Serum neutrophil gelatinase-associated lipocalin in ballistic injuries: a comparison between blast injuries and gunshot wounds.
Neutrophil gelatinase-associated lipocalin (NGAL) is part of a functionally diverse family of proteins that generally bind small, hydrophobic ligands. Neutrophil gelatinase-associated lipocalin is expressed in a number of human tissues including gastrointestinal, respiratory, and urinary tracts and tends to rise in response to inflammation. For this reason, we hypothesized that levels of NGAL might be expressed at higher levels after blast injury compared with other ballistic injury.


OBJECTIVE
The purpose of this study is to test the hypothesis that NGAL may be a marker of injury severity in blast injury.


METHODS
Twenty-three combat casualties (13 blast, 10 gunshot wounds) admitted to the multinational role 3 facility in Helmand province were studied. Serum NGAL was measured using a Biosite Triage point-of-care monitor at 5 time points after injury.


RESULTS
Neutrophil gelatinase-associated lipocalin rose in both groups of casualties and was significantly predictive of death or renal failure at intensive care unit admission, 12 and 24 hours after injury.


CONCLUSIONS
Neutrophil gelatinase-associated lipocalin is not a specific marker of blast injury but is predictive of both renal failure and poor outcome.
Surg Cdr RN, Defence Medical Services, UK. adrian.mellor@stees.nhs.uk
Adrian J
AJ
Mellor
David
D
Woods
D058186:Acute Kidney Injury / Q000097:blood; D000209:Acute-Phase Proteins / Q000096:biosynthesis*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D001753:Blast Injuries / Q000097:blood* / Q000401:mortality*; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000096:biosynthesis*; D015599:Trauma Severity Indices; D014948:Wounds, Gunshot / Q000097:blood* / Q000401:mortality*; D055815:Young Adult
D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins