Changes Of Plasma Endotoxin In Children With Craniocerebral Injury And Its Clinical Significance

Objective: To study the changes of plasma endotoxin levels in children with brain injury and its clinical significance.Methods:Twenty-nine children with craniocerebral injury who were hospitalized by PICU in Shengjing Hospital affiliated to China Medical University were enrolled in the case group.Peripheral blood was collected at 1d,3d and 5d after craniocerebral injury,and 10 healthy children were selected as control group.Toxin determination was used to dynamically detect plasma endotoxin levels,and to compare the changes of endotoxin levels at 1d,3d and 5d after craniocerebral injury;to evaluate the correlation between endotoxin levels and GCS;1d,3d and 5d after craniocerebral injury The average GCS score was divided into light,medium and heavy groups,and the endotoxin levels were compared.The endotoxin changes were analyzed according to the diagnostic criteria of children’s gastrointestinal dysfunction and the multiple organ dysfunction syndrome(MODS)diagnostic criteria.At the same time,the children’s fever,hospitalization time,feeding mode,surgical history,mechanical ventilation,PCIS,ISS were collected to evaluate the factors affecting plasma endotoxin levels in the clinic.Result:Endotoxin levels on day 1,day 3 and day 5 after craniocerebral injury were significantly higher than those in the control group(p<0.05),and endotoxin levels on day 3 and day 5 were higher than day 1(p<0.05).GCS score was negatively correlated with endotoxin levels(p<0.05).The level of endotoxin in the severe head injury group was higher than that in the light and medium group.The level of toxin in the MODS group was higher than that in the non-MODS group.The endotoxin level in the gastrointestinal dysfunction group was higher than that in the non-gastrointestinal dysfunction group.Intestinal feeding and GCS score at admission were independent factors of endotoxemia(p<0.05).PCIS score was negatively correlated with endotoxemia,but it was not an independent factor.Conclusion:The level of endotoxin is significantly increased in the early stage after traumatic injury(day 3 post-injury),which is significantly correlated with GCS score.The more severe the brain injury,the higher the endotoxin level;the gastrointestinaldysfunction and plasma endotoxin in children with MODS The level was significantly elevated;enteral feeding at admission reduced endotoxin levels,and the lower the GCS score and PCIS score,the higher the endotoxin level.