ELEVATED LEVELS OF SOLUBLE ICAM-1 CORRELATE WITH THE DEVELOPMENT OF MULTIPLE ORGAN FAILURE IN SEVERELY INJURED TRAUMA PATIENTS

Serum levels of Interleukin-6, Interleukin-8, the soluble receptor for tumor necrosis factor (sTNF(r)), and the soluble receptor for interce llular adhesion molecule-1 (sICAM-1) were measured serially in a serie s of 13 severely injured trauma patients to determine if any of these elements of the inflammatory response are predictive of multiple organ failure (MOF). Six of the 13 patients developed MOF as determined by a MOF scoring system. At the completion of resuscitation (when oxygen delivery and consumption were maximized) sICAM-1 levels were significa ntly higher in MOF patients before the development of clinical evidenc e of organ failure (700 +/- 67 ng/mL) compared with non-MOF patients ( 302 +/- 18 ng/mL). There was a significant correlation between the abs olute level of sICAM-1 at the time of resuscitation and the severity o f subsequent MOF. This finding suggests that leukocyte-endothelial cel l interactions are upregulated immediately after injury and may be imp licated in the end-organ injury that leads to MOF.