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Early inflammatory response correlates with the severity of injury

 

作者: Michael D. MD Pasquale,   Mark D. MD Cipolle,   JoAn MS Monaco,   Neal PhD Simon,  

 

期刊: Critical Care Medicine  (OVID Available online 1996)
卷期: Volume 24, issue 7  

页码: 1238-1242

 

ISSN:0090-3493

 

年代: 1996

 

出版商: OVID

 

数据来源: OVID

 

摘要:

ObjectiveTo determine if the early inflammatory response correlates with the severity of injury in a blunt trauma model in rats.DesignProspective, randomized, controlled trial.SettingResearch laboratory.SubjectsMale Sprague-Dawley rats, weighing 250 to 400 g.InterventionsTwenty-two male Sprague-Dawley rats were divided randomly into single hindlimb fracture, bilateral hindlimb fracture, and no fracture groups. At 90 mins, all animals underwent midline laparotomy and aspiration of blood from the inferior vena cava. Venous blood gas, plasma lactate, and plasma concentrations of tumor necrosis factor (TNF), prostaglandin F (6-keto-PGF1alpha), and interleukin (IL)-6 were sampled. Statistical analysis was done via one-way analysis of variance and Scheffe post hoc analysis. In a second part of this experiment, the effect of hemorrhage on the release of IL-6 was evaluated. Animals in this group were compared with control and bilateral hindlimb fracture animals, using the Student's t-test.Measurements and Main ResultsThere were no significant differences in venous pH or base deficit among the groups. Oxygen saturation was significantly decreased in the bilateral hindlimb fracture group when compared with the control group. In the hemorrhage plus bilateral fracture group, oxygen saturation was significantly decreased when compared with the bilateral fracture group. Lactate concentrations in plasma were increased in both fracture groups as well as the hemorrhaged groups. Plasma TNF concentrations were increased in the injured groups but there was no significant difference between single and bilateral hindlimb fracture groups. The 6-keto-PGF sub 1 alpha concentrations were increased in both of the fracture groups when compared with the control group and there was a significant difference between single and bilateral hindlimb fracture groups. Similarly, circulating IL-6 concentrations were significantly higher in the bilateral fracture group than in the single fracture group; both fracture groups were significantly higher than the control group. Hemorrhaged animals had even higher IL-6 concentrations.ConclusionsPlasma lactate and TNF concentrations were affected by injury, however their concentrations did not correlate with degree of injury. IL-6 concentrations were increased early postinjury and correlated with severity of injury. The 6-keto-PGF sub 1 alpha concentrations in plasma also correlated with the severity of injury and this phenomenon may represent early endothelial activation which may be the source of IL-6 release.(Crit Care Med 1996; 24:1238-1242)

 



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