The influence of coagulation and inflammation research on the improvement of polytrauma care
The influence of coagulation and inflammation research on the improvement of polytrauma care
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凝血和炎症研究对改善多发伤护理的影响
DOI：
10.1007/s00068-011-0159-5
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发表时间：
2012
影响因子：
2.1
通讯作者：
Gebhard F
中科院分区：
文献类型：
--
作者：
Perl M;Huber-Lang M;Gebhard F
多发伤患者的治疗指南和管理原则主要来源于经验，并辅之以少数临床研究结果。它们对生存结局的临床影响很少得到科学评估。因此，研究算法需要开发，使目前的治疗策略在多发性创伤护理的快速和深刻的重新评估，并提供了一个坚实的基础，为未来的治疗方案的评估。这些新概念可能包括更个性化的方法和更好地确定早期确定性护理的手术窗口。由于多发性创伤导致复杂的生理和免疫障碍，这是额外的多个混杂变量的影响，这是具有挑战性的，建立这样的新算法，仅通过临床研究。在这方面，在有效的基础科学模型中定义良好的参数可以为评估当前的概念和研究未来的治疗方案提供坚实的基础。在这里，我们分析了基础科学的贡献，在多发性创伤护理，如创伤引起的凝血功能障碍的管理或损害控制骨科的概念建立的概念。许多这些想法从以前的基础科学活动转移到临床研究，但在许多情况下，基础科学对临床试验甚至临床管理策略的直接影响往往仍然难以捉摸。然而，基础科学研究每天创造的知识是一个宝贵的数据库，临床研究人员可以访问和组合这些数据库，以开发和解决临床相关问题，为他们提供全面的信息库，以仔细计划和进行临床试验。这可能随后导致多发伤患者新的管理原则的发展。
Treatment guidelines and management principles of polytrauma patients are largely derived from experience, supplemented by the results of few clinical studies. Their clinical impact on survival outcome is rarely scientifically evaluated. Hence, research algorithms need to be developed which enable a rapid and profound reevaluation of the current treatment strategies in polytrauma care and which provide a solid basis for the assessment of future treatment options. Such new concepts might include a more individualized approach and a better identification of operative windows for early definitive care. Since polytrauma results in a complex physiological and immunological disorder, which is additionally influenced by multiple confounding variables, it is challenging to establish such novel algorithms by clinical research only. In this regard, the well defined parameters in valid basic science models can provide a solid base for evaluating current concepts and investigating future treatment options. Here we have analyzed the contribution of basic science to well-established concepts in polytrauma care, such as the management of trauma induced coagulopathy or the damage control orthopedics concept. Many of these ideas moved from previous basic science activities to clinical studies but in many cases the direct effects of basic science on clinical trials or even clinical management strategies often remain elusive. Nevertheless, the knowledge which is created on a daily basis by basic science studies acts as an invaluable data pool, which can be accessed and combined for the clinical researcher to develop and address clinically relevant questions, providing them with a comprehensive pool of information to carefully plan and conduct their clinical trials. This may then subsequently lead to the development of new management principles for polytrauma patients.
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DOI：
10.1097/ta.0b013e318034204b
发表时间：
2007
期刊：
The Journal of trauma
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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DOI：
10.1007/978-1-4614-0106-3_8
发表时间：
2012-01-01
期刊：
CURRENT TOPICS IN INNATE IMMUNITY II
影响因子：
--
作者：
Perl, Mario;Denk, Stephanie;Huber-Lang, Markus
通讯作者：
Huber-Lang, Markus
影响因子：
8.8
作者：
Perl, M;Gebhard, F;Knöferl, MW
通讯作者：
Knöferl, MW