SERUM GC-GLOBULIN IN THE EARLY COURSE OF MULTIPLE TRAUMA

Objectives: In patients with multiple trauma, actin released from dama ged cells may cause severe circulatory disturbance due to thrombi form ation. The aim of this study was to evaluate serum concentrations of t he actin scavenger, Gc-globulin, in relation to the severity of injury and outcome. Design: Prospective, longitudinal, observational study. Setting: Trauma center at a university hospital. Patients: Twelve pati ents with multiple trauma, consecutively included, according to define d criteria. Interventions: None. Measurements and Main Results: Serum Gc-globulin concentrations were measured at the time of admission and daily thereafter for 1 wk or until death. In all patients, the Gc-glob ulin concentration was significantly low (p < .0001), and the proporti on of Gc-globulin bound to actin was already increased compared with n ormal values (p < .0001) by the time of hospital arrival. There was an inverse correlation between the mean concentration of serum Gc-globul in in the first week after trauma and the Injury Severity Score (r = - 0.72, p < .05). Surviving patients had a significantly (p < .05) highe r concentration of serum Gc-globulin in the first week after trauma co mpared with nonsurvivors. Conclusions: Serum concentrations of Gc-glob ulin were significantly low in trauma patients. The reduction took pla ce within 60 mins after injury. Because the normal half-life of Gc-glo bulin is almost 48 hrs, our observations suggest a marked consumption of Gc-globulin immediately after the trauma. This finding could be the first clinical evidence that Gc-globulin plays a role in the systemic inflammatory response syndrome after trauma. This result is supported by the finding that lack of Gc-globulin was related to nonsurvival an d the severity of the trauma.