Sepsis is a major cause of mortality and morbidity in the trauma patient. Sepsis following traumatic injury is related to the type of injury, together with the extent of injury and the anatomical location. Burn injuries are associated with the highest risk of sepsis. The diagnosis of sepsis in the trauma patient remains difficult. Interpretation of abnormal results is key to successful diagnosis, particularly in conjunction with clinical findings. This review will consider the specific features of sepsis in the context of trauma relating to epidemiology, risk factors, diagnosis and management.
Interpretation of diagnostic data: 5. How to do it with simple maths. Can Med Assoc J. (1983). 129: 947-54.
2.
Aas JA, Paster BJ, Stokes LN, Olsen I., Dewhirst FE2005. Defining the normal bacterial flora of the oral cavity . J Clin Microbiol43: 5721-32.
3.
Adamik B., Zimecki M., Wlaszczyk A., Kubler A.1997a. Immunological status of septic and trauma patients. I. High tumor necrosis factor alpha serum levels in septic and trauma patients are not responsible for increased mortality; a prognostic value of serum interleukin 6. Arch Immunol Ther Exp (Warsz) 45: 169-75.
4.
Adamik B., Zimecki M., Wlaszczyk A., Kubler A.1997b. Immunological status of septic and trauma patients. II. Proliferative response and production of interleukin 6 and tumor necrosis factor alpha by peripheral blood mononuclear cells from septic survivor, nonsurvivor and trauma patients: a correlation with the survival rate. Arch Immunol Ther Exp (Warsz) 45: 277-84.
5.
Adams JM, Hauser CJ, Livingston DH, Lavery RF, Fekete Z., Deitch EA2001. Early trauma polymorphonuclear neutrophil responses to chemokines are associated with development of sepsis, pneumonia, and organ failure. J Trauma51: 452-6; discussion 456-57.
6.
Ahmad R., Cherry RA, Lendel I., et al. 2007. Increased hospital morbidity among trauma patients with diabetes mellitus compared with age- and injury severity score-matched control subjects. Arch Surg142: 613-18.
7.
Allen GS, Moore FA, Cox Jr CS, Wilson JT, Cohn JM, Duke JH1998. Hollow visceral injury and blunt trauma. J Trauma45: 69-75; discussion 75-78.
8.
American College of Chest Physicians/ Society of Critical Care Medicine.1992. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med20: 864-74.
9.
Anderson RN, Smith BL2003. Deaths: leading causes for 2001. Natl Vital Stat Rep52: 186.
10.
Angele MK, Ayala A., CioffI WG, Bland KI, Chaudry IH1998a. Testosterone: the culprit for producing splenocyte immune depression after trauma hemorrhage. Am J Physiol274: C1530-6.
11.
Angele MK, Ayala A., Monfils BA, Cioffi WG, Bland KI, Chaudry IH1998b. Testosterone and/or low estradiol: normally required but harmful immunologically for males after trauma-hemorrhage. J Trauma44: 78-85.
12.
Angele MK, Catania RA, Ayala A., Cioffi WG, Bland KI, Chaudry IH1998c. Dehydroepiandrosterone: an inexpensive steroid hormone that decreases the mortality due to sepsis following trauma-induced hemorrhage . Arch Surg133: 1281-8.
13.
Angele MK, Wichmann MW, Ayala A., Cioffi WG, Chaudry IH1997. Testosterone receptor blockade after hemorrhage in males. Restoration of the depressed immune functions and improved survival following subsequent sepsis. Arch Surg132: 1207-14.
14.
Angle N., Cabello-Passini R., Hoyt DB, et al. 2000. Hypertonic saline infusion: can it regulate human neutrophil function? Shock14: 503-8.
15.
Angle N., Hoyt DB, Coimbra R., et al. 1998. Hypertonic saline resuscitation diminishes lung injury by suppressing neutrophil activation after hemorrhagic shock. Shock9: 164-70.
16.
Appelgren P., Bjornhagen V., Bragderyd K., Jonsson CE, Ransjo U.2002. A prospective study of infections in burn patients . Burns28: 39-46.
17.
Assicot M., Gendrel D., Carsin H., Raymond J., Guilbaud J., Bohuon C.1993. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet341: 515-8.
18.
Baker CC, Oppenheimer L., Stephens B., Lewis FR, Trunkey DD1980. Epidemiology of trauma deaths. Am J Surg140: 144-50.
19.
Barati M., Alinejad F., Bahar MA, et al. 2008. Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns34: 770-4.
