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Article
August 1992

The Catecholamine Response to Multisystem Trauma

Author Affiliations

From the Departments of Medicine (Dr Woolf and Mss Kelly and Nichols), Neurosurgery (Dr McDonald), Surgery (Dr Feliciano), and Biostatistics (Dr Cox), University of Rochester (NY) School of Medicine and Dentistry.

Arch Surg. 1992;127(8):899-903. doi:10.1001/archsurg.1992.01420080033005
Abstract

• We studied the catecholamine response in two groups of patients with multisystem injuries according to the presence (group 1, N=124) or absence (group 2, N=82) of head injury. Markers of injury severity included the Injury Severity Score, the Glasgow Coma Scale, the need for intubation, admission hypotension, the amount of blood products and fluid expanders administered during the first 24 hours, and patient outcome. In group 1, higher norepinephrine levels always and epinephrine concentrations usually were associated with worsening indexes of injury severity. The best correlations were between the Injury Severity Score and the Glasgow Coma Scale and norepinephrine concentrations. In group 2, despite elevated catecholamine levels, such associations were seldom present. Thus, circulating catecholamine levels, especially norepinephrine levels, significantly correlated with the severity of injury in patients who had suffered multisystem injury, but only if the injury included the brain.

(Arch Surg. 1992;127:899-903)

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