Differential expression of the immunoinflammatory response in trauma patients: Burn vs. non-burn

作者：Mace James E; Park Myung S; Mora Alejandra G; Chung Kevin K^*; Martini Wenjun; White Christopher E; Holcomb John B; Merrill Gerald A; Dubick Michael A; Wolf Steven E; Wade Charles E; Schwacha Martin G

来源：Burns, 2012, 38(4): 599-606.

DOI：10.1016/j.burns.2011.10.013

• Burn
• Trauma
• Cytokine
• Inflammation
• Interleukin-6
• Interleukin-8
• Multiple

Rationale: Cytokines are central mediators of the immune-inflammatory response to injury and subsequent multiple organ dysfunction syndrome (MODS). Although previous studies evaluated cytokine levels after trauma, differences between patients with burn and non-burn trauma have not been assessed systematically. %26lt;br%26gt;Methods: A prospective database of trauma patients admitted between May 2004 and September 2007 to the burn or surgical intensive care units within 24 h of injury with an anticipated stay of at least 72 h was analyzed. Sequential clinical and laboratory parameters were collected in the first week, including multiplex analysis data for plasma levels of inflammatory cytokines (IL-6, and IL-8). Patients with known pre-injury coagulopathy were excluded. A Marshall score of 10 or greater was defined as MODS. %26lt;br%26gt;Results: A total of 179 patients were enrolled (67 burn and 112 non-burn). Plasma IL-6 and IL-8 levels were markedly elevated in both burn and non-burn patients compared to healthy volunteers. Burn subjects had higher levels of IL-6 and IL-8 than the non-burn on days through 7 after injury. Subjects with burns and at least 30% total body surface area were older and had a lower injury severity score, a higher prevalence of MODS, and correspondingly higher mortality. Multivariate analysis of injury type, MODS, and time did not demonstrate an influence of MODS. %26lt;br%26gt;Conclusions: Burns were associated with a greater and more sustained immune-inflammatory response than non-burn trauma as evidenced by elevated plasma IL-6 and IL-8 levels during the first week. There was no association between MODS and plasma cytokine levels. Published by Elsevier Ltd and ISBI

• 出版日期2012-6