title: Soluble Receptor for Advanced Glycation End Products Quantifies Lung Injury in Polytraumatized Patients.
abstract: BACKGROUND
  Biomarkers caused by blunt chest trauma might leak into the vascular compartment and therefore reflect the severity of parenchymal lung injury (PLI). Five promising proteins were preselected after a literature scan. The objective of our study was to identify a biomarker that is released abundantly into the serum shortly after trauma and reliably quantifies the loss of functional lung tissue.
  
  
  METHODS
  Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred. Immediately after stabilizing the patient's condition, blood samples were taken and a whole-body computed tomographic (CT) scan was obtained. Biomarker levels were measured directly after admission and on day 2. PLI volume was calculated using volumetric analysis.
  
  
  RESULTS
  One hundred thirty patients met the inclusion criteria. Compared with a matched healthy control population, median levels of the soluble receptor for advanced glycation end products (sRAGE) was almost 3 times higher and decreased by 41% on day 2. Higher initial median sRAGE levels were detected in patients with PLI compared with patients without PLI and in individuals with severe PLI compared with those with mild PLI. Spearman correlation analysis and a univariate linear log regression model revealed a significant correlation/equation between initial sRAGE levels and relative PLI volume. Receiver operating characteristic (ROC) statistics identified the initial sRAGE level as an indicator of severe PLI.
  
  
  CONCLUSIONS
  sRAGE levels measured shortly after trauma seem to be a promising diagnostic tool to assess the severity of PLI in polytraumatized patients.
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: lukas.negrin@meduniwien.ac.at.
authors.forename: Lukas L
authors.initials: LL
authors.lastname: Negrin
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Halat
authors.affiliation: Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Helmut
authors.initials: H
authors.lastname: Prosch
authors.affiliation: Department of Anesthesiology, General Intensive Care, and Pain Management, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Hüpfl
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hajdu
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Heinz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D055370:Lung Injury / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood*; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000067759:Receptor for Advanced Glycation End Products