Yohei Kumabe1,2, Yannik Kalbas1,2, Sascha Halvachizadeh1,2, Michel Teuben1,2, Nikola Cesarovic2, Miriam Weisskopf2, Andreas Hülsmeier1, Thorsten Hornemann1, Paolo Cinelli2, Hans-Christoph Pape1,2, Roman Pfeifer3,4. 1. Department of Trauma, Institute for Clinical Chemistry, Zurich University Hospital, Zurich, Switzerland. 2. Department of Surgical Research, Harald Tscherne Laboratory for Orthopaedic and Trauma Research, Zurich University Hospital, Zurich, Switzerland. 3. Department of Trauma, Institute for Clinical Chemistry, Zurich University Hospital, Zurich, Switzerland. Roman.Pfeifer@usz.ch. 4. Department of Surgical Research, Harald Tscherne Laboratory for Orthopaedic and Trauma Research, Zurich University Hospital, Zurich, Switzerland. Roman.Pfeifer@usz.ch.
Abstract
BACKGROUND: Occult hypoperfusion describes the absence of sufficient microcirculation despite normal vital signs. It is known to be associated with prolonged elevation of serum lactate and later complications in severely injured patients. We hypothesized that changes in circulating lipids are related to responsiveness to resuscitation. The purpose of this study is investigating the relation between responsiveness to resuscitation and lipidomic course after poly trauma. METHODS: Twenty-five male pigs were exposed a combined injury of blunt chest trauma, liver laceration, controlled haemorrhagic shock, and femoral shaft fracture. After 1 h, animals received resuscitation and fracture stabilization. Venous blood was taken regularly and 233 specific lipids were analysed. Animals were divided into two groups based on serum lactate level at the end point as an indicator of responsiveness to resuscitation (<2 mmol/L: responder group (R group), ≧2 mmol/L: occult hypoperfusion group (OH group)). RESULTS: Eighteen animals met criteria for the R group, four animals for the OH group, and three animals died. Acylcarnitines showed a significant increase at 1 h compared to baseline in both groups. Six lipid subgroups showed a significant increase only in R group at 2 h. There was no significant change at other time points. CONCLUSIONS: Six lipid groups increased significantly only in the R group at 2 h, which may support the idea that they could serve as potential biomarkers to help us to detect the presence of occult hypoperfusion and insufficient resuscitation. We feel that further study is required to confirm the role and mechanism of lipid changes after trauma.
BACKGROUND: Occult hypoperfusion describes the absence of sufficient microcirculation despite normal vital signs. It is known to be associated with prolonged elevation of serum lactate and later complications in severely injured patients. We hypothesized that changes in circulating lipids are related to responsiveness to resuscitation. The purpose of this study is investigating the relation between responsiveness to resuscitation and lipidomic course after poly trauma. METHODS: Twenty-five male pigs were exposed a combined injury of blunt chest trauma, liver laceration, controlled haemorrhagic shock, and femoral shaft fracture. After 1 h, animals received resuscitation and fracture stabilization. Venous blood was taken regularly and 233 specific lipids were analysed. Animals were divided into two groups based on serum lactate level at the end point as an indicator of responsiveness to resuscitation (<2 mmol/L: responder group (R group), ≧2 mmol/L: occult hypoperfusion group (OH group)). RESULTS: Eighteen animals met criteria for the R group, four animals for the OH group, and three animals died. Acylcarnitines showed a significant increase at 1 h compared to baseline in both groups. Six lipid subgroups showed a significant increase only in R group at 2 h. There was no significant change at other time points. CONCLUSIONS: Six lipid groups increased significantly only in the R group at 2 h, which may support the idea that they could serve as potential biomarkers to help us to detect the presence of occult hypoperfusion and insufficient resuscitation. We feel that further study is required to confirm the role and mechanism of lipid changes after trauma.
Authors: David Bar-Or; Kristin M Salottolo; Alessandro Orlando; Charles W Mains; Pamela Bourg; Patrick J Offner Journal: J Am Geriatr Soc Date: 2013-07-26 Impact factor: 5.562
Authors: Gabrielle E Hatton; Michelle K McNutt; Bryan A Cotton; Jessica A Hudson; Charles E Wade; Lillian S Kao Journal: J Am Coll Surg Date: 2020-01-16 Impact factor: 6.113
Authors: Sascha Halvachizadeh; Larissa Baradaran; Paolo Cinelli; Roman Pfeifer; Kai Sprengel; Hans-Christoph Pape Journal: PLoS One Date: 2020-01-24 Impact factor: 3.240