Predictors of Acute Lung Injury.

摘要

This study measured inflammatory mediators in tracheal secretions and plasma of subjects with severe multiple blunt trauma for 4 days post injury. The goal was to determine if biomarkers in tracheal fluid could be used to discriminate between subjects who developed acute lung injury (ALI) after Day 1 from those who did not develop ALI. The tracheal samples were analyzed by enzyme-linked immunosorbent assay for quantities of tumor necrosis factor (TNF), interleukin 1 beta (IL-1 ), IL-6, IL-8, IL-10, C-reactive protein, pentraxin 3 (PTX3), and activated complement 5 daily for 4 days. The diagnosis of ALI or acute respiratory distress syndrome was made using the international consensus criteria. Comparisons were made from samples collected on the first 24 hours following injury (Day1) between the No ALI group (n=15) and the ALI group (n=6). The levels of all eight mediators on Day 1 were higher in the No ALI group vs. levels in the group that developed ALI after Day 1. The levels of TNF, IL-1 , and PTX3 were statistically higher in the No ALI group. The significant differences in biomarkers in tracheal fluid demonstrate that these markers are potentially predictive of which trauma subjects are at risk for ALI.