ABSTRACT
In a review of autopsy specimens and reports in 35 trauma cases, we found signs of generalized inflammation and tissue damage with increases in organ weights in organs not primarily injured. These abnormalities occurred independent of the time of death and were also found in patients who died of brain injury alone. The most pronounced signs of inflammation and increases in organ weights were found when the adult respiratory distress syndrome, hypovolemic shock, or multiple organ failure were the causes of death. These findings are similar to those found in several organs of rabbits after four hours of complement activation in combination with 20 minutes of hypoxia. Therefore, the autopsy findings in this series of trauma patients might represent the morphologic features of adult respiratory distress syndrome and multiple organ failure in an early, preclinical stage.
Subject(s)
Inflammation/pathology , Multiple Organ Failure/pathology , Wounds and Injuries/complications , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Brain Injuries/pathology , Child , Child, Preschool , Female , Humans , Infant , Inflammation/etiology , Leukocyte Count , Male , Middle Aged , Neutrophils , Organ Size , Rabbits , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/pathology , Retrospective Studies , Severity of Illness Index , Shock, Traumatic/etiology , Shock, Traumatic/pathology , Time FactorsABSTRACT
The autopsy reports of 35 trauma patients were reviewed. We found signs of generalized inflammation and tissue damage with increases in organ weights. Organs not primarily injured by trauma were also affected. These abnormalities were found in patients who died within 24 hours after trauma, as well as in patients who died of mere brain injury. The most pronounced signs of inflammation and increases in organ weights were found especially when the "Adult Respiratory Distress Syndrome" (ARDS), hypovolemic shock or "Multiple Organ Failure" (MOF) were the causes of death. Our findings are similar to those found in the lungs of humans suffering from ARDS and in several organs of rabbits after 4 hours of complement activation in combination with 20 minutes of hypoxia. Therefore, the autopsy findings in this series of trauma patients might represent the morphologic features of ARDS and MOF in an early-even preclinical-stage. We interpret these syndromes as the clinical expression of an uncontrolled inflammatory response to trauma, mediated by massive activation of the complement system.
