A clinical study of multiple trauma combined with acute lung injury

Objective: To study the changes of the contents of inflammatory mediators in serum of polytrauma patients with acute lung injury (ALI) and their correlation with the disease. Methods: Patients suffering from multiple trauma combined with ALI were selected as ALI group (n = 54). Patients suffering from multiple trauma without ALI were considered as the control group (n = 117). The severity of the disease of patients in the two groups was assessed. Arterial blood was extracted for blood gas analysis. Venous blood was extracted to detect the contents of inflammatory mediators tumor necrosis factor-alpha, interleukin-1 beta (IL-1 beta), IL-10, granulocyte-macrophage colony stimulating factor, NO, endothelin-1. Results: The scores of injury severity score [(25.42 +/- 3.58) vs. (17.03 +/- 2.25)], systemic inflammatory response syndrome [(3.85 +/- 0.52) vs. (2.20 +/- 0.36)] and acute physiology and chronic health evaluation II [(92.63 +/- 11.04) vs. (60.46 +/- 8.87)] in patients in ALI group were all significantly higher than those in the control group and its correcting shock time [(8.39 +/- 1.05) vs. (5.15 +/- 0.72) h] was longer than that of the control group. The amount of blood transfusion [(674.69 +/- 93.52) vs. (402.55 +/- 57.65) mL] was greater than that in the control group. The contents of the arterial partial pressure of oxygen [(76.65 +/- 9.68) vs. (86.51 +/- 10.56) mmHg], arterial blood pressure of carbon dioxide [(27.76 +/- 4.82) vs. (36.78 +/- 5.82) mmHg] and arterial partial pressure of oxygen/fraction of inspired oxygen [(236.94 +/- 36.49) vs. (353.95 +/- 47.76)] were all significantly lower than those in the control group. The contents of serum tumor necrosis factor-alpha, IL-1 beta, IL10, granulocyte-macrophage colony stimulating factor, NO and endothelin-1 were obviously higher than those of control group and also positively correlated with the scores of injury severity score, systemic inflammatory response syndrome and acute physiology and chronic health evaluation II. Conclusions: The activation of the inflammatory reactions and the excessive release of inflammatory mediators are the key link causing multiple trauma combined with ALI. The content of serum inflammatory mediators is closely related to the severity of the disease.