[Value of monitoring oxygen metabolism in multiple organ dysfunction syndrome after severe trauma]

To study changes in oxygen metabolism and evaluate metabolic status in tissue and cell after severe trauma, and to investigate value of monitoring oxygen metabolism in the course of development of multiple organ dysfunction syndrome (MODS) in trauma between patients.

The data of 146 patients with severe trauma in Tongji Hospital were collected. The variables pertaining to oxygen metabolism were analyzed, and the data were compared between patients with risky trauma and those with severe trauma, between patients complicated with MODS and non--MODS (NMODS), and between survivors and nonsurvivors. With patients with minor trauma as control, the data were analyzed according to injury severity score (ISS), revised trauma score (RTS), acute physiology and chronic health evaluation II (APACHE II), trauma and injury severity score (TRISS(RTS)) methods for trauma and outcome study of probability of survival (Ps).

Oxygen metabolism abnormality was found after trauma, and it was correlated with ISS, RTS, injured organ or region and number of injured organs, shock, systemic inflammatory response syndrome (SIRS) and respiratory complications. It was more intense in the patients with MODS. There was marked difference in the ratio of change in oxygen metabolism between MODS and NMODS groups. Oxygen deficiency metabolic variables tended to deteriorate in the non survival group. More marked changes in metabolic variables indicated severer organ dysfunction, reaching their peak values before death.

Changes in level of oxygen metabolism might be closely correlated with development of MODS in trauma patients. Dynamic monitorings of metabolic status of tissue and cell are valuable in predicting the development of MODS after severe trauma.