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The catecholamine response to multisystem trauma.

P D Woolf1, J V McDonald, D V Feliciano

  • 1Departments of Medicine, University of Rochester School of Medicine, NY.

Archives of Surgery (Chicago, Ill. : 1960)
|August 1, 1992
PubMed
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Elevated norepinephrine levels correlate with injury severity in patients with multisystem injuries, particularly when a brain injury is present. This association was not observed in patients without head trauma.

Area of Science:

  • Trauma research
  • Neuroscience
  • Endocrinology

Background:

  • Multisystem injuries present complex physiological challenges.
  • Catecholamine response is a key indicator of physiological stress.
  • The role of head injury in modulating catecholamine response in trauma is not fully understood.

Purpose of the Study:

  • To investigate the relationship between catecholamine levels (norepinephrine and epinephrine) and injury severity in patients with multisystem injuries.
  • To determine if the presence of a head injury influences this relationship.

Main Methods:

  • Retrospective study of 206 patients with multisystem injuries.
  • Patients were divided into two groups: with (N=124) and without (N=82) head injury.
  • Injury severity assessed using Injury Severity Score (ISS), Glasgow Coma Scale (GCS), need for intubation, hypotension, fluid/blood resuscitation, and patient outcome.

Related Experiment Videos

  • Circulating catecholamine levels (norepinephrine and epinephrine) were measured.

    • Main Results:

    • In patients with head injury (group 1), higher norepinephrine and epinephrine levels were consistently associated with worsening injury severity indexes (ISS, GCS).
    • The strongest correlations were found between norepinephrine levels and ISS/GCS in the head injury group.
    • In patients without head injury (group 2), elevated catecholamine levels showed minimal association with injury severity markers.

    Conclusions:

    • Circulating catecholamine levels, particularly norepinephrine, significantly correlate with injury severity in multisystem trauma patients.
    • This correlation is dependent on the presence of a concomitant head injury.
    • Brain injury appears to be a critical factor in the catecholamine-mediated response to severe trauma.