Papurica Marius, Rogobete Alexandru F, Sandesc Dorel, Dumache Raluca, Cradigati Carmen A, Sarandan Mirela, Nartita Radu, Popovici Sonia E, Bedreag Ovidiu H
Clin Lab. 2016;62(6):977-86. doi: 10.7754/clin.lab.2015.151103.
The complexity of the cases of critically ill polytrauma patients is given by both the primary, as well as the secondary, post-traumatic injuries. The severe injuries of organ systems, the major biochemical and physiological disequilibrium, and the molecular chaos lead to a high rate of morbidity and mortality in this type of patient. The 'gold goal' in the intensive therapy of such patients resides in the continuous evaluation and monitoring of their clinical status. Moreover, optimizing the therapy based on the expression of certain biomarkers with high specificity and sensitivity is extremely important because of the clinical course of the critically ill polytrauma patient. In this paper we wish to summarize the recent studies of biomarkers useful for the intensive care unit (ICU) physician.
For this study the available literature on specific databases such as PubMed and Scopus was thoroughly analyzed. Each article was carefully reviewed and useful information for this study extracted. The keywords used to select the relevant articles were "sepsis biomarker", "traumatic brain injury biomarker" "spinal cord injury biomarker", "inflammation biomarker", "microRNAs biomarker", "trauma biomarker", and "critically ill patients".
For this study to be carried out 556 original type articles were analyzed, as well as case reports and reviews. For this review, 89 articles with relevant topics for the present paper were selected. The critically ill polytrauma patient, because of the clinical complexity the case presents with, needs a series of evaluations and specific monitoring. Recent studies show a series of either tissue-specific or circulating biomarkers that are useful in the clinical status evaluation of these patients.
The biomarkers existing today, with regard to the critically ill polytrauma patient, can bring a significant contribution to increasing the survival rate, by adapting the therapy according to their expressions. Nevertheless, the necessity remains to research new non-invasive diagnostic methods that present with higher specificity and selectivity.
重症多发伤患者病例的复杂性源于原发性创伤以及继发性创伤后损伤。器官系统的严重损伤、主要的生化和生理失衡以及分子紊乱导致这类患者的发病率和死亡率很高。对此类患者进行强化治疗的“黄金目标”在于持续评估和监测其临床状态。此外，鉴于重症多发伤患者的临床病程，基于某些具有高特异性和敏感性的生物标志物的表达来优化治疗极为重要。在本文中，我们希望总结对重症监护病房（ICU）医生有用的生物标志物的近期研究。
对于本研究，我们对PubMed和Scopus等特定数据库中的现有文献进行了全面分析。仔细审阅了每篇文章，并提取了对本研究有用的信息。用于选择相关文章的关键词有“脓毒症生物标志物”“创伤性脑损伤生物标志物”“脊髓损伤生物标志物”“炎症生物标志物”“微小RNA生物标志物”“创伤生物标志物”以及“重症患者”。
为开展本研究，我们分析了556篇原创型文章以及病例报告和综述。对于本综述，我们选择了89篇与本文相关主题的文章。重症多发伤患者由于病例所呈现的临床复杂性，需要一系列评估和特定监测。近期研究显示了一系列组织特异性或循环生物标志物，它们对评估这些患者的临床状态有用。
就重症多发伤患者而言，现有的生物标志物通过根据其表达调整治疗，可为提高生存率做出重大贡献。然而，仍有必要研究具有更高特异性和选择性的新型非侵入性诊断方法。
