CHANGES IN THE SERUM SEROTONIN LEVEL DURING THE ACUTE PERIOD OF MULTIPLE TRAUMA OF VARYING DEGREES OF SEVERITY

Abstract

Introduction. The roles of endogenous serotonin such as its effect in the increased permeability of the blood-brain barrier, its effects upon the formation of cerebral edema as well as its participation in early cellular changes are well known and its significance as a marker of severity of traumatic brain injuries is recognized. However, the role of serotonin and its effect on hemodynamics in multiple trauma have not been sufficiently studied yet.Aim. To determine the pathogenetic role of serum serotonin, depending on the initial primary severity of injury in the acute period of multiple trauma with traumatic brain injury.Materials and methods. The study consisted of 40 patients with moderate and severe degrees of multiple trauma which were treated in the Lviv emergency hospital. The average age of the patients was 48.4 ± 5.2 years. In addition to standard laboratory parameters, serum serotonin levels were determined by the improved spectrofluorometry method.Results and discussion. In the group of patients with severe multiple trauma the initial cardiac output (CO) was 4.40 ± 0.07 l / min with a normalization during the first day. The serum serotonin level on admission was 0.075 ± 0.003 мg / cmі and after 24 hours it decreased significantly to 0.043 ± 0.005 мg / cmі. At the end of the 2nd day of treatment, the serotonin levels increased to 0.090 ± 0.008 мg / cmі. In the group of patients with moderate multiple trauma, the initial CO was 4,06 ± 0,10 l / min which was a significantly lower than those of the severe multiple trauma patients. After 6 hours of treatment the CO normalized with a significantly lower volume of infusion. The content of serotonin in the blood serum on admission was significantly lower compared to the group with severe multiple trauma and amounted to 0,055 ± 0,008 мg / cmі, after 24 hours 0,038 ± 0,005 мg / cmі, at the end of the 2 nd day 0,085 ± 0,007 мg / cmі.Conclusion. Serotonin content in the serum of patients with multiple trauma during hospitalization varies significantly depending on the severity of the multiple trauma, which makes it possible to use its as a diagnostic-prognostic bio-marker. A two-phased activation of the sympathetic nervous system during the first two days of treatment was noted, which manifested itself in significant fluctuations in the level of serotonin, regardless of the primary severity of the multiple trauma.