title: Relation between both oxidative and metabolic-osmotic cell damages and initial injury severity in bombing casualties.
abstract: OBJECTIVE
  We have recently reported the development of oxidative cell damages in bombing casualties within a very early period after the initial injury. The aim of this study, was to investigate malondialdehyde (MDA), as an indicator of lipid peroxidation, and osmolal gap (OG), as a good indicator of metabolic cell damages and to assess their relationship with the initial severity of the injury in bombing casualties.
  
  
  METHODS
  The study included the males (n = 52), injured during the bombing with the Injury Severity Score (ISS) ranging from 3 to 66. The whole group of casualties was devided into a group of less severely (ISS < 25, n = 24) and a group of severely (ISS > or = 26, n = 28) injured males. The uninjured volunteers (n = 10) were the controls. Osmolality, MDA, sodium, glucose, urea, creatinine, total bilirubin and total protein levels were measured in the venous blood, sampled daily, within a ten-day period.
  
  
  RESULTS
  In both groups of casualties, MDA and OG levels increased, total protein levels decreased, while other parameters were within the control limits. MDA alterations correlated with ISS (r = 0.414, p < 0.01), while a statistically significant correlation between OG and ISS was not obtained. Interestingly, in spite of some differences in MDA and OG trends, at the end of the examined period they were at the similar level in both groups.
  
  
  CONCLUSIONS
  The initial oxidative damages of the cellular membrane with intracellular metabolic disorders contributed to the gradual development of metabolic-osmotic damages of cells, which, consequently caused the OG increase. In the bombing casualties, oxidative cell damages were dependent on the initial injury severity, while metabolic-osmotic cell damages were not.
authors.affiliation: Military Medical Academy, Institute for Biochemistry, Belgrade, Serbia and Montenegro. vucmina@Eunet.yu
authors.forename: Marina
authors.initials: M
authors.lastname: Vuceljić
authors.forename: Gordana
authors.initials: G
authors.lastname: Zunić
authors.forename: Predrag
authors.initials: P
authors.lastname: Romić
authors.forename: Miodrag
authors.initials: M
authors.lastname: Jevtić
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000097:blood / Q000473:pathology*; D001798:Blood Proteins / Q000032:analysis; D006801:Humans; D015601:Injury Severity Score; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009994:Osmolar Concentration; D018384:Oxidative Stress; D014857:Warfare; D014882:Water-Electrolyte Balance; D015022:Yugoslavia
chemical_list: D001798:Blood Proteins; D008315:Malondialdehyde