The comet assay, or single-cell gel electrophoresis (SCGE), is
a sensitive, rapid, relatively simple and inexpensive method for
detecting DNA strand breaks in individual cells. It is used in
a broad variety of applications and as a tool to investigate DNA
damage and repair. The sensitivity and specificity of the assay
are greatly enhanced if the DNA incubated with an enzyme,
which recognizes a specific kind of DNA damage. This damage
induced by oxidative stress plays a pivotal role in many diseases
and in aging. This article is a critical review of the possible
application of the comet assay in some pathological states in
clinical practice. Most of the studies relate to evaluating the
response of an organism to chemotherapy or radiotherapy with
statistically significant evidence of DNA damage in patients. Other
useful applications have been demonstrated for patients with
heart or neurodegenerative diseases. Only a few studies have
been published on the use of this method in critically ill patients,
although its use would be appropriate. There are also other
scenarios where the comet assay could prove to be very useful in
the future, such as in predicting the likelihood of certain
pathological conditions.
Although the fluid therapy plays a fundamental role in the
management of polytrauma patients (PP), a tool which could
determine it appropriately is still lacking. The aim of this study
was to evaluate the application of a bioimpedance spectroscopy
(BIS) for body fluids volume and distribution monitoring in these
patients. This prospective, observational study was performed on
25 severe PP and 25 healthy subjects. The body fluids
composition was repeatedly assessed using BIS between days 3
to 11 of intensive care unit stay while the impact of fluid intake
and balance was evaluated. Fluid intake correlated significantly
with fluid excess (FE) in edemas, and their values were
significantly higher in comparison with the control group. FE was
strongly associated with cumulative fluid balance (p<0.0001,
r=0.719). Furthermore, this parameter was associated with the
entire duration of mechanical ventilation (p=0.001, r=0.791)
independently of injury severity score. In conclusion, BIS
measured FE could be useful in PP who already achieved
negative fluid balance in prevention the risk of repeated
hypovolemia through inappropriate fluid restriction. What is
more, measured FE has a certain prognostic value. Further
studies are required to confirm BIS as a potential instrument for
the improvement of PP outcome.