Diagnostic and Predictive Markers of Acute Lung Injury in Severe Concomitant Trauma

Abstract

Objective: to define the diagnostic and predictive value of the markers of fat embolism as a cause of acute lung injury (ALI) in severe concomitant trauma. Subjects and methods: 34 patients with severe concomitant trauma were examined. A dynamic study was undertaken to examine by biochemical tests and hemoviscosimetry and lipid metabolism (very low-density lipoproteins (VLDL) and triglycerides (TG)). The Murray scale was used to evaluate the severity of ALI. The authors calculated the trauma shock genicity index in accordance with the recommendations developed by the Dzhanelidze Research Institute of Emergency Care (Saint Petersburg) and the patients’ condition by the TRISS scale. Results. In all the groups, patients with severe concomitant trauma develop ALI whose severity correlates with the severity of a trauma. In the group of patients with a shock genicity index of more than 14 scores, the most significant severe hemostatic disorders develop, which are retained within 9 days. In the same group, the levels of VLDL and TG increased within the first 3 days after trauma. Conclusion. In patients with severe concomitant trauma, the parameters of the hemostatic vascular platelet link and the elevated serum VLDL and TG levels are of diagnostic and predictive value in the development of ALI and fat embolism. Key words: fat embolism, severe concomitant trauma, acute lung injury, hemostasis, lipid metabolism.