Variations of p38 MAPK and sICAM-1 with therapeutic effect of different resuscitation fluids on severe traumatic patients / 中华创伤杂志(英文版)
Chinese Journal of Traumatology
;
(6): 263-268, 2007.
Article
in English
| WPRIM
| ID: wpr-236769
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of lactated Ringer's solution(LR), 7.5% sodium chloride solution(HS) and 20% albumin injection(ALB) on the incidence and mortality of multiple organ dysfunction syndrome (MODS).</p><p><b>METHODS</b>Seventy-two severe trauma patients (ISS score 16-43) were divided into ISS < or = 25 and ISS > 25 groups (each group was subdivided into LR, HS and ALB groups). ELISA was used to measure the concentration of sICAM-1. Western blot was used to measure the expression of p38 MAPK.</p><p><b>RESULTS</b>Compared with LR group, the transfusion volume needed for maintaining systolic blood pressure > or = 90 mm Hg was significantly decreased in HS and ALB groups (P < 0.05). Compared with the control group, the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups (P < 0.05-0.01). At 4, 12, and 24 hours, there was significant correlation between the expression of p38 MAPK and sICAM-1 (P < 0.01). Compared with LR group, sICAM-1 and p38 MAPK in HS and ALB groups were decreased (P < 0.05). sICAM-1 and p38 MAPK were significantly higher in the group of ISS > 25 than that of ISS < or = 25 (P < 0.05). MODS incidence and mortality were significantly higher in the group of ISS > 25 than that of ISS < or = 25 (P < 0.05). MODS incidence and mortality were lower in HS and ALB groups than LR group (P < 0.05).</p><p><b>CONCLUSIONS</b>The up-regulation of polymorphonuclear neutrophil-endotheliocytes (PMN-EC) adhesion may be due to the increased sICAM-1 expression during severe trauma. The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK. During severe trauma, the levels of sICAM-1 and p38 MAPK, as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Physiology
/
Resuscitation
/
Saline Solution, Hypertonic
/
Systole
/
Therapeutics
/
Wounds and Injuries
/
Blood
/
Cell Adhesion
/
Epidemiology
/
Mortality
Type of study:
Prognostic study
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Chinese Journal of Traumatology
Year:
2007
Type:
Article
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