Development of multiple organ dysfunction syndrome in older and young adult trauma patients

Abstract Background Multiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS. Methods In total, 14 multiple trauma patients with an injury severity score (ISS) ≥ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72 h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA. Results In the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF. Conclusions Leptin and IL-17A could be suitable diagnostic markers to identify severely injured patients with a developing SIRS and MOF earlier, to adjust surgical therapy planning and intensive care.

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Tissue factor pathway inhibitor response does not correlate with tissue factor-induced disseminated intravascular coagulation and multiple organ dysfunction syndrome in trauma patients

Critical Care Medicine ◽

10.1097/00003246-200102000-00006 ◽

2001 ◽

Vol 29 (2) ◽

pp. 262-266 ◽

Cited By ~ 43

Author(s):

Satoshi Gando ◽

Satoshi Nanzaki ◽

Yuji Morimoto ◽

Toshiteru Ishitani ◽

Osamu Kemmotsu

Keyword(s):

Tissue Factor ◽

Organ Dysfunction ◽

Multiple Organ Dysfunction Syndrome ◽

Disseminated Intravascular Coagulation ◽

Tissue Factor Pathway Inhibitor ◽

Multiple Organ ◽

Trauma Patients ◽

Multiple Organ Dysfunction ◽

Intravascular Coagulation ◽

Tissue Factor Pathway

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Jaundice Occurrence After a Large Area Burn Is a Possible Indication to Delay Surgery

Journal of Burn Care & Research ◽

10.1093/jbcr/irz206 ◽

2019 ◽

Vol 41 (3) ◽

pp. 727-730

Author(s):

Xiqiao Wang ◽

Bo Yuan

Keyword(s):

Organ Dysfunction ◽

Clinical Manifestation ◽

Multiple Organ Dysfunction Syndrome ◽

Total Body Surface Area ◽

Multiple Organ ◽

Trauma Patients ◽

Burn Patients ◽

Multiple Organ Dysfunction ◽

Liver Support ◽

Liver Protection

Abstract The mortality of burn patients with sepsis is higher than that of trauma patients. Sepsis causes liver dysfunction, which is an independent risk factor for multiple organ dysfunction syndrome and sepsis-induced death. We present the case of a 57-year-old female with burns covering 59% of her total body surface area and the presence of full-thickness burns. She was transferred to our burn center due to the appearance of fever and skin jaundice during the previous treatment. Based on the clinical manifestation, two main strategies were performed: debridement to remove necrotic wound tissue and treatment with a combination of drugs for liver protection. The patient’s condition appeared stable for a period thereafter. Skin grafting to cover the wound was unexpectedly followed by a rapid deterioration in clinical manifestation. We can learn from this failed case that jaundice might be a sign of a systemic crisis. In such cases, surgery could aggravate the severity of the condition and cause multiple organ dysfunction syndrome. Therefore, jaundice may be a sign that skin surgery is not the best option. The optimal treatment should enhance liver protection or provide artificial liver support systems to facilitate the recovery of the liver from severe sepsis. This case suggests that skin graft surgery should not be conducted until jaundice is resolved in burn patients.

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The Potential of Adipokines in Identifying Multiple Trauma Patients at Risk of Developing Multiple Organ Dysfunction Syndrome

10.21203/rs.3.rs-92157/v1 ◽

2020 ◽

Author(s):

Julian Haupt ◽

Niels Krysiak ◽

Marina Unger ◽

Viktoria Bogner-Flatz ◽

Peter Biberthaler ◽

...

Keyword(s):

Multiple Trauma ◽

Organ Dysfunction ◽

Multiple Organ Dysfunction Syndrome ◽

Plasma Concentrations ◽

Multiple Organ ◽

Control Group ◽

Trauma Patients ◽

Multiple Organ Dysfunction ◽

Patients At Risk ◽

Multiple Trauma Patients

Abstract BackgroundMultiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS.MethodsIn total, 14 multiple trauma patients with an injury severity score (ISS) ³ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA. ResultsIn the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF. ConclusionsThe results of this study may contribute to identify severely injured patients with a developing SIRS and MOF earlier, in order to adjust therapy strategies.

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