title: Predictive Value of Biochemical Markers for Extremity Vascular Trauma Outcome.
abstract: OBJECTIVE
  To evaluate the predictive value of some biochemical markers in the outcome of extremity vascular trauma.
  
  
  METHODS
  This study comprised 30 patients with traumatic arterial injury and acute limb ischemia referred to Namazi hospital affiliated with Shiraz University of Medical Ssciences, over a period of 8 months, from Sep 2009 to Jul 2010. Venous blood samples were drawn from distal ischemic limb to determine pH, HCO3, PCO2, PO2, Na and K before definitive surgical intervention. Comparable samples were also obtained from veins of non-ischemic upper extremities. The biochemical assays were compared after monitoring the revasculurized limbs and evaluation of viability during a period of 7 days.
  
  
  RESULTS
  The mean age of the patients was 28.3 ± 7.8 (range: 18-56) years. Two (6.6%) patients underwent amputation because of developing irreversible limb ischemia after vascular reconstruction. Both patients had blunt traumatic knee injury accompanied by nerve, vein and soft tissue damage. The statistical analysis showed correlations between parameters, except for Na of local (ischemic limb) and systemic samples. In this context, the highest correlation was observed in regard to HCO3.
  
  
  CONCLUSIONS
  The correlation was most pronounced with respect to HCO3. Ischemic limbs exhibited reduction in pH and PO but, PCO2 and K increased after ischemia of injured limbs. PO2 reflects tissue perfusion and is of value in predicting the outcome. We believe that blunt trauma and associated nerve, vein and soft tissue injuries pose negative prognostic effects on limb survival postoperatively.
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Bolandparvaz
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Ghaffari
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Mousavi
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Paydar
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Abbasi
keywords: Biochemical assay; Limb ischemia; Trauma; Vascular injury; Vascular reconstruction