ENDOCRINE PROFILE FOR OUTCOME PREDICTION IN MULTIPLE TRAUMATIZED CRITICALLY ILL PATIENT

Document Type : Original Article

Authors

1 Departments of General Surgery, Faculty of Medicine Mansoura University

2 Critical Care Medicine, Faculty of Medicine Mansoura University

3 Critical Care Medicine, Faculty of Medicine Alexandria University

Abstract

Major trauma is a pathophysiological state, which threaten the integrity of the internal environment causing alteration
in the sympathoadrenal activity.The aim of this work was to study some endocrinal changes in multiple trauma critically ill
patients, and to study the correlation between the level of the hormones and the severity of trauma.This study was conducted on 20 critically ill multitrauma patients with injury severity score more than 14 in addition to 10 healthy persons as a control group.The separated plasma was analysed for adrenaline, noradrenaline, cortisol, growth hormone, thyroxine, and tri-iodothyronine levels.There were significant elevation of plasma adrenaline, noradrenaline, and cortisol in all patients. Growth hormone level was elevated in the low risk group patients. There was significant decrease in plasma thyroxine (T3) and truodothyronine (T4) in all patients.T3 and cortisol can be taken in the first day in multiple trauma critically ill patients to predict their mortality and identify the quality of health care. Growth hormone and thyroid hormone replacement may be of value in trauma patients. Other endocrinal changes occur during trauma but need to be evaluated in further studies.

Keywords