MONOETHYLGLYCINEXYLIDIDE AS AN EARLY PREDICTOR OF POSTTRAUMATIC MULTIPLE ORGAN FAILURE

The prognostic value of a dynamic liver-function test, based on the he patic conversion of lidocaine to monoethylglycinexylidide (MEGX), in p redicting multiple organ failure (MOF) was prospectively investigated in 28 critically ill patients after multiple trauma. The MEGX test and conventional static liver tests (bilirubin, aspartate aminotransferas e, glutamate dehydrogenase, and factor V) were performed on days 1, 3, 5, and 7 after trauma. Patients were classified by a modified MOF sco re into a group without (n = 18) and a group with the MOF syndrome (n = 10). One patient who developed MOF on the basis of a bacterial septi cemia was excluded from the general evaluation. No significant differe nces were observed in the MEGX Values of the two groups on day 1, All patients who subsequently developed MOF, however, displayed a sharp de crease in their MEGX values between days 1 and 3. Analysis of the data using receiver operating characteristic (ROC) curves revealed that th e results of the MEGX test on day 3 provided the greatest discriminati ng power between patients with and without subsequent MOF. A cut-off M EGX value of 30 mu g/L on day 3 was associated with a prognostic sensi tivity of 89% and a prognostic specificity of 94%.