[Lack of prognostic value of the determination of 3 serum proteins during the acute phase of brain injury].

In has been suggested that monitoring of blood levels of serum proteins could be of value in order to assess the prognosis of trauma patients. A study was set up to assess the value of albuminaemia, prealbuminaemia, transferrin and ceruleoplasmin levels in intensive care unit patients admitted after multiple trauma including head injury. This study involved 43 patients (31 men and 12 women), with a mean age of 26 years (range: 15 and 71 years). Two patients had extradural haematoma. The other patients had brain contusion associated with extradural haematoma (5 cases), subdural haematoma (1 case) and open brain wound (1 case). All these patients were sedated with penthiobarbital, paralysed with pancuronium bromide and mechanically ventilated. Serum protein levels were measured on the first and eighth days of the stay in the intensive care unit. In these patients that survived, there was a significant decrease in albuminaemia and transferrin levels, no change in prealbuminaemia and a significant increase in ceruleoplasmin levels. Ten patients died during the study. They presented a greater decrease in albuminaemia and prealbuminaemia as compared with the survivors. There was no difference in the evolution of ceruleoplasmin and transferrin levels between the two groups. Thus, whilst the difference between survivors and non-survivors was significant for the group, for the individual patient the difference was too small to be of any prognostic value.