α-Melanocyte stimulating hormone in critically injured trauma patients

S. Rob Todd, Lillian S. Kao, Anna Catania, David W. Mercer, Sasha D. Adams, Frederick A. Moore

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND: α-Melanocyte stimulating hormone (α-MSH) is a neuropeptide which modulates inflammation. Prior studies have documented decreased α-MSH concentrations in patients with acute traumatic brain injury and subarachnoid hemorrhage. We hypothesized that α-MSH levels would be decreased in critically injured patients and that this would correlate with poor outcome. METHODS: We performed a retrospective review of prospectively collected data more than 12 months ending December 2005. α-MSH concentrations were measured in major torso trauma patients (excluding severe head injuries) who underwent standardized shock resuscitation. α-MSH concentrations were measured every 4 hours for the first 24 hours of intensive care unit admission and daily thereafter for hospital days 2 to 5. Controls were similarly aged, healthy volunteers. Outcomes measured included lengths of stay, infectious morbidity, and the incidence of multiple organ failure (MOF) and mortality. RESULTS: Fifty-one trauma patients were studied with a median age of 33 (22-54) years. Seventy-five percent were male and 82% sustained blunt trauma. The median Injury Severity Score was 25 (16-34). Eighteen percent of the patients developed MOF, 18% died, and 24% developed MOF and died. The mean initial (first value on the first day) α-MSH concentration was significantly lower than in controls (15.9 pg/mL ± 7.6 pg/mL vs. 26.1 pg/mL ± 7.4pg/mL, p = 0.0008) and did not change significantly during the 5-day study period. On univariate and adjusted multivariate analyses, initial α-MSH concentrations did not predict either MOF or mortality. CONCLUSIONS: The current study is the first to document significantly decreased α-MSH concentrations in critically injured trauma patients as compared with controls. Furthermore, α-MSH concentrations remained so throughout the study period.

Original languageEnglish (US)
Pages (from-to)465-469
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume66
Issue number2
DOIs
StatePublished - Feb 1 2009

Fingerprint

Melanocyte-Stimulating Hormones
Wounds and Injuries
Multiple Organ Failure
Traumatic Brain Hemorrhage
Traumatic Subarachnoid Hemorrhage
Torso
Injury Severity Score
Mortality
Neuropeptides
Craniocerebral Trauma
Resuscitation
Brain Injuries
Intensive Care Units
Shock
Length of Stay
Healthy Volunteers
Multivariate Analysis
Inflammation
Morbidity

Keywords

  • Alpha-melanocyte stimulating hormone
  • Critically injured trauma patients
  • α-MSH

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

α-Melanocyte stimulating hormone in critically injured trauma patients. / Todd, S. Rob; Kao, Lillian S.; Catania, Anna; Mercer, David W.; Adams, Sasha D.; Moore, Frederick A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 66, No. 2, 01.02.2009, p. 465-469.

Research output: Contribution to journalArticle

Todd, S. Rob ; Kao, Lillian S. ; Catania, Anna ; Mercer, David W. ; Adams, Sasha D. ; Moore, Frederick A. / α-Melanocyte stimulating hormone in critically injured trauma patients. In: Journal of Trauma - Injury, Infection and Critical Care. 2009 ; Vol. 66, No. 2. pp. 465-469.
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AU - Moore, Frederick A.

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AB - BACKGROUND: α-Melanocyte stimulating hormone (α-MSH) is a neuropeptide which modulates inflammation. Prior studies have documented decreased α-MSH concentrations in patients with acute traumatic brain injury and subarachnoid hemorrhage. We hypothesized that α-MSH levels would be decreased in critically injured patients and that this would correlate with poor outcome. METHODS: We performed a retrospective review of prospectively collected data more than 12 months ending December 2005. α-MSH concentrations were measured in major torso trauma patients (excluding severe head injuries) who underwent standardized shock resuscitation. α-MSH concentrations were measured every 4 hours for the first 24 hours of intensive care unit admission and daily thereafter for hospital days 2 to 5. Controls were similarly aged, healthy volunteers. Outcomes measured included lengths of stay, infectious morbidity, and the incidence of multiple organ failure (MOF) and mortality. RESULTS: Fifty-one trauma patients were studied with a median age of 33 (22-54) years. Seventy-five percent were male and 82% sustained blunt trauma. The median Injury Severity Score was 25 (16-34). Eighteen percent of the patients developed MOF, 18% died, and 24% developed MOF and died. The mean initial (first value on the first day) α-MSH concentration was significantly lower than in controls (15.9 pg/mL ± 7.6 pg/mL vs. 26.1 pg/mL ± 7.4pg/mL, p = 0.0008) and did not change significantly during the 5-day study period. On univariate and adjusted multivariate analyses, initial α-MSH concentrations did not predict either MOF or mortality. CONCLUSIONS: The current study is the first to document significantly decreased α-MSH concentrations in critically injured trauma patients as compared with controls. Furthermore, α-MSH concentrations remained so throughout the study period.

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