August 1986

Posttraumatic Complications and Inflammatory Mediators

Author Affiliations

From the Department of General Surgery (Drs Nuytinck and Goris) and the Laboratory for Clinical Chemistry (Dr van Munster), University Hospital St Radboud, Nijmegen, the Netherlands; and the Ludwig Boltzmann Institute for Experimental Traumatology, Vienna (Drs Redl and Schlag).

Arch Surg. 1986;121(8):886-890. doi:10.1001/archsurg.1986.01400080028004

• In a series of 71 patients with trauma, we measured weekly the blood levels of a number of complement proteins and activation products. We also measured the following: leukocytes, platelets, granulocyte enzyme elastase, alpha1-antitrypsin, total protein, albumin, haptoglobin, and fibronectin. The intensity of complement activation and the blood levels of elastase correlated with the following factors: (1) injury severity (especially the severity of limb injury), (2) development of adult respiratory distress syndrome, (3) development and severity of multiple organ failure, and (4) probability of a fatal outcome. The plasma elastase level seemed to be the best predictor of adult respiratory distress syndrome and the best correlate of injury severity and multiple organ failure severity. Our findings support the hypothesis that posttraumatic activation of the complement system leads to activation of granulocytes, followed by microvascular injury and finally by organ failure.

(Arch Surg 1986;121:886-890)