Major Trauma Clinical Trial
Official title:
Markers of Tissue Injury and Rhabdomyolysis in Patients With Major Trauma
Major trauma is associated with a release of alarmins (DAMPs - damage-associated molecular patterns) from the injured tissues. This process results in the activation of the immune system, which is one of the main mechanisms participating in the development of organ dysfunctions in patients with major trauma.
Major trauma is associated with a release of alarmins (DAMPs - damage-associated molecular patterns) from the injured tissues. This process results in the activation of the immune system, which is one of the main mechanisms participating in the development of organ dysfunctions in patients with major trauma. Limited literary sources describe a correlation between the mitochondrial DNA (mDNA) and the value of plasma creatine kinase (sCK) (which is released from the injured muscles), which suggests a possible correlation between the number of released alarmins and the degree of rhabdomyolysis (damage of striated muscles). Rhabdomyolysis is further - due to the direct nephrotoxicity of myoglobin (sMb) released from the injured muscles - a significant factor participating in the development of acute renal failure in patients with serious injuries. Considering the fact that the serious injury need not include a vast damage of the muscle mass (especially in traumas with a minimal impairment of extremities), the correlation between the DAMPs and sCK/sMb values need not be constant in relation to the extent and localization of the injury defined with the AIS (Abbreviated Injury Scale) and ISS (Injury Severity Scale) scales. The DAMPs released from injured tissues immediately after trauma include HMGB-1 (high mobility group box 1); a correlation has been observed between the early post-injury levels of HMGB-1 and unfavorable outcome (defined with development of organ dysfunctions and increased mortality). Considering the fact that the DAMPs examination (including HMGB-1) are routinely available, and are also rather expensive, they are not a standard part of examinations performed in patients with serious trauma. Determination of correlation between HMGB-1 and the routinely available examinations of sCK and sMb would make the use of sCK and sMb examinations as direct indicators of mechanical tissue damage. Furthermore, this data has a significant descriptive impact in case of direct inclusion of sCK and sMb into predictive scoring systems, which currently do not contain relevant physiological parameters correlating with the extent of the injury. In the second part of the study, the authors will concentrate upon evaluation of correlation of HMGB-1, serum creatine kinase and serum myoglobin in relation to the development of acute kidney injury (AKI), and in relation to the values of AKI markers, specifically NGAL (neutrophil-gelatinase associated lipocalin). The currently used AKI criteria are based upon relatively imprecise and late parameters (urine output, level of serum creatinine), and that is why AKI is identified in the clinical practice only in the stage of advanced and irreversible morphological and functional changes of kidneys. The aims of the study are the following: - To verify the correlation between the levels of circulating alarmins (HMGB-1) and the levels of sCK and sMb - To identify the correlation between the levels of circulating alarmins and localization of the injury (according to AIS and ISS scoring systems) - Mutual comparison of predictive levels of sCK and sMb in relation to the development of post-injury kidney failure - Mutual comparison of predictive levels of sCK and sMb in relation to the serum and urine levels of AKI biomarkers - Comparison of predictive levels of serum and urine NGAL in relation to the development of post-injury AKI ;
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT02509390 -
Hyperfibrinogenemia After Major Trauma
|
N/A | |
| Recruiting |
NCT04970433 -
The Effects of Acupuncture for Major Trauma
|
N/A | |
| Recruiting |
NCT04588311 -
ErythroPOietin Alfa to Prevent Mortality and Reduce Severe Disability in Critically Ill TRAUMA Patients
|
Phase 3 | |
| Active, not recruiting |
NCT04144803 -
Brain Oxygenation During Prehospital Anesthesia: an Observational Study
|
||
| Completed |
NCT03259776 -
Experiences of Visitors to a Regional Major Trauma Intensive Care Unit
|
||
| Recruiting |
NCT05449522 -
Vitamin D for Critically Traumatic Patients
|
N/A | |
| Not yet recruiting |
NCT06103292 -
Calcium Levels in Major Trauma
|
||
| Recruiting |
NCT02877342 -
Pre-hospital Notification of Injured Patients Presenting to Trauma Centres in India
|
N/A | |
| Terminated |
NCT01545635 -
RETIC Trial: Reversal of Trauma Induced Coagulopathy Using Coagulation Factor Concentrates or Fresh Frozen Plasma
|
Phase 3 | |
| Completed |
NCT03005509 -
Structured Trauma Quality Improvement Meetings at Four Trauma Centres in India
|
N/A | |
| Completed |
NCT02165137 -
Management of Major Trauma Patients at Aarau Trauma Center - Evaluation of Processes and Patient Outcome
|
||
| Recruiting |
NCT05996068 -
Arterial Line in Trauma Resuscitation
|
N/A | |
| Completed |
NCT06007807 -
Severe Trauma Registry in Tarragona
|
||
| Completed |
NCT03354559 -
Trauma Associated Bleeding: Effectiveness of an Early Coagulation Support Protocol
|
N/A | |
| Recruiting |
NCT05652790 -
Enhanced Rehabilitation After Major Trauma (PROPERLY)
|
N/A | |
| Completed |
NCT00588796 -
Study of Fibrinogen Metabolism During Severe Trauma and Burns
|
N/A | |
| Completed |
NCT04216459 -
Effect of Anti-inflammatory and Anti-microbial Co-supplementations in Traumatic ICU Patients at High Risk of Sepsis
|
N/A | |
| Terminated |
NCT04551157 -
Impact of Psychoeducational Video on Adjustment to Open Fracture.
|
N/A | |
| Completed |
NCT02000674 -
Succinylcholine vs Rocuronium for Prehospital Emergency Intubation
|
Phase 3 | |
| Completed |
NCT03736005 -
Skeletal Muscle Wasting and Renal Dysfunction After Critical Illness Trauma - Outcomes Study
|