Inflammatory Response in Polytraumatized Patients
Inflammatory Response in Polytraumatized Patients
The purpose of this study is to determine the inflammatory response after multiple trauma in humans.
Polytraumatized patients are via a systemic inflammatory response syndrome at high risk for an uneventful outcome in the posttraumatic phase. One of the main functions of the inflammatory response is the recognition and elimination of damaged tissues and microorganisms. In polytraumatized patients, a huge amount of damaged cells occurs which has to be eliminated by programmed cell death (apoptosis)without damaging surrounding tissues. It remains unclear whether, when and how an interplay of complement system, NF-kB, danger and pattern recognition receptors, apoptosis, mesenchymal stem cells and their regulation may be beneficial and harmful. Differing activation of the complement system, pro-inflammatory biomarkers and predisposing polymorphisms of response and receptor genes are expected to lead to varying outcome. Therefore, this prospective observational study will enroll n=60 polytraumatized patients with an ISS>18 to monitor longitudinally their inflammatory response after trauma and to find out whether there is a discriminating pattern of the cross talk between complement system, biomarkers and apoptosis in patients with beneficial or harmful outcome.
Inclusion Criteria:
multiple trauma injury, injury severity score (ISS) > 18 with
isolated fractures of the extremities
fractures of the extremities combined with blunt/penetrating visceral trauma
fractures of the extremities combined with blunt/penetrating thoracic trauma
isolated head injury with morphological changes in CCT
combination of points 1 - 4
Exclusion Criteria:
life expectancy < 24 hours
participation in other trials
ISS < 18
cardiopulmonary reanimation on the accident scene or dying immediately after hospital admission
age < 18 years
known or suspected pregnancy
patients with ray-treatment or chemotherapy within the last three months