Predictive model of indirect lung injuries in experimental trauma

Abstract

Introduction: Trauma remains a medical and social problem, with an increased rate of lethality. "Indirect" lung injury occurs in traumatic conditions due to systemic activation of neutrophils with the release of proteases in intact tissues. In the literature, there are no data on predictive models of distant lung injuries in traumatic conditions. Purpose: Development of a predictive model of indirect lung lesions in experimental trauma for the issuance of hypotheses regarding the pathophysiological mechanisms, prophylaxis and potential treatments of this post-traumatic complication. Material and methods: In the experimental study (19 traumatized rabbits), the proteases, antiproteases and the pulmonary morphological picture were assessed according to the Semiquantitatively Reflected Qualitative Changes Assessment Score (SRQCAS). Statistical method used - correlational analysis and multivariate linear regression. Results: Initially, to highlight potential predictors, a correlational analysis was performed between SRQCAS score values and proteases/antiproteases. Subsequently, multivariate analysis was applied. The null hypothesis was rejected (F = 7.017, p = .002). The correlation coefficient of the predicted results and the real values of SRQCASlungs constituted .854, the determination coefficient being .626. The final model included the following parameters: constant (B = 9,427; 95% CI 7,341, 11,513; p <.001); α2-macroglobulin0(B = -4,053; 95% Cl -6,350, -1,757; p = .002); ALDS0 (B = .002; 95% CI .000, .004; p = .075); ALDS24 (B = -. 006; 95% CI -.010, - .002; p = .003); CGA2 (B = .081; 95% CI .040, .122; p = .001); EA0 (B = -. 026; 95% CI -.040, -.011; p = .002). Conclusions: In the study, a predictive model was developed for indirect lung lesions in experimental trauma, the predictors being some elements of the protease/antiprotease system. It allows the issuance of hypotheses regarding the pathophysiology, prophylaxis and treatment of this complication.