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Mediators of Inflammation
Volume 2017, Article ID 6305387, 8 pages
Research Article

High Mobility Group Box-1 Protein and Outcomes in Critically Ill Surgical Patients Requiring Open Abdominal Management

1Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada
2Critical Care Medicine, University of Calgary, Calgary, AB, Canada
3Department of General Surgery, University of Calgary, Calgary, AB, Canada
4The Regional Trauma Program, University of Calgary, Calgary, AB, Canada

Correspondence should be addressed to Andrew W. Kirkpatrick; ac.secivreshtlaehatrebla@kcirtapkrik.werdna

Received 11 October 2016; Revised 19 December 2016; Accepted 22 January 2017; Published 14 February 2017

Academic Editor: Dmitri V. Krysko

Copyright © 2017 Michelle S. Malig et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Previous studies assessing various cytokines in the critically ill/injured have been uninformative in terms of translating to clinical care management. Animal abdominal sepsis work suggests that enhanced intraperitoneal (IP) clearance of Damage-Associated Molecular Patterns (DAMPs) improves outcome. Thus measuring the responses of DAMPs offers alternate potential insights and a representative DAMP, High Mobility Group Box-1 protein (HMGB-1), was considered. While IP biomediators are being recognized in critical illness/trauma, HMGB-1 behaviour has not been examined in open abdomen (OA) management. Methods. A modified protocol for HMGB-1 detection was used to examine plasma/IP fluid samples from 44 critically ill/injured OA patients enrolled in a randomized controlled trial comparing two negative pressure peritoneal therapies (NPPT): Active NPPT (ANPPT) and Barker’s Vacuum Pack NPPT (BVP). Samples were collected and analyzed at the time of laparotomy and at 24 and 48 hours after. Results. There were no statistically significant differences in survivor versus nonsurvivor HMGB-1 plasma or IP concentrations at baseline, 24 hours, or 48 hours. However, plasma HMGB-1 levels tended to increase continuously in the BVP cohort. Conclusions. HMGB-1 appeared to behave differently between NPPT cohorts. Further studies are needed to elucidate the relationship of HMGB-1 and outcomes in septic/injured patients.