Time Course of Changes in LipopolysaccharideBinding Protein and Lactate in the Blood of Patients with Polytrauma

Abstract

Objective: to estimate the clinical and prognostic value of the blood levels of lipopolysaharidebinding protein (LPSBP) and lactate in critically ill polytrauma patients.Subjects and methods. An analysis was made of the results of an examination in critical ly ill polytrauma victims who were retrospectively classified in accordance with the 1992 ACCP/SCCM criteria: systemic inflammatory response syndrome (n=18), local infection (n=36), sepsis (n=27), severe sepsis (n=12), and septic shock (n=6). A case was regarded as infection when the source of the latter was established and it was microbiologically verified. The investigators determined serum LPSBP levels by an immunochemiluminescence analyzer (IMMULITE ONE, USA) and venous whole blood lactate concentrations by a Roche Omni S analyzer (Germany).Results. The development of infectious complications was notedin 81% of the polytrauma patients by days 5—7; by days 8—10, 45% were diagnosed as having sepsis whose severe course was characterized by the addition of polyresistant gramnegative microorganisms. An early increase in the concentration and frequency of diagnostic levels of serum LPSBP was ascertained in the polytrauma patients before infection was microbiologically verified. There was a strong direct correlation between lactate and LPSBP levels.Conclusion. The findings suggest that LPS BP and lactate are of diagnostic and prognostic value and may be used as early markers of pyoseptic complications.

Keywords

• polytrauma
• systemic inflammatory response syndrome
• sepsis
• lipopolysaccharidebinding protein
• lactate