20.
Barber RC, Aragaki CC, Chang LY, et al. 2007. CD14-159 C allele is associated with increased risk of mortality after burn injury. Shock27: 232-7.
21.
Barber RC, Chang LY, Arnoldo BD, et al. 2006. Innate immunity SNPs are associated with risk for severe sepsis after burn injury. Clin Med Res4: 250-5.
22.
Bargues L., Chancerelle Y., Catineau J., Jault P., Carsin H.2007. Evaluation of serum procalcitonin concentration in the ICU following severe burn. Burns33: 860-4.
23.
Barie PS2000. Importance, morbidity, and mortality of pneumonia in the surgical intensive care unit. Am J Surg179: 2S-7S.
24.
Bartholomew CF, Jones AM2006. Human bites: a rare risk factor for HIV transmission . AIDS20: 631-2.
25.
Bashir MM, Abu-Zidan FM2003. Damage control surgery for abdominal trauma. Eur J Surg Suppl588: 8-13.
26.
Behar DM, Edelshtein S., Ben-Ami H., Mansano R., Edoute Y.2000. Human bite on penile shaft from oral sex as a portal of entry for streptococcal toxic shock syndrome. Isr Med Assoc J2: 945-7.
27.
Bickell WH, Wall Jr MJ, Pepe PE, et al. 1994. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med331: 1105-9.
28.
Bik EM, Eckburg PB, Gill SR, et al. 2006. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci U S A103: 732-7.
29.
Billeter A., Turina M., Seifert B., Mica L., Stocker R., Keel M.2009. Early serum procalcitonin, interleukin-6, and 24-hour lactate clearance: useful indicators of septic infections in severely traumatized patients. World J Surg33: 558-66.
30.
Billy LJ, Amato JJ, Rich NM1971. Aortic injuries in Vietnam. Surgery70: 385-91.
31.
Blocksom JM, Tyburski JG, Sohn RL, et al. 2004. Prognostic determinants in duodenal injuries . Am Surg70: 248-55; discussion 255.
32.
Bochicchio GV, Napolitano LM, Joshi M., et al. 2002. Persistent systemic inflammatory response syndrome is predictive of nosocomial infection in trauma. J Trauma53: 245-50; discussion 250-51.
33.
Bochicchio GV, Napolitano LM, Joshi M., Mccarter Jr RJ, Scalea TM2001. Systemic inflammatory response syndrome score at admission independently predicts infection in blunt trauma patients. J Trauma50: 817-20.
34.
Bochicchio GV, Salzano L., Joshi M., Bochicchio K., Scalea TM2005a. Admission preoperative glucose is predictive of morbidity and mortality in trauma patients who require immediate operative intervention . Am Surg71: 171-74.
35.
Bochicchio GV, Sung J., Joshi M., et al. 2005b. Persistent hyperglycemia is predictive of outcome in critically ill trauma patients. J Trauma58: 921-24.
36.
Bowles BJ, Roth B., Demetriades D.2003. Sexual dimorphism in trauma? A retrospective evaluation of outcome. Injury34: 27-31.
37.
Brunner M., Krenn C., Roth G., et al. 2004. Increased levels of soluble ST2 protein and IgG1 production in patients with sepsis and trauma. Intensive Care Med30: 1468-73.
38.
Bubenik O., Meakins JL, Mclean AP1980. Delayed perforation of the colon in blunt abdominal trauma . Can J Surg23: 473-75.
39.
Bulger EM, Cuschieri J., Warner K., Maier RV2007. Hypertonic resuscitation modulates the inflammatory response in patients with traumatic hemorrhagic shock. Ann Surg245: 635-41.
40.
Bulger EM, Jurkovich GJ, Nathens AB, et al. 2008. Hypertonic resuscitation of hypovolemic shock after blunt trauma: a randomized controlled trial. Arch Surg143: 139-48; discussion 149.
41.
Calder PC2003. Long-chain n-3 fatty acids and inflammation: potential application in surgical and trauma patients. Braz J Med Biol Res36: 433-46.
42.
Carsin H., Assicot M., Feger F., et al. 1997. Evolution and significance of circulating procalcitonin levels compared with IL-6, TNF alpha and endotoxin levels early after thermal injury. Burns23: 218-24.
43.
Casali M., Di Saverio S., TugnolI G., et al. 2008. Penetrating abdominal trauma: 20 years experience in a Western European Trauma Center. Ann Ital Chir79: 399-407.
