title: High Mobility Group Box-1 Protein and Outcomes in Critically Ill Surgical Patients Requiring Open Abdominal Management.
abstract: Background. Previous studies assessing various cytokines in the critically ill/injured have been uninformative in terms of translating to clinical care management. Animal abdominal sepsis work suggests that enhanced intraperitoneal (IP) clearance of Damage-Associated Molecular Patterns (DAMPs) improves outcome. Thus measuring the responses of DAMPs offers alternate potential insights and a representative DAMP, High Mobility Group Box-1 protein (HMGB-1), was considered. While IP biomediators are being recognized in critical illness/trauma, HMGB-1 behaviour has not been examined in open abdomen (OA) management.Methods. A modified protocol for HMGB-1 detection was used to examine plasma/IP fluid samples from 44 critically ill/injured OA patients enrolled in a randomized controlled trial comparing two negative pressure peritoneal therapies (NPPT): Active NPPT (ANPPT) and Barker's Vacuum Pack NPPT (BVP). Samples were collected and analyzed at the time of laparotomy and at 24 and 48 hours after.Results. There were no statistically significant differences in survivor versus nonsurvivor HMGB-1 plasma or IP concentrations at baseline, 24 hours, or 48 hours. However, plasma HMGB-1 levels tended to increase continuously in the BVP cohort.Conclusions. HMGB-1 appeared to behave differently between NPPT cohorts. Further studies are needed to elucidate the relationship of HMGB-1 and outcomes in septic/injured patients.
authors.affiliation: Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Malig
authors.affiliation: Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada; Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Craig N
authors.initials: CN
authors.lastname: Jenne
authors.affiliation: Critical Care Medicine, University of Calgary, Calgary, AB, Canada; Department of General Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Chad G
authors.initials: CG
authors.lastname: Ball
authors.affiliation: Department of General Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Roberts
authors.affiliation: The Regional Trauma Program, University of Calgary, Calgary, AB, Canada.
authors.forename: Zhengwen
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Critical Care Medicine, University of Calgary, Calgary, AB, Canada; Department of General Surgery, University of Calgary, Calgary, AB, Canada; The Regional Trauma Program, University of Calgary, Calgary, AB, Canada.
authors.forename: Andrew W
authors.identifier: 0000-0002-1692-5919
authors.initials: AW
authors.lastname: Kirkpatrick
mesh_terms: D000328:Adult; D016638:Critical Illness; D005260:Female; D024243:HMGB1 Protein / Q000097:blood* / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000378:metabolism; D007813:Laparotomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D065629:Peritoneal Absorption; D010537:Peritoneum / Q000378:metabolism; D013997:Time Factors
chemical_list: D024243:HMGB1 Protein