Browsing by Author "Ladjevic, Nebojša (16233432900)"

Aim: To assess IL-10 serum concentration according to outcome of severe trauma treatment and influence of short nuclear polymorphism (SNP) 1082G/A within IL-10 gene on treatment outcome of patients with severe trauma. Methods: Forty-seven patients with major trauma were prospectively recruited, and they were divided into two groups according to outcome (survivors and non-survivors). The IL-10 gene polymorphisms were genotyped using restriction fragment length polymorphism analysis. Serum IL-10 levels were determined with enzyme-linked immunosorbent assay. Association between IL-10 serum concentration, IL-10 SNP type and IL-10 serum concentration in groups of patients with different SNPs with outcome after severe trauma was evaluated. Results: Mean age of patients was 35.53±14.53 years. The major mechanism of injury was traffic, and the mean injury severity score was 35.47±11.23. Despite higher values of IL-10 serum concentrations in patients with lethal outcome, the difference was not statistically significant. In 40 (85%) patients no gene polymorphism for IL-10 was recorded. No statistical significance in frequency of IL-10-1082 gene polymorphism was observed between the patients with different outcomes of polytrauma. No statistically significant difference in IL-10 values was evidenced between the subjects with and without polymorphisms in any of the observed times of measurement, although a trend toward the higher values may be observed in patients with polymorphism in heterozygous form. Conclusion: The patients with IL-10 SNP gene polymorphism despite no proven statistical significance appeared to have higher values of IL-10 and consequently worse outcome.

The purpose of the study was to point to the importance of measuring intra-abdominal pressure (IAP) and of early recognition of the consequences of increased IAP on basic vital functions. Measurement of IAP via urinary bladder was conducted every 12 hours in 70 surgical patients with acute abdominal syndromes not previously operated on. Based on the measured IAP values, all patients were divided into groups of patients with normal IAP values (n=20) and patients with increased IAP values (n=50). Vital functions and basic laboratory analysis were monitored and the values obtained were compared with IAP in both patient groups. A statistically significant difference was found in body weight, body mass index, urine output, creatinine, urea, heart rate, partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) between patients with normal and increased IAP values. The increase in IAP values was found to be associated with an increase in PaCO2, respiratory rate, peak inspiratory pressure, central venous pressure, heart rate, Acute Physiology, Age and Chronic Health Evaluation II score, mortality rate, creatinine and urea values, and number of days of treatment in the intensive care unit. At the same time, the values of PaO2, blood oxygen saturation, diuresis and abdominal perfusion pressure were declining. IAP measurement is an old, cost-effective, reliable technique that is easy to perform and should be applied in all high risk patients.