44.
Castelli GP, Pognani C., Cita M., Paladini R.2009. Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma. Crit Care Med37: 1845-9.
45.
Castelli GP, Pognani C., Cita M., Stuani A., Sgarbi L., Paladini R.2006. Procalcitonin, C-reactive protein, white blood cells and SOFA score in ICU: diagnosis and monitoring of sepsis. Minerva Anestesiol72: 69-80.
46.
Castelli GP, Pognani C., Meisner M., Stuani A., Bellomi D., Sgarbi L.2004. Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Crit Care8: R234-42.
47.
Claridge JA, Edwards NM, Swanson J., et al. 2007. Aerosolized ceftazidime prophylaxis against ventilator-associated pneumonia in high-risk trauma patients: results of a double-blind randomized study. Surg Infect ( Larchmt) 8: 83-90.
48.
Cohen J.2002. The immunopathogenesis of sepsis. Nature420: 885-91.
49.
Cumming J., Purdue GF, Hunt JL, O’keefe GE2001. Objective estimates of the incidence and consequences of multiple organ dysfunction and sepsis after burn trauma. J Trauma50: 510-15.
50.
Danino AM, Malka G.2004. A lethal necrotizing fasciitis after human bite . Plast Reconstr Surg113: 2234-35.
51.
Davies JM, Barnes R., Milligan D.2002. Update of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Clin Med2: 440-43.
52.
Dellinger EP, Oreskovich MR, Wertz MJ, Hamasaki V., Lennard ES1984. Risk of infection following laparotomy for penetrating abdominal injury. Arch Surg119: 20-27.
53.
Dendle C., Looke D.2008. Review article: Animal bites: an update for management with a focus on infections. Emerg Med Australas20: 458-67.
54.
De Werra I., Jaccard C., Corradin SB, et al. 1997. Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations: Comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia. Crit Care Med25: 607-13.
55.
Dhar SA, Bhat MI, Mustafa A., et al. 2008. ‘Damage control orthopaedics’ in patients with delayed referral to a tertiary care center: experience from a place where Composite Trauma Centers do not exist. J Trauma Manag Outcomes2: 2.
56.
Dissanaike S., Pham T., Shalhub S., et al. 2008. Effect of immediate enteral feeding on trauma patients with an open abdomen: protection from nosocomial infections. J Am Coll Surg207: 690-97.
57.
Dorshkind K., Montecino-Rodriguez E., Signer RA2009. The ageing immune system: is it ever too old to become young again?Nat Rev Immunol9: 57-62.
58.
Douzinas EE, Pitaridis MT, Louris G., et al. 2000. Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins. Crit Care Med28: 8-15.
59.
Dunne JR, Riddle MS, Danko J., Hayden R., Petersen K.2006. Blood transfusion is associated with infection and increased resource utilization in combat casualties. Am Surg72: 619-25; discussion 625-26.
60.
Dutton RP, Mackenzie CF, Scalea TM2002. Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. J Trauma52: 1141-46.
61.
Effros RB2003. Genetic alterations in the ageing immune system: impact on infection and cancer. Mech Ageing Dev124: 71-77.
62.
Egger G., Burda A., Mitterhammer H., Baumann G., Bratschitsch G., Glasner A.2003. Impaired blood polymorphonuclear leukocyte migration and infection risk in severe trauma. J Infect47: 148-54.
63.
El-Masri MM, Joshi M., Hebden J., Korniewicz DM2002. Use of the injury severity score to predict nosocomial bloodstream infections among critically ill trauma patients. AACN Clin Issues13: 367-72.
64.
Engel JM, Welters I., Rupp M., et al. 2001. Influence of colloid fluids on polymorphonuclear granulocyte function in vivo. Acta Anaesthesiol Scand45: 385-89.
65.
Ertel W., Eid K., Keel M., Trentz O.2000. Therapeutical strategies and outcome of polytraumatized patiemnts with pelvic injuries. Eur J Trauma26: 278-86.
66.
Finfer S., Chittock DR, Su SY, et al. 2009. Intensive versus conventional glucose control in critically ill patients. N Engl J Med360: 1283-97.
67.
Fischer JE, Bachmann LM, Jaeschke R.2003. A readers’ guide to the interpretation of diagnostic test properties: clinical example of sepsis. Intensive Care Med29: 1043-51.
68.
