Document Detail

Monitoring the response to injury.
MedLine Citation:
PMID:  1806499     Owner:  NLM     Status:  MEDLINE    
Tissue trauma leads to a severity-dependent activation of plasma and cellular systems. This response can be recorded by determining parameters which represent the activation state of these systems. In severely injured patients with multiple trauma three out of 14 parameters measured at the time of admission proved to be indicators of subsequent septic complications with a high degree of accuracy: Fibrinopeptide A (FPA--the first split product of fibrinogen), the C3 split product C3a, and the elastase-alpha 1 proteinase inhibitor-complex (E alpha 1 PI). In a second series of multiple-injured patients with femoral fractures who did not develop clinical sepsis (N = 25) these parameters were measured continuously to evaluate the influence of injury severity and of therapeutic strategy on the further course. We found a strong correlation between injury severity (ISS) and the degree of activation. The signs of activation decreased rapidly following immediate operative fixation, and remained elevated or even increased after primary femoral traction and secondary stabilization. The operative procedure did not cause any additional activation. Complications such as infection or the formation of haematomas were reflected by raised parameter levels.
U Schöffel; F Bonnaire; B U van Specht; E H Kuner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Injury     Volume:  22     ISSN:  0020-1383     ISO Abbreviation:  Injury     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1992-05-14     Completed Date:  1992-05-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  377-82     Citation Subset:  IM    
Department of Surgery and Traumatology, University of Freiburg, FRG.
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MeSH Terms
Complement C3a / analysis
Femoral Fractures / blood,  surgery
Fibrinopeptide A / analysis
Fracture Fixation
Injury Severity Score
Middle Aged
Monitoring, Physiologic / methods*
Multienzyme Complexes / blood
Multiple Trauma / blood*,  surgery
Pancreatic Elastase / blood
Sepsis / blood*
Time Factors
alpha 1-Antitrypsin
Reg. No./Substance:
0/Multienzyme Complexes; 0/alpha 1-Antitrypsin; 25422-31-5/Fibrinopeptide A; 80295-42-7/Complement C3a; EC Elastase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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