Lukas L Negrin1, Gabriel Halat2, Helmut Prosch3, Michael Hüpfl4, Stefan Hajdu2, Thomas Heinz2. 1. Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: lukas.negrin@meduniwien.ac.at. 2. Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria. 3. Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria. 4. Department of Anesthesiology, General Intensive Care, and Pain Management, Medical University of Vienna, Vienna, Austria.
Abstract
BACKGROUND: Biomarkers caused by blunt chest trauma might leak into the vascular compartment and therefore reflect the severity of parenchymal lung injury (PLI). Five promising proteins were preselected after a literature scan. The objective of our study was to identify a biomarker that is released abundantly into the serum shortly after trauma and reliably quantifies the loss of functional lung tissue. METHODS: Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred. Immediately after stabilizing the patient's condition, blood samples were taken and a whole-body computed tomographic (CT) scan was obtained. Biomarker levels were measured directly after admission and on day 2. PLI volume was calculated using volumetric analysis. RESULTS: One hundred thirty patients met the inclusion criteria. Compared with a matched healthy control population, median levels of the soluble receptor for advanced glycation end products (sRAGE) was almost 3 times higher and decreased by 41% on day 2. Higher initial median sRAGE levels were detected in patients with PLI compared with patients without PLI and in individuals with severe PLI compared with those with mild PLI. Spearman correlation analysis and a univariate linear log regression model revealed a significant correlation/equation between initial sRAGE levels and relative PLI volume. Receiver operating characteristic (ROC) statistics identified the initial sRAGE level as an indicator of severe PLI. CONCLUSIONS: sRAGE levels measured shortly after trauma seem to be a promising diagnostic tool to assess the severity of PLI in polytraumatized patients.
BACKGROUND: Biomarkers caused by blunt chest trauma might leak into the vascular compartment and therefore reflect the severity of parenchymal lung injury (PLI). Five promising proteins were preselected after a literature scan. The objective of our study was to identify a biomarker that is released abundantly into the serum shortly after trauma and reliably quantifies the loss of functional lung tissue. METHODS: Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred. Immediately after stabilizing the patient's condition, blood samples were taken and a whole-body computed tomographic (CT) scan was obtained. Biomarker levels were measured directly after admission and on day 2. PLI volume was calculated using volumetric analysis. RESULTS: One hundred thirty patients met the inclusion criteria. Compared with a matched healthy control population, median levels of the soluble receptor for advanced glycation end products (sRAGE) was almost 3 times higher and decreased by 41% on day 2. Higher initial median sRAGE levels were detected in patients with PLI compared with patients without PLI and in individuals with severe PLI compared with those with mild PLI. Spearman correlation analysis and a univariate linear log regression model revealed a significant correlation/equation between initial sRAGE levels and relative PLI volume. Receiver operating characteristic (ROC) statistics identified the initial sRAGE level as an indicator of severe PLI. CONCLUSIONS: sRAGE levels measured shortly after trauma seem to be a promising diagnostic tool to assess the severity of PLI in polytraumatized patients.
Authors: Carlos Machahua; Ana Montes-Worboys; Lurdes Planas-Cerezales; Raquel Buendia-Flores; Maria Molina-Molina; Vanesa Vicens-Zygmunt Journal: Respir Res Date: 2018-11-08
Authors: Gabriel Halát; Thomas Haider; Michel Dedeyan; Thomas Heinz; Stefan Hajdu; Lukas L Negrin Journal: World J Emerg Surg Date: 2019-07-19 Impact factor: 5.469
Authors: Thomas Haider; Elisabeth Simader; Olaf Glück; Hendrik J Ankersmit; Thomas Heinz; Stefan Hajdu; Lukas L Negrin Journal: Sci Rep Date: 2019-07-03 Impact factor: 4.379