Frantz MC, Prix NJ, Wichmann MW, et al. 2005. Dehydroepiandrosterone restores depressed peripheral blood mononuclear cell function following major abdominal surgery via the estrogen receptors. Crit Care Med33: 1779-86.
69.
Friese RS, Sperry JL, Phelan HA, Gentilello LM2008. The use of leukoreduced red blood cell products is associated with fewer infectious complications in trauma patients. Am J Surg196: 56-61.
70.
Giannoudis PV, Smith MR, Evans RT, Bellamy MC, Guillou PJ1998a. Serum CRP and IL-6 levels after trauma. Not predictive of septic complications in 31 patients. Acta Orthop Scand69: 184-88.
71.
Giannoudis PV, Smith RM, Banks RE, Windsor AC, Dickson RA, Guillou PJ1998b. Stimulation of inflammatory markers after blunt trauma . Br J Surg85: 986-90.
72.
Gomez CR, Nomellini V., Faunce DE, Kovacs EJ2008. Innate immunity and aging. Exp Gerontol43: 718-28.
73.
Gomez R., O’keeffe T., Chang LY, Huebinger RM, Minei JP, Barber RC2009. Association of mitochondrial allele 4216C with increased risk for complicated sepsis and death after traumatic injury. J Trauma66: 850-57; discussion 857-58.
74.
Griffiths RD, Allen KD, Andrews FJ, Jones C.2002. Infection, multiple organ failure, and survival in the intensive care unit: influence of glutamine-supplemented parenteral nutrition on acquired infection. Nutrition18: 546-52.
75.
Gustilo RB, Anderson JT1976. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am58: 453-58.
76.
Harwood PJ, Giannoudis PV, Van Griensven M., Krettek C., Pape HC2005. Alterations in the systemic inflammatory response after early total care and damage control procedures for femoral shaft fracture in severely injured patients. J Trauma58: 446-52; discussion 452-54.
77.
Hensler T., Sauerland S., Lefering R., et al. 2003. The clinical value of procalcitonin and neopterin in predicting sepsis and organ failure after major trauma. Shock20: 420-26.
78.
Hotchkiss RS, Schmieg Jr RE, Swanson PE, et al. 2000. Rapid onset of intestinal epithelial and lymphocyte apoptotic cell death in patients with trauma and shock. Crit Care Med28: 3207-17.
79.
Huber-Wagner S., Qvick M., Mussack T., et al. 2007. Massive blood transfusion and outcome in 1062 polytrauma patients: a prospective study based on the Trauma Registry of the German Trauma Society. Vox Sang92: 69-78.
80.
Jackson MR, Olson DW, Beckett Jr WC, Olsen SB, Robertson FM1992. Abdominal vascular trauma: a review of 106 injuries . Am Surg58: 622-26.
81.
Jaeger K., Heine J., Ruschulte H., et al. 2001. Effects of colloidal resuscitation fluids on the neutrophil respiratory burst. Transfusion41: 1064-68.
82.
Jamulitrat S., Narong MN, Thongpiyapoom S.2002. Trauma severity scoring systems as predictors of nosocomial infection. Infect Control Hosp Epidemiol23: 268-73.
83.
Jerassy Z., Yinnon AM, Mazouz-Cohen S., et al. 2006. Prospective hospital-wide studies of 505 patients with nosocomial bacteraemia in 1997 and 2002. J Hosp Infect62: 230-36.
84.
Jones SE2007. The marine microbial world: a voyage of discovery . ISME J1: 469-70.
85.
Kanafani ZA, Kara L., Hayek S., Kanj SS2003. Ventilator-associated pneumonia at a tertiary-care center in a developing country: incidence, microbiology, and susceptibility patterns of isolated microorganisms. Infect Control Hosp Epidemiol24: 864-69.
86.
Kao LS, Todd SR, Moore FA2006. The impact of diabetes on outcome in traumatically injured patients: an analysis of the National Trauma Data Bank. Am J Surg192: 710-14.
87.
Kennedy MT, Higgins BD, Costello JF, Curtin WA, Laffey JG2008. Hypertonic saline reduces inflammation and enhances the resolution of oleic acid induced acute lung injury. BMC Pulm Med8: 9.
88.
Kirton OC, O’neill PA, Kestner M., Tortella BJ2000. Perioperative antibiotic use in high-risk penetrating hollow viscus injury: a prospective randomized, double-blind, placebo-control trial of 24 hours versus 5 days. J Trauma49: 822-32.
89.
