Measurement of Cytokines and Adhesion Molecules in the First 72 Hours after Severe Trauma: Association with Severity and Outcome

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Sousa, A (Author) Other; Raposo, F (Author) Other; Fonseca, S (Author) Other; Valente, L (Author) Other; Duarte, F (Author) Other; Goncalves, M (Author) Other; Tuna, D (Author) Other; Paiva, J-A (Author) FMUP

Journal

Title: Disease Markers

Vol. 2015

Pages: 1-8

ISSN: 0278-0240

Publisher: Hindawi

Indexing

ISI Web of Knowledge - 23 Citations

Scopus - 24 Citations

Other information

Authenticus ID: P-00A-9E4

DOI: 10.1155/2015/747036

Abstract (EN): Introduction. Severity and outcome assessments are crucial in trauma. Our aim was to describe the role of a group of cytokines (TNF alpha, IL-6, IL-10, and HMGB-1) and ICAM-1 as severity and outcome assessment tools and their kinetics in the first 72 h after severe trauma. Materials and Methods. Authors designed a prospective cohort study of severe polytrauma patients (ISS > 15) in a level 1 Trauma Centre. Cytokines and ICAM-1 levels and Th1/Th2 ratios were assessed at admission, 24, 48, and 72 h. SIRS, SIRS with hypoperfusion, and shock were identified. Outcomes considered were ICU admission, ARDS, MODS, and death. Results. Ninety-nine patients were enrolled (median ISS: 29 and age 31). There was an early release of pro-and anti-inflammatory mediators with higher values at admission (except for ICAM-1). On admission, IL-6 was associated with ISS, IL-10 with SIRS with hypoperfusion, and HMGB-1 with shock. Several cytokines were associated with outcomes, especially IL-6 and IL-10 at 72 h with MODS and death. Low TNF alpha/IL-10 and IL-6/IL-10 ratios at 24 and 72h were associated with MODS and death. Conclusions. Pro-and anti-inflammatory responses occur simultaneously and earlier after injury. Cytokines may be useful for outcome assessment, especially IL-6 and IL-10. Low Th1/Th2 ratio at 24 to 72 h is associated with MODS and death.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8