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Total antioxidant status and lipid metabolism in patients with severe multiple trauma

Introduction

The objective was to study the parameters of free radical processes and cholesterol metabolism in sufferers with severe multiple trauma (SMT).

Methods

The investigation included 77 persons. The patients were divided into two groups in relation to the outcome of disease: group I, nonsurvivors; group II, survivors. The concentrations of lipid metabolic parameters, total antioxidant status (TAOS) and a number of biochemical plasma parameters were determined on the biochemical analyzer on days 1, 3, 5, 7 and 15. Very low-density lipoprotein and low-density lipoprotein (LDL) cholesterols were calculated. 8-Hydroxy-2-desoxyguanosine was determined using the method of gel electrophoresis of isolated blood cells.

Results

The study indicated normal levels of 8-hydroxy-2-desoxyguanosine in group II in the early period after SMT. There was a rise of this parameter on days 5 and 7 in group I. The TAOS was decreased in comparison with the normal range in both groups and has a tendency to decrease later. The level of total cholesterol was decreased in both groups during the first week after the SMT. A rise of total cholesterol occurred in group II on day 15 (4.48 ± 1.81 mmol/l). At the same time, this parameter remained decreased in group I. The content of LDL cholesterol in the first week after trauma tended to increase in group II and to decrease in group I. The study findings suggest that a level of LDL cholesterol lower than 2.0 mmol/l during the first week after SMT with a decreased (<3.2 mmol/l) level of total cholesterol are unfavourable prognostic factors of disease. There was a reduction of high-density lipoprotein cholesterol in the early period after trauma. This parameter, however, tended to increase in group II and to decrease in group I. There was a rise of GGT in group I, although the total protein tended to decrease. Enhanced alkaline phosphatase activity was observed in both groups, and on day 15 was in 1.5–2 times higher than the normal range.

Conclusion

The dynamics of changes of total cholesterol, LDL cholesterol, total protein, GGT and 8-hydroxy-2-desoxyguanosine can be used as a prognostic factor in sufferers in the early period after SMT.

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Muravyeva, M., Zhanataev, A., Moroz, V. et al. Total antioxidant status and lipid metabolism in patients with severe multiple trauma. Crit Care 12, P199 (2008). https://doi.org/10.1186/cc6420

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Keywords

  • Cholesterol
  • Alkaline Phosphatase
  • Total Cholesterol
  • Lipoprotein Cholesterol
  • Early Period