Knoferl MW, Angele MK, Diodato MD, et al. 2002. Female sex hormones regulate macrophage function after trauma-hemorrhage and prevent increased death rate from subsequent sepsis . Ann Surg235: 105-12.
90.
Knoferl MW, Jarrar D., Angele MK, et al. 2001. 17 beta-Estradiol normalizes immune responses in ovariectomized females after trauma-hemorrhage. Am J Physiol Cell Physiol281: C1131-38.
91.
Laird AM, Miller PR, Kilgo PD, Meredith JW, Chang MC2004. Relationship of early hyperglycemia to mortality in trauma patients. J Trauma56: 1058-62.
92.
Lamagni TL, Darenberg J., Luca-Harari B., et al. 2008. Epidemiology of severe Streptococcus pyogenes disease in Europe. J Clin Microbiol46: 2359-67. Lavrentieva A., Kontakiotis T., Lazaridis L., et al. 2007. Inflammatory markers in patients with severe burn injury. What is the best indicator of sepsis?Burns33: 189-94.
93.
Lee S., Gura KM, Kim S., Arsenault DA, Bistrian BR, Puder M.2006. Current clinical applications of omega-6 and omega-3 fatty acids. Nutr Clin Pract, 21: 323-41.
94.
Lever A., Mackenzie I.2007. Sepsis: definition, epidemiology, and diagnosis . BMJ335: 879-83.
95.
Lim PL2005. Wound infections in tsunami survivors: a commentary . Ann Acad Med Singapore34: 582-85.
96.
Macbean CE, Taylor DM, Ashby K.2007. Animal and human bite injuries in Victoria, 1998-2004 . Med J Aust186: 38-40.
97.
Mackenzie I., Lever A.2007. Management of sepsis. BMJ, 335: 929-32.
98.
Mattox KL, Maningas PA, Moore EE, et al. 1991. Prehospital hypertonic saline/dextran infusion for post-traumatic hypotension. The U.S.A. Multicenter Trial. Ann Surg213: 482-91.
99.
Meisner M., Adina H., Schmidt J.2006. Correlation of procalcitonin and C-reactive protein to inflammation, complications, and outcome during the intensive care unit course of multiple-trauma patients. Crit Care10: R1.
100.
Meisner M., Lohs T., Huettemann E., Schmidt J., Hueller M., Reinhar TK2001. The plasma elimination rate and urinary secretion of procalcitonin in patients with normal and impaired renal function. Eur J Anaesthesiol18: 79-87.
101.
Meisner M., Schmidt J., Huttner H., Tschaikowsky K.2000. The natural elimination rate of procalcitonin in patients with normal and impaired renal function. Intensive Care Med26: S212-16.
102.
Menges T., Engel J., Welters I., et al. 1999. Changes in blood lymphocyte populations after multiple trauma: association with posttraumatic complications. Crit Care Med27: 733-40.
103.
Menges T., Konig IR, Hossain H., et al. 2008. Sepsis syndrome and death in trauma patients are associated with variation in the gene encoding tumor necrosis factor. Crit Care Med36: 1456-62.
104.
Merrison AF, Chidley KE, Dunnett J., Sieradzan KA2002. Wound botulism associated with subcutaneous drug use. BMJ325: 1020-21.
105.
Moinard C., Caldefie-Chezet F., Walrand S., Vasson MP, Cynober L.2002. Evidence that glutamine modulates respiratory burst in stressed rat polymorphonuclear cells through its metabolism into arginine . Br J Nutr88: 689-95.
106.
Moore EE, Dunn EL, Moore JB, Thompson JS1981. Penetrating abdominal trauma index. J Trauma21: 439-45.
107.
Moore EE, Jones TN1986. Benefits of immediate jejunostomy feeding after major abdominal trauma- a prospective, randomized study. J Trauma26: 874-81.
108.
Mostafa G., Huynh T., Sing RF, Miles WS, Norton HJ, Thomason MH2002. Gender-related outcomes in trauma. J Trauma53: 430-34; discussion 434-35.
109.
Moyer VA, Kennedy KA2003. Understanding and using diagnostic tests. Clin Perinatol30: 189-204.
110.
Muckart DJ, Bhagwanjee S.1997. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definitions of the systemic inflammatory response syndrome and allied disorders in relation to critically injured patients . Crit Care Med25: 1789-95.
111.
Murray CK2008. Infectious disease complications of combat-related injuries . Crit Care Med36: S358-64.
112.
