Evaluation of Dynamic / Thiol Disulfide Balance and İschemia Modified Albumin in Children with Trauma

Abstract

Introduction: Trauma is the most common cause of death in childhood. Tissue damage, ischemia-reperfusion injury and inflammatory response are mainly responsible for increasing serbest oxiygen radicals. In this study, we aimed to investigate the use of thiol-disulfide and ischemia-modified albumin levels as a diagnostic laboratory parameter in trauma children. Method: Of 202 children, 101 of them were hospitalized in pediatric surgical intensive care unit with trauma and 101 of others were healthy children. Levels of native thiol (-SH), total thiol (SH + SS), dynamic disulfide (SS), dynamic disulfide (SS) / total thiol (SH + SS), albumin and ischemic modified albumin (IMA) were measured from the sera of patients and healthy volunteers. For statistical analyses, SPSS 17.0 was used. Mann-Whitney U and paired correlation test were used where appropriate. p <0.05 was considered significant. Results: The mean age of the patients in the trauma group (Boys: 61 Girls: 40) was 7,88 years and the control group was 8,00 years. In trauma group, 86 of children were exposed to blunt trauma, 15 of children had penetrating trauma and 54 patients had multiple trauma. Surgical procedures were performed in 17 patients. In the trauma group, native thiol, total thiol, dynamic disulfide / total thiol, albumin and IMA levels were significantly lower than that of control (p <0.001) and their dynamic disulfide (p = 0.001) was higher compared to the control. There was no difference thiol-disulfide parametres in trauma groups sub-division as surgery(n=17) vs. follow-up(n=84) groups or multiple trauma(n=54) vs. isolated organ trauma(n=47) groups, or penetrating(n=15) or blunt trauma(n=86) groups. Conclusion: Thiol-disulfide balance and IMA levels show changes in favor of oxidative stress in children with trauma, however, it cannot be used as a laboratory marker that helps to show the system and organ affected by the trauma and to decide the surgical intervention.