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Related Experiment Videos

[Multiple organ failure after severe trauma: predictable by the MEGX liver function test?]

D Pape1, U Lehmann, M Oellerich

  • 1Unfallchirurgische Klinik der BG-Kliniken Bergmannsheil, Ruhr-Universität Bochum.

Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1996
PubMed
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The monoethylglycinexylidide (MEGX) test can predict multiple organ failure (MOF) in critically ill trauma patients. A significant drop in MEGX levels between days 1 and 3 indicates a high risk of developing MOF.

Area of Science:

  • Critical care medicine
  • Hepatology
  • Trauma surgery

Background:

  • Multiple organ failure (MOF) is a significant complication in critically ill trauma patients.
  • Early prediction of MOF is crucial for timely intervention and improved patient outcomes.
  • Conventional static liver tests have limitations in dynamically assessing liver function post-trauma.

Purpose of the Study:

  • To prospectively evaluate the prognostic value of a dynamic liver function test, the monoethylglycinexylidide (MEGX) test, in predicting MOF.
  • To compare the predictive capability of the MEGX test with conventional static liver function tests.

Main Methods:

  • A prospective study involving 28 critically ill patients following multiple trauma.
  • The MEGX test, measuring hepatic conversion of lidocaine, was performed on days 1, 3, 5, and 7 post-trauma.

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  • Conventional static liver tests (bilirubin, AST, GDH, Factor V) were also conducted.
  • Patients were classified into groups with and without MOF using a modified MOF score.

    • Main Results:

    • Patients who developed MOF showed a distinct pattern of liver function.
    • A sharp decrease in MEGX values between days 1 and 3 post-trauma was observed in all patients who subsequently developed MOF.
    • Static liver tests did not show as clear a predictive pattern for MOF.

    Conclusions:

    • The dynamic MEGX test demonstrates significant prognostic value in predicting MOF in critically ill trauma patients.
    • Early detection of declining MEGX levels can serve as an important early warning sign for MOF development.
    • The MEGX test offers a more sensitive indicator of hepatic dysfunction related to MOF risk compared to static liver tests.