Early inflammatory response in polytraumatized patients: Cytokines and heat shock proteins. A pilot study

摘要: Abstract Introduction In the initial phases after polytrauma there is an hyperinflammatory state that sometimes leads to multiple organ dysfunction syndrome (MODS) and death, appears be responsible for posttraumatic immunosuppression; among trigger endogenous stimuli, heat shock proteins (HSPs) have been proposed. The objectives of this study were analyze if some inflammatory mediators can considered prognostic biomarkers outcome, possible role HSPA1A in immunosuppression. Hypothesis Cytokines HSPs could early immune response patients. Materials methods A prospective observational descriptive pilot was carried out, evaluating stress 18 polytraumatized patients (ISS > 16) on hospital admission, at 12 hours, 24 hours, 48 hours posttrauma. Variable means compared using non-parametric tests; qualitative quantitative variables analyzed a Spearman's correlation test. Results Seven met criteria MODS. Statistically significant changes recorded leukocyte count, C-reactive-protein (CRP), IL-6, TNF-α, IL-1s concentrations. levels significantly higher immediately accident followed by gradual lowering. Anti-Hsp70 antibodies showed reduction all studied time-points. MODS did not influence either plasma leukocytes, fibrinogen, RCP or anti-Hsp70, but with had IL-6 TNF-α slower decrease Discussion serum concentrations found MODS, suggests as potential predictive markers systemic clinical complications. allows proposing useful trauma biomarker severe injury consider “damage control surgery”. anti-Hsp70 reflect part immunosuppression hydrocortisone treatment might suggested. Level evidence III: case-control study.