Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients
We hypothesized that elevated base deficit (BD) ≥ 4 mEq/L upon admission could be associated with an altered inflammatory response, which in turn may impact differential clinical trajectories. Using clinical and biobank data from 472 blunt trauma survivors, 154 patients were identified after excludi...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2016/7950374 |
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| author | Othman Abdul-Malak Yoram Vodovotz Akram Zaaqoq Jesse Guardado Khalid Almahmoud Jinling Yin Brian Zuckerbraun Andrew B. Peitzman Jason Sperry Timothy R. Billiar Rami A. Namas |
| author_facet | Othman Abdul-Malak Yoram Vodovotz Akram Zaaqoq Jesse Guardado Khalid Almahmoud Jinling Yin Brian Zuckerbraun Andrew B. Peitzman Jason Sperry Timothy R. Billiar Rami A. Namas |
| author_sort | Othman Abdul-Malak |
| collection | DOAJ |
| description | We hypothesized that elevated base deficit (BD) ≥ 4 mEq/L upon admission could be associated with an altered inflammatory response, which in turn may impact differential clinical trajectories. Using clinical and biobank data from 472 blunt trauma survivors, 154 patients were identified after excluding patients who received prehospital IV fluids or had alcohol intoxication. From this subcohort, 84 patients had a BD ≥ 4 mEq/L and 70 patients with BD < 4 mEq/L. Three samples within the first 24 h were obtained from all patients and then daily up to day 7 after injury. Twenty-two cytokines and chemokines were assayed using Luminex™ and were analyzed using two-way ANOVA and dynamic network analysis (DyNA). Multiple mediators of the innate and lymphoid immune responses in the BD ≥ 4 group were elevated differentially upon admission and up to 16 h after injury. DyNA revealed a higher, sustained degree of interconnectivity of the inflammatory response in the BD ≥ 4 patients during the initial 16 h after injury. These results suggest that elevated admission BD is associated with differential immune/inflammatory pathways, which subsequently could predispose patients to follow a complicated clinical course. |
| format | Article |
| id | doaj-art-0604dd9290374aecb4ae5adb9916c780 |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-0604dd9290374aecb4ae5adb9916c7802025-02-03T01:23:50ZengWileyMediators of Inflammation0962-93511466-18612016-01-01201610.1155/2016/79503747950374Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma PatientsOthman Abdul-Malak0Yoram Vodovotz1Akram Zaaqoq2Jesse Guardado3Khalid Almahmoud4Jinling Yin5Brian Zuckerbraun6Andrew B. Peitzman7Jason Sperry8Timothy R. Billiar9Rami A. Namas10Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Critical Care Medicine, University of Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USADepartment of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USAWe hypothesized that elevated base deficit (BD) ≥ 4 mEq/L upon admission could be associated with an altered inflammatory response, which in turn may impact differential clinical trajectories. Using clinical and biobank data from 472 blunt trauma survivors, 154 patients were identified after excluding patients who received prehospital IV fluids or had alcohol intoxication. From this subcohort, 84 patients had a BD ≥ 4 mEq/L and 70 patients with BD < 4 mEq/L. Three samples within the first 24 h were obtained from all patients and then daily up to day 7 after injury. Twenty-two cytokines and chemokines were assayed using Luminex™ and were analyzed using two-way ANOVA and dynamic network analysis (DyNA). Multiple mediators of the innate and lymphoid immune responses in the BD ≥ 4 group were elevated differentially upon admission and up to 16 h after injury. DyNA revealed a higher, sustained degree of interconnectivity of the inflammatory response in the BD ≥ 4 patients during the initial 16 h after injury. These results suggest that elevated admission BD is associated with differential immune/inflammatory pathways, which subsequently could predispose patients to follow a complicated clinical course.http://dx.doi.org/10.1155/2016/7950374 |
| spellingShingle | Othman Abdul-Malak Yoram Vodovotz Akram Zaaqoq Jesse Guardado Khalid Almahmoud Jinling Yin Brian Zuckerbraun Andrew B. Peitzman Jason Sperry Timothy R. Billiar Rami A. Namas Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients Mediators of Inflammation |
| title | Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients |
| title_full | Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients |
| title_fullStr | Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients |
| title_full_unstemmed | Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients |
| title_short | Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients |
| title_sort | elevated admission base deficit is associated with a complex dynamic network of systemic inflammation which drives clinical trajectories in blunt trauma patients |
| url | http://dx.doi.org/10.1155/2016/7950374 |
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