Napolitano LM, Greco ME, Rodriguez A., Kufera JA, West RS, Scalea TM2001. Gender differences in adverse outcomes after blunt trauma . J Trauma50: 274-80.
113.
Nassif LS, Repka JC, Nassif AC, Branco Filho AJ, Olandoski M.2004. Effects of splenectomy on peritonitis produced by a colonic injury: study in rats. Rev Assoc Med Bras50: 268-71.
114.
Neidhardt R., Keel M., Steckholzer U., et al. 1997. Relationship of interleukin-10 plasma levels to severity of injury and clinical outcome in injured patients. J Trauma42: 863-70; discussion 870-71.
115.
Nicholas JM, Rix EP, Easley KA, et al. 2003. Changing patterns in the management of penetrating abdominal trauma: the more things change, the more they stay the same. J Trauma55: 1095-108; discussion 1108-10.
116.
Nichols RL, Smith JW, Klein DB, et al. 1984. Risk of infection after penetrating abdominal trauma. N Engl J Med311: 1065-70.
117.
Noonburg GE2005. Management of extremity trauma and related infections occurring in the aquatic environment. J Am Acad Orthop Surg13: 243-53.
118.
Nylen ES, Al Arifi A., Becker KL, Snider Jr RH, Alzeer A.1997. Effect of classic heatstroke on serum procalcitonin . Crit Care Med25: 1362-65.
119.
Oberholzer A., Keel M., Zellweger R., Steckholzer U., Trentz O., Ertel W.2000. Incidence of septic complications and multiple organ failure in severely injured patients is sex specific. J Trauma48: 932-37.
120.
O’connor E., Venkatesh B., Mashongonyika C., Lipman J., Hall J., Thomas P.2004. Serum procalcitonin and C-reactive protein as markers of sepsis and outcome in patients with neurotrauma and subarachnoid haemorrhage . Anaesth Intensive Care32: 465-70.
121.
Oehler RL, Velez AP, Mizrachi M., Lamarche J., Gompf S.2009. Bite-related and septic syndromes caused by cats and dogs . Lancet Infect Dis9: 439-47.
122.
O’keefe GE, Hybki DL, Munford RS2002. The G-A single nucleotide polymorphism at the -308 position in the tumor necrosis factor-alpha promoter increases the risk for severe sepsis after trauma. J Trauma52: 817-25; discussion 825-26.
123.
Offner PJ, Moore EE, Biffl WL, Johnson JL, Silliman CC2002. Increased rate of infection associated with transfusion of old blood after severe injury. Arch Surg, 137: 711-16; discussion 716-17.
124.
Osborn TM, Tracy JK, Dunne JR, Pasquale M., Napolitano LM2004. Epidemiology of sepsis in patients with traumatic injury . Crit Care Med32: 2234-40.
125.
Ozturk H., Onen A., Otcu S., et al. 2003. Diagnostic delay increases morbidity in children with gastrointestinal perforation from blunt abdominal trauma. Surg Today33: 178-82.
126.
Pachter HL, Guth AA, Hofstetter SR, Spencer FC1998. Changing patterns in the management of splenic trauma: the impact of nonoperative management. Ann Surg227: 708-17; discussion 717-19.
127.
Palmieri TL, Caruso DM, Foster KN, et al. 2006. Effect of blood transfusion on outcome after major burn injury: a multicenter study. Crit Care Med34: 1602-07.
128.
Pape HC, Hildebrand F., Pertschy S., et al. 2002. Changes in the management of femoral shaft fractures in polytrauma patients: from early total care to damage control orthopedic surgery. J Trauma53: 452-61; discussion 461-62.
129.
Papia G., Mclellan BA, El-Helou P., et al. 1999. Infection in hospitalized trauma patients: incidence, risk factors, and complications. J Trauma47: 923-27.
130.
Pascual JL, Ferri LE, Seely AJ, et al. 2002. Hypertonic saline resuscitation of hemorrhagic shock diminishes neutrophil rolling and adherence to endothelium and reduces in vivo vascular leakage. Ann Surg236: 634-42.
131.
Peden M.2004. World report on road traffic injury prevention: summary . World Health Organization: Geneva .
132.
Peden M., Mcgee K., Sharma G.2002. The injury chart book: a graphical overview of the burden of injuries. World Health Organization: Geneva.
133.
Pei Z., Bini EJ, Yang L., Zhou M., Francois F., Blaser MJ2004. Bacterial biota in the human distal esophagus. Proc Natl Acad Sci U S A, 101: 4250-55.
