Early inflammatory response in polytraumatized @entity1 : Cytokines and XXXX . A pilot study.

@entity1 @entity650 @entity2002 @entity2285 @entity310 @entity1878 @entity1457 @entity1230 @entity1192 @entity701 @entity881 @entity204 @entity1851
INTRODUCTION: In the initial phases after @entity1230 there is an hyperinflammatory state that sometimes leads to @entity881 ( @entity881 ) and @entity204 , and that appears to be responsible for posttraumatic immunosuppression; among the trigger endogenous stimuli, @entity1457 ( @entity1457 ) have been proposed. The objectives of this study were to analyze if some inflammatory mediators can be considered prognostic biomarkers of outcome, and the possible role of @entity1878 in posttraumatic immunosuppression. HYPOTHESIS: Cytokines and @entity1457 could be early prognostic biomarkers of inflammatory and immune response in @entity1230 @entity1 . MATERIALS AND METHODS: A prospective observational descriptive pilot study was carried out, evaluating the early inflammatory and stress response of 18 polytraumatized @entity1 (ISS>16) on hospital admission, at 12hours, 24hours, and 48hours posttrauma. Variable means were compared using non-parametric tests; qualitative and quantitative variables were analyzed using a Spearman's correlation test. RESULTS: Seven @entity1 met criteria for @entity881 . Statistically significant changes were recorded in leukocyte count, @entity1851 ( @entity1851 ), @entity650 , @entity310 , and @entity1192   concentrations. @entity1878 levels were significantly higher immediately after the accident followed by gradual lowering. Anti- @entity2285 antibodies showed a significant reduction in all the studied time-points. @entity881 did not influence either plasma levels of leukocytes, @entity2002 , RCP or anti- @entity2285 , but @entity1 with @entity881 had higher plasma levels of @entity650 and @entity310 and a slower decrease of @entity1878 concentrations. DISCUSSION: The higher serum concentrations of @entity310 and @entity650 found in @entity1 with @entity881 , suggests a possible role as potential early predictive markers for systemic inflammatory response and clinical complications. The higher levels of @entity1878 in @entity1 with @entity881 , allows proposing @entity1878 as a useful prognostic trauma biomarker early after severe injury and to consider a "damage control surgery". The significant reduction in the levels of anti- @entity2285 antibodies could reflect a part of posttraumatic immunosuppression and @entity701 treatment might be suggested. LEVEL OF EVIDENCE: Level III: case-control study.
