, especially in emergency or trauma settings. We present a case of a severely injured elderly Jehovah's Witness patient who survived. We also review the literature and offer an organized approach to care for such patients.
Accidents, Traffic↗
Mononuclear cell function and energetics in early traumatic injury.
BACKGROUND: The reason for increased infectious complications after traumatic injury is complex and incompletely understood. We propose a relationship between the energetic state of circulating immune cells and immune cell function in traumatic injury. To examine this relationship, cellular adenosine triphosphate (ATP) concentration and cellular functions were measured in peripheral blood mononuclear cells from trauma patients and normal subjects. MATERIALS AND METHODS: Mononuclear cells were isolated within 24 h of injury from trauma patients without (n = 12) or with (n = 10) hypotension (groups 1 and 2, respectively), and a group of normal control subjects (group 3, n = 13). Mononuclear cells were assayed for ATP levels using bioluminescence. Phagocytosis was quantified via flow cytometry after ingestion of fluorescent microspheres and phagocytic index (PI) was calculated (average number of particles ingested per monocyte). Protein synthesis was quantified using incorporation of (35)S-labeled methionine into cultured cells. Comparisons between groups were performed using one-way analysis of variance (ANOVA) with adjustment for multiple comparisons. RESULTS: All but one trauma patient suffered blunt injury. There were significantly more transfusions in group 2 (hypotensive) patients (p = 0.0005). Nosocomial infections, length of stay (LOS), and mortality did not differ between groups 1 and 2. Concentrations of ATP and PI in both groups of traum a patients did not significantly differ from controls. In hypotensive trauma patients, increased duration of hypotension was associated with increased mononuclear cell ATP levels (r(2) = 0.227). A negative correlation between PI and ATP levels in trauma patients was discovered. Incorporation of (35)S was significantly greater in normotensive trauma patients than controls. CONCLUSION: Mononuclear cell ATP levels and measured functions are preserved in early traumatic injury.
Adenosine Triphosphate↗
Internal jugular vein and anatomic relationship at the root of the neck.
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Catheterization, Peripheral↗
A subclavian artery injury, secondary to internal jugular vein cannulation, is a predictable right-sided phenomenon.
IMPLICATIONS: Internal jugular vein cannulation is a frequently performed procedure. We present a case with a review of the literatures of subclavian artery injury secondary to this procedure, recognizing that this complication may be a right-sided phenomenon secondary to its unique anatomical layout.
Aged↗