134.
Petersen K., Riddle MS, Danko JR, et al. 2007. Trauma-related infections in battlefield casualties from Iraq. Ann Surg245: 803-11.
135.
Polk Jr HC, Cheadle WG, Livingston DH, et al. 1992. A randomized prospective clinical trial to determine the efficacy of interferon-gamma in severely injured patients. Am J Surg163: 191-96.
136.
Prelog M.2006. Aging of the immune system: a risk factor for autoimmunity ? Autoimmun Rev5: 136-39.
137.
Reller ME, Douce RW, Maslanka SE, Torres DS, Manock SR, Sobel J.2006. Wound botulism acquired in the Amazonian rain forest of Ecuador. Am J Trop Med Hyg74: 628-31.
138.
Rhee P., Wang D., Ruff P., et al. 2000. Human neutrophil activation and increased adhesion by various resuscitation fluids. Crit Care Med28: 74-78.
139.
Rizoli SB, Rhind SG, Shek PN, et al. 2006. The immunomodulatory effects of hypertonic saline resuscitation in patients sustaining traumatic hemorrhagic shock: a randomized, controlled, double-blinded trial. Ann Surg243: 47-57.
140.
Sadjadi J., Cureton EL, Twomey P., Victorino GP2009. Transfusion, not just injury severity, leads to posttrauma infection: a matched cohort study. Am Surg75: 307-12.
141.
Samy TS, Knoferl MW, Zheng R., Schwacha MG, Bland KI, Chaudry IH2001. Divergent immune responses in male and female mice after trauma-hemorrhage: dimorphic alterations in T lymphocyte steroidogenic enzyme activities. Endocrinology142: 3519-29.
142.
Sands KE, Bates DW, Lanken PN, et al. 1997. Epidemiology of sepsis syndrome in 8 academic medical centers. JAMA278: 234-40.
143.
Sangrasi AK, Leghari AA, Memon A., Talpur AK, Qureshi GA, Memon JM2008. Surgical site infection rate and associated risk factors in elective general surgery at a public sector medical university in Pakistan . Int Wound J5: 74-78.
144.
Sarani B., Dunkman WJ, Dean L., Sonnad S., Rohrbach JI, Gracias VH2008. Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection. Crit Care Med36: 1114-18.
145.
Sauaia A., Moore FA, Moore EE, et al. 1995. Epidemiology of trauma deaths: a reassessment . J Trauma38: 185-93.
146.
Schweizer W., Bohlen L., Dennison A., Blumgart LH1992. Prospective study in adults of splenic preservation after traumatic rupture. Br J Surg79: 1330-33.
147.
Sena MJ, Utter GH, Cuschieri J., et al. 2008. Early supplemental parenteral nutrition is associated with increased infectious complications in critically ill trauma patients. J Am Coll Surg207: 459-67.
148.
Shen XJ, Xue XC, Wang Y., et al. 2009. Predictors of mortality in critically multiple trauma patients after damage control surgery. Zhonghua Wai Ke Za Zhi47: 755-57.
149.
Sherry RM, Cue JI, Goddard JK, Parramore JB, Dipiro JT1996. Interleukin-10 is associated with the development of sepsis in trauma patients. J Trauma40: 613-16; discussion 616-17.
150.
Shin S., Britt RC, Reed SF, Collins J., Weireter LJ, Britt LD2007. Early glucose normalization does not improve outcome in the critically ill trauma population. Am Surg73: 769-72; discussion 772.
151.
Shuck JM, Lowe RJ1978. Intestinal disruption due to blunt abdominal trauma . Am J Surg136: 668-73.
152.
Spahn DR, Cerny V., Coats TJ, et al. 2007. Management of bleeding following major trauma: a European guideline. Crit Care11: R17.
153.
Sperry JL, Minei JP2008. Gender dimorphism following injury: making the connection from bench to bedside. J Leukoc Biol83: 499-506.
154.
Spindler-Vesel A., Bengmark S., Vovk I., Cerovic O., Kompan L.2007. Synbiotics, prebiotics, glutamine, or peptide in early enteral nutrition: a randomized study in trauma patients. JPEN J Parenter Enteral Nutr31: 119-26.
155.
Stern SA2001. Low-volume fluid resuscitation for presumed hemorrhagic shock: helpful or harmful? Curr Opin Crit Care7: 422-30.
156.
