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Heparin-binding protein (HBP): an early marker of respiratory failure after trauma?
J Johansson1, O Brattström, F Sjöberg
1Department of Anaesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden.
Insights
Plasma heparin-binding protein (HBP) may help detect acute respiratory distress syndrome (ARDS) after trauma. Elevated HBP levels correlate with ARDS development, suggesting its potential as an early biomarker in trauma patients.
Area of Science:
- Trauma and Critical Care Medicine
- Immunology
- Biomarker Discovery
Background:
- Trauma complications, including ARDS and sepsis, are significant causes of morbidity and mortality.
- Activated polymorphonuclear leucocytes (PMNs) in trauma patients contribute to ARDS development.
- Heparin-binding protein (HBP), released by activated PMNs, is implicated in acute inflammatory responses.
Purpose of the Study:
- To investigate plasma HBP levels in trauma patients.
- To determine if elevated HBP correlates with trauma severity, sepsis, or ARDS development.
Main Methods:
- Plasma HBP levels were measured within 36 hours of trauma in 47 patients.
- Injury Severity Score (ISS), SOFA, and APACHE II scores were recorded.
- Development of ARDS and severe sepsis was monitored daily during intensive care.
Main Results:
- No correlation was found between maximal plasma HBP levels and ISS, SOFA, or APACHE II scores.
- A significant correlation was observed between HBP levels and the development of ARDS (P = 0.026).
- No correlation was found between HBP levels and the development of severe sepsis.
Conclusions:
- Plasma HBP shows potential as an early biomarker for ARDS development post-trauma.
- Further research is needed to establish a causal relationship between plasma HBP and ARDS.
- HBP may aid in the early identification of trauma patients at risk for ARDS.
Background:
Trauma and its complications contribute to morbidity and mortality in the general population. Trauma victims are susceptible to acute respiratory distress syndrome (ARDS) and sepsis. Polymorphonuclear leucocytes (PMNs) are activated after trauma and there is substantial evidence of their involvement in the development of ARDS. Activated PMNs release heparin-binding protein (HBP), a granule protein previously shown to be involved in acute inflammatory reactions. We hypothesised that there is an increase in plasma HBP content after trauma and that the increased levels are related to the severity of the trauma or later development of severe sepsis and organ failure (ARDS).
Methods And Material:
We investigated HBP in plasma samples within 36 h from trauma in 47 patients admitted to a level one trauma centre with a mean injury severity score (ISS) of 26 (21-34). ISS, admission sequential organ failure assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were recorded at admission. ARDS and presence of severe sepsis were determined daily during intensive care.
Results:
We found no correlation between individual maximal plasma HBP levels at admission and ISS, admission SOFA or APACHE II. We found, however, a correlation between HBP levels and development of ARDS (P = 0.026, n = 47), but not to severe sepsis.
Conclusion:
HBP is a potential biomarker candidate for early detection of ARDS development after trauma. Further research is required to confirm a casual relationship between plasma HBP and the development of ARDS.
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