Der additive Effekt eines schweren Schädel-Hirn-Traumas auf die Plasma-Mediatorspiegel polytraumatisierter Patienten

Introduction: We investigated whether the additional presence of severe head trauma (SHT) in multiple injury patients leads to an increase in systemic mediator levels. Methods: Blood samples were collected from 125 trauma patients every 6 h during the first 3 days post-injury and with longer time intervals thereafter. For controls, 37 healthy blood donors were studied. The systemic levels of interleukin (IL)-6, IL-10, soluble TNF receptors (sTNFR) P55, sTNFR P75, and PMN-elastase were determined. Mediator levels were compared between patients with and without SHT while adjusting for age, sex, and injury severity score (ISS) in multivariate linear regression models. Results: The patients’ mean (°SD) age and ISS were 38°17 years and 27°13 points, respectively. At all four time points (3,12,24, and 108 h post-injury) sTNFR P55 levels were significantly increased by the additional presence of head injuries: +55%, +37%, +32%, and +24%, respectively. The levels of sTNFR P75, IL-6, IL-10, and PMN-elastase were similarly, but non-significantly increased. Conclusions: SHT leads to a systemic mediator release that is independent of injury severity itself as described by the ISS.