Study of Human Neutrophil Elastase Levels and the Correlation with ARDS Severity in Thoracic Trauma Patients

Abstract

Introduction: Thoracic trauma is trauma that hits the thoracic wall or intra-thoracic organs, either due to blunt trauma or due to sharp trauma. In thoracic trauma often causes impaired ventilation perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of Acute respiratory distress Syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. Method: This study will examine the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. The research subjects were thoracic trauma patients who fit the criteria. Result: I t can be concluded that there is a significant relationship between elastase levels and BGA-3. The elastase level is below the value of 11.65 ±1.85, the patient is likely not to experience ARDS in the future. If the value of elastase levels is limited to 23.79 ±3.95, the patient will experience mild type ARDS. Meanwhile, if the value of elastase levels is limited to 57.68 ±18.55, in the future the patient will experience moderate type of ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Conclusion: Based on the characteristic test of the sample characteristics, diagnosis and action, there are significant differences in the causes of ARDS. Neutophil elastase levels correlate with the degree of ARDS incidence.