[Vasoactive factors in patients with a severe combined trauma]

46 patients with craniocerebral trauma combined with chest, abdominal, locomotor injuries were hospitalized to the critical care unit. At admission, blood pressure was low, blood loss reached 28% of circulating blood volume. Serum levels of hydrocortisone, nitrite, the activity of angiotensin-converting enzyme (ACE) were measured at admission, on admission hour 4, 24, day 3 and 7. Vasopressor to vasodepressor ratio (hydrocortisone x ACE/nitrite) was also estimated. It was found that severe combined trauma induces an intensive and long-term rise of blood hydrocortisone (a 3-fold rise at admission). ACE activity was low at all the measurements, nitrite levels were reduced only on day 1 and went up to normal on posttrauma day 3-7. The ratio hydrocortisone x ACE/nitrite was significantly elevated in all tests. It is concluded that in severe combined trauma low blood pressure was unrelated to nitric oxide.