EARLY POSTTRAUMATIC INCREASE IN PRODUCTION OF NITRIC-OXIDE IN HUMANS

Citation
F. Gebhard et al., EARLY POSTTRAUMATIC INCREASE IN PRODUCTION OF NITRIC-OXIDE IN HUMANS, Shock, 10(4), 1998, pp. 237-242
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Peripheal Vascular Diseas","Emergency Medicine & Critical Care",Hematology,Surgery
Journal title
ShockACNP
ISSN journal
1073-2322
Volume
10
Issue
4
Year of publication
1998
Pages
237 - 242
Database
ISI
SICI code
1073-2322(1998)10:4<237:EPIIPO>2.0.ZU;2-K
Abstract
Since nitric oxide (NO) contributes to both circulatory disorders and host defense, we analyzed the NO production in (poly)trauma patients ( pts) in a prospective (pre)clinical study starting as early as at the scene of accident. Upon approval of the local IRB/EC, 85 multiple inju red pts were enrolled. Subsets were performed according to trauma seve rity (ISS) and injury pattern, and between survivors versus nonsurvivo rs. The first blood sample was collected at the scene of accident, the n in hourly to daily intervals. NO production was assessed by measurin g nitrate+nitrite plasma levels. To estimate dilution effects, all val ues were calculated according to the actual plasma protein content. Th e extent of trauma was appraised by C-reactive protein (CRP) levels. I mmediately after trauma, NO2-+NO3- plasma levels were always elevated. This was most pronounced in thoracic injury, irrespective of whether it was combined with multiple trauma. Nitrate+nitrite levels returned to normal within 24 h, CRP generation increased during 12 h following trauma and was most marked in severest trauma (ISS >50). For the first time, we show very early data following major trauma that demonstrate that NO overproduction starts immediately after trauma. However, syst emic NO2-+NO3- levels actually reflect the severity of injury only dur ing the first 2 h. Thereafter, NO generation is rather related to the individual trauma pattern, e.g., chest trauma. Nonetheless, the role o f NO after severe trauma and especially in thoracic injury remains unc lear and should further be elucidated in a specific study.