Stewart RM, Myers JG, Dent DL, et al. 2003. Seven hundred fifty-three consecutive deaths in a level I trauma center: the argument for injury prevention. J Trauma54: 66-70; discussion 70-71.
Sung J., Bochicchio GV, Joshi M., Bochicchio K., Tracy K., Scalea TM2005. Admission hyperglycemia is predictive of outcome in critically ill trauma patients. J Trauma59: 80-83.
159.
Surbatovic M., Filipovic N., Radakovic S., Stankovic N., Slavkovic Z.2007. Immune cytokine response in combat casualties: blast or explosive trauma with or without secondary sepsis. Mil Med172: 190-95.
160.
Taylor JV, Gordon LE, Hall H., Heinzelmann M., Polk Jr HC1999. Differences between bacterial species shown by simultaneous assessment of neutrophil phagocytosis and generation of reactive oxygen intermediates in trauma patients. Arch Surg134: 1222-27; discussion 1227-28.
161.
Toschlog EA, Newton C., Allen N., et al. 2007. Morbidity reduction in critically ill trauma patients through use of a computerized insulin infusion protocol: a preliminary study. J Trauma62: 1370-75; discussion 1375-76.
162.
Toutouzas KG, Velmahos GC, Kaminski A., Chan L., Demetriades D.2002. Leukocytosis after posttraumatic splenectomy: a physiologic event or sign of sepsis?Arch Surg137: 924-28; discussion 928-29.
163.
Tschoeke SK, Hellmuth M., Hostmann A., Ertel W., Oberholzer A.2007. The early second hit in trauma management augments the proinflammatory immune response to multiple injuries. J Trauma62: 1396-403; discussion 1403-04.
164.
Turner J., Nicholl J., Webber L., Cox H., Dixon S., Yates D.2000. A randomised controlled trial of prehospital intravenous fluid replacement therapy in serious trauma. Health Technol Assess4: 1-57.
165.
Uzzan B., Cohen R., Nicolas P., Cucherat M., Perret GY2006. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis . Crit Care Med34: 1996-2003.
166.
Vally H., Whittle A., Cameron S., Dowse GK, Watson T.2004. Outbreak of Aeromonas hydrophila wound infections associated with mud football. Clin Infect Dis38: 1084-89.
167.
Velmahos GC, Toutouzas KG, Sarkisyan G., et al. 2002. Severe trauma is not an excuse for prolonged antibiotic prophylaxis. Arch Surg137: 537-41; discussion 541-42.
168.
Venet F., Tissot S., Debard AL, et al. 2007. Decreased monocyte human leukocyte antigen-DR expression after severe burn injury: Correlation with severity and secondary septic shock. Crit Care Med35: 1910-17.
169.
Wanner GA, Keel M., Steckholzer U., Beier W., Stocker R., ErteL W.2000. Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients . Crit Care Med28: 950-57.
170.
Weil MH, Shubin H., Biddle M.1964. Shock caused by gram-negative microorganisms. Analysis of 169 cases. Ann Intern Med60: 384-400.
171.
Weinberg JA, Mcgwin Jr G., Griffin RL, et al. 2008a. Age of transfused blood: an independent predictor of mortality despite universal leukoreduction. J Trauma65: 279-82; discussion 282-84.
172.
Weinberg JA, Mcgwin Jr G., Marques MB, et al. 2008b. Transfusions in the less severely injured: does age of transfused blood affect outcomes?J Trauma65: 794-98.
173.
Weng J., Brown CV, Rhee P., et al. 2005. White blood cell and platelet counts can be used to differentiate between infection and the normal response after splenectomy for trauma: prospective validation. J Trauma59: 1076-80.
174.
WHO.2002. World report on violence and health. World Health Organization: Geneva.
175.
Wichmann MW, Angele MK, Ayala A., Cioffi WG, Chaudry IH1997. Flutamide: a novel agent for restoring the depressed cell-mediated immunity following soft-tissue trauma and hemorrhagic shock . Shock8: 242-48.
176.
Wohltmann CD, Franklin GA, Boaz PW, et al. 2001. A multicenter evaluation of whether gender dimorphism affects survival after trauma. Am J Surg181: 297-300.
177.
Yendamuri S., Fulda GJ, Tinkoff GH2003. Admission hyperglycemia as a prognostic indicator in trauma . J Trauma55: 33-38.
178.
Zellweger R., Ayala A., Stein S., Demasso CM, Chaudry IH1995. Females in proestrus state tolerate sepsis better than males. Surgical Forum46: 65-67.
