| Evidence for early supply independent mitochondrial dysfunction in patients developing multiple organ failure after trauma. | |
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MedLine Citation:
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PMID: 9095123 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether early supply independent mitochondrial oxidative dysfunction occurs in trauma patients who develop multiple organ failure (MOF). DESIGN: Prospective focused observational trial. METHODS: High-risk patients were aggressively resuscitated while being continuously monitored by near infrared spectroscopy. Near infrared spectroscopy monitoring strips allow for a direct comparison of changes in tissue oxyhemoglobin levels (HbO2), which reflect local oxygen supply, and cytochrome a,a3 redox, which reflects mitochondrial oxygen consumption. Under normal conditions, HbO2 and a,a3 redox are tightly coupled. On the other hand, decoupled HbO2 and a,a3 redox is a sign of mitochondrial oxidative dysfunction. Outcomes included MOF, oxygen delivery, oxygen consumption, lactate, and the presence of decoupled HbO2 and a,a3 redox. RESULTS: Twenty-four high-risk patients were studied; nine (38%) developed MOF. At 12 hours of resuscitation, MOF and non-MOF patients did not have statistically different oxygen delivery and oxygen consumption, but lactate levels were significantly higher in MOF patients. Additionally, HBO2 and a,a3 redox were decoupled in eight (89%) MOF patients compared with two (13%) non-MOF patients (p < 0.05). CONCLUSION: Severely injured trauma patients who develop MOF preferentially display evidence of mitochondrial oxidative dysfunction early in the course of their resuscitation despite early goal-oriented maximization of oxygen delivery. |
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Authors:
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C B Cairns; F A Moore; J B Haenel; B L Gallea; J P Ortner; S J Rose; E E Moore |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Journal of trauma Volume: 42 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 1997 Mar |
Date Detail:
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Created Date: 1997-05-01 Completed Date: 1997-05-01 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 532-6 Citation Subset: AIM; IM |
Affiliation:
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Colorado Emergency Medicine Research Center, University of Colorado, Denver, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Data Interpretation, Statistical Electron Transport Complex IV / metabolism Female Humans Male Middle Aged Mitochondria / metabolism* Multiple Organ Failure / etiology, metabolism* Oxidation-Reduction Oxygen Consumption Oxyhemoglobins / analysis Prospective Studies Spectroscopy, Near-Infrared Wounds and Injuries / complications*, metabolism |
| Grant Support | |
ID/Acronym/Agency:
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P50 GM49222/GM/NIGMS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Oxyhemoglobins; EC 1.9.3.1/Electron Transport Complex IV |
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