CHEST TRAUMA AND ITS IMPACT ON THE RELEASE OF VASOACTIVE MEDIATORS

Every year, major chest injury is involved in 56% of deaths in trauma victims. Blunt chest trauma apparently plays a crucial role in trauma- induced death of multiply injured patients. Therefore, the aim of this study was to evaluate the impact of different types of injuries, incl uding lung tissue damage, on the release of various prostanoids. In a prospective study, the release of arachidonic acid (AA) metabolites wa s estimated in patients suffering blunt chest trauma alone, i.e., sing le thoracic injury, and in multiple injured patients including blunt c hest trauma. The results were compared with those of patients sufferin g from single long bone fractures of the leg without additional injury . The plasma concentrations of the AA metabolites, prostacyclin, throm boxane, prostaglandin F-2 alpha and prostaglandin M were determined im mediately after admission and in hourly and daily intervals thereafter . Despite clearly different injury scores, elevated levels of circulat ing AA metabolites were found in the plasma in all patients. This stud y reveals that any trauma increases significantly the release of prost anoids into the peripheral blood without regard to the impact of tissu e damage. This phenomenon is, however, most pronounced following lung injury. On the basis of these results we suggest that there is a speci fic impact of those mediators in blunt chest trauma. The prostanoids a pparently are suitable to describe and even to monitor the extent of t horacic trauma, thus giving additional information in some respect to the individual outcome.