medigraphic.com
ISSN 1561-3046 (Electronic)

2012, Number 1

<< Back Next >>

Rev Cub Med Mil 2012; 41 (1)

Value of the third component of the complement system in the evolution of poly-trauma patient

Rodríguez AM, Sin MA, Castellanos PE, Díaz GM, Rodríguez ND, Alfonso ALE

Language: Spanish
References: 19
Page: 4-10
PDF size: 132.72 Kb.


ABSTRACT

Introduction: the complement system has a major function, the protection in face of microorganisms and it is one of the first defensive lines to aggression from biological agents. The complicated injured patient has poor immune responses, associated with a decrease of the third complement component (C3), secondary to the severe trauma with a massive cellular deterioration, alterations of inflammatory process and modifications in the polymorphonuclear function generating an immuno-dysregulation leading to multi-organ failure, sepsis and mortal complications.
Objective: to assess the behavior of C3 serum concentrations in the course of polytrauma patient.
Methods: an analytical and prospective study was conducted in 55 poly-trauma patient admitted in the Intensive Care Unit (ICU) and in the Surgical Special Care Units of the "Dr. Luis Díaz Soto" Central Military Hospital and previous fulfilment of inclusion criteria and according to the ethical considerations established for this type of research. The survival probability (SP) of sample was determined and analyzing kinetically the C3 behavior and its relation to SP.
Results: the relation between SP by groups and C3 concentrations, showed a decrease of this component insofar as SP decreased even from the first day of measurement of variable. This fact gain more significance in the group of patients with SP≤ 78 % (0.6 g/L) and in the group with a SP between 79 and 91 % (0.7 g/L).
Conclusions: the C3 levels were committed in study patients from the firs 24 hours after trauma and it was more obvious in those with a SP minor, demonstrating the directly proportional relation between the decrease of this complement component, the severity of injuries and the development of fatal infectious complications.


REFERENCES

  1. Abbas AK, Lichtman AH, Pober J. Mecanismos efectores de las respuestas inmunitarias. En: Abbas AK, Lichtman AH. Inmunología celular y molecular. 4th ed. Madrid: McGraw Hill Interamericana; 2002. p. 241-353.

  2. Castellanos Puerto E, Vázquez González T, Rodríguez Acosta M, Sin Mayor A. Comportamiento de variables inmunológicas en el paciente politraumatizado. Rev Cubana Invest Biomed. 2001;20(3):173-7.

  3. Wen L, Atkinson JP, Giclas PC. Clinical and laboratory evaluation of complement deficiency. J Allergy Clinic Immunol. 2004;113(4):585-93.

  4. Flohé S, Flohé SB, Schade FU, Waydhas C. Immune response of severely injured patients-influence of surgical intervention and therapeutic impact. Langerbecks Arch Surg. 2007;392(5):639-48.

  5. Ni ChN, Redmond HP. The immunological consequences of injury. Surgeon. 2006;4(1):23-31.

  6. Brochner AC, Toff P. Pathophysiology of the systemic inflammatory response after major accidental trauma. Scand J Trauma Resusc Emerg Med. 2009;17(2):39-43.

  7. Kapur MM, Jain P, Gigh M. Defect of trauma on serum C3 activation and its correlation with injury severity score in man. J Trauma. 1986;26(5):464-6.

  8. Ganter MT, Brohi K, Cohen MJ, Shaffer LA, Walsh MC, Stahl GL, et al. Role of the alternative pathway in early complement activation following major trauma. Shok. 2007;28(1):29-34.

  9. Manual del SPSS. Guía para el análisis de datos versión 17.00 para el Windows. Madrid: Hispanoportuguesa/SPSS [Internet]. 2008 [citado 27 Ago 2009]. Disponible en: http://www.emagister.com/guia-rapida-spss-para-windows-cursos-1076231.htm

  10. Cuacuas Cano V, Escobar Martínez M, Torres Menéndez JL, Hernández Aureoles E. Trauma de alta energía y su respuesta inflamatoria sistémica. Ortho-tips [Internet]. 2008 [citado 17 Nov 2010];4(1). Disponible en: http://www.medigraphic.com/pdfs/orthotips/ot-2008/ot081h.pdf

  11. Sin Mayor A, Castellanos Puerto E, Rodríguez Acosta M, Vázquez González T, JonhstonDreke N, Rojas Moya A. Alteraciones del mecanismo de la fagocitosis en el paciente lesionado. Rev Cubana Med Mil. 2000;29(2):109-13.

  12. Rubial León A. Síndrome de respuesta inflamatoria sistémica. En: García Gutiérrez A, Pardo Gómez G. Cirugía. Vol I. La Habana: Editorial Ciencias Médicas; 2008. p. 124-32.

  13. Wen L, Atkinson JP, Giclas PC. Clinical and laboratory evaluation of complement deficiency, J Allergy Clinicoimmunol. 2004;113(4):585-93.

  14. Rodríguez Acosta M, Vázquez González T, Castellanos Puerto E, Alfonso Alfonso LE, Rojas Moya A, JonnstonDreke N. Evaluación inmunológica del paciente politraumatizado. Rev Cubana Med Mil. 2000;29(1):12-9.

  15. Kapur MM, Jain P, Gigh M. Defect of trauma on serum C3 activation and its correlation with injury severity score in man. J Trauma. 1986;26(5):464-6.

  16. Ayala A, Perrín NM, Wagner MA, Chandri IH. Enhanced susceptibility to sepsis after simple hemorrhage. Arch Surg. 1990;125(1):70-5.

  17. Smrcka M, Mrlian A, Klabusay M. Immune system status in the patients after severe brain injury. BratislLekListy. 2005;106(3):144-6.

  18. Alfonso Alfonso LE. Repercusión de los traumatismos sobre el sistema inmunológico y su correlación con el índice predictivo TRISS. Tesis para optar por el Grado de Doctor en Ciencias Médicas. La Habana: ISMM "Dr. Luis Díaz Soto"; 1998.

  19. Yadav K, Zehtabchi S, Nemes PC, Miller AC, Azher M, Durking H, et al. Early immunologic responses to trauma in the emergency department patients with major trauma. Resuscitation. 2009;80(1):83-8.




2020     |     www.medigraphic.com