SOME INDICES OF PROTEIN EXCHANGE IN EVALUATION OF INFECTION COMPLICATION RISK IN POLYTRAUMA

Background. Patients with higher risk of infection are to be identified for early prophylaxis of complications, reduction in mortality rate and related costs of treatment and rehabilitation. Aim. The purpose of the study was to identify most informative methods of clinical biochemistry that can be used for prognosis and early diagnosis of infection in polytrauma patients. Materials and Methods. Biochemical parameters of 35 non-infection and 22 patients with post-traumatic infection were reviewed during the first 10 days of severe combined injury. Total protein concentration, relative and quantitative content of albumin, globulin and the correlation were tested to evaluate protein spectrum of blood serum. Endogenous intoxication was assessed using low and average molar mass (LAMM) and oligopeptides (OP) in blood plasma and red blood cells (RBC). Results. Our findings showed that all polytrauma patients presented with hypoproteinemia and hypoalbuminemia during the period of relative stabilization of vital organs (12 to 24 hours). A significant increase in concentration of plasma LAMM was observed on the first day of injury in non-infection group. Plasma LAMM to RBC LAMM ratio was found to be a major prognostic criterion of osseous infection. The ratio of less than 3 units was recognized as a poor prognostic factor, and the ratio of greater than 3 as a good prognosis. Sensitivity and specificity of the method were 100% and 75%, correspondingly. Beta-globulin to alpha1-globulin ratio was identified as another prognostic factor with the measure of more than 4 units being a poor prognosis. Sensitivity and specificity of the method were 100% and 75%, correspondingly. Conclusion. The estimated indices can be used as additional prognostic criterion for development of infection in patients with multiple open and closed injuries of the limbs.