title: Circulating leukotriene B4 identifies respiratory complications after trauma.
abstract: BACKGROUND
  Leukotriene B4 (LTB4), a proinflammatory lipid mediator correlates well with the acute phase of Acute Respiratory Distress Syndrome (ARDS). Therefore, LTB4-levels were investigated to determine whether they might be a useful clinical marker in predicting pulmonary complications (PC) in multiply traumatized patients.
  
  
  METHODS
  Plasma levels of LTB4 were determined in 100 patients on admission (ED) and for five consecutive days (daily). Twenty healthy volunteers served as control. LTB4-levels were measured by ELISA. Thirty patients developed PC (pneumonia, respiratory failure, acute lung injury (ALI), ARDS, pulmonary embolism) and 70 had no PC (ØPC).
  
  
  RESULTS
  LTB4-levels in the PC-group [127.8 pg/mL, IQR: 104-200pg/ml] were significantly higher compared to the ØPC-group on admission [95.6 pg/mL, IQR: 55-143 pg/mL] or control-group [58.4 pg/mL, IQR: 36-108 pg/mL]. LTB4 continuously declined to basal levels from day 1 to 5 without differences between the groups. The cutoff to predict PC was calculated at 109.6 pg/mL (72% specificity, 67% sensitivity). LTB4 was not influenced by overall or chest injury severity, age, gender or massive transfusion. Patients with PC received mechanical ventilation for a significantly longer period of time, and had prolonged intensive care unit and overall hospital stay.
  
  
  CONCLUSIONS
  High LTB4-levels indicate risk for PC development in multiply traumatized patients.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Goethe University Frankfurt am Main, 60590 Frankfurt, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Auner
authors.forename: Emanuel V
authors.initials: EV
authors.lastname: Geiger
authors.forename: Dirk
authors.initials: D
authors.lastname: Henrich
authors.forename: Mark
authors.initials: M
authors.lastname: Lehnert
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
authors.forename: Borna
authors.initials: B
authors.lastname: Relja
mesh_terms: D055371:Acute Lung Injury / Q000097:blood* / Q000145:classification; D000328:Adult; D001803:Blood Transfusion; D003422:Critical Care; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D007975:Leukotriene B4 / Q000097:blood*; D008171:Lung Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000150:complications; D012680:Sensitivity and Specificity; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis
chemical_list: D007975:Leukotriene B4