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