Objective:To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases(MAPK)signal transduction in human severe trauma and resuscitation,as well as the effect of lactated Ringer’s solution(LR),7.5% sodium chloride solution(HS)and 20% albumin injection(ALB)on the incidence and mortality of multiple organ dysfunction syndrome(MODS). Methods:Seventy-two severe trauma patients(ISS score 16-43)were divided into ISS≤25 and ISS>25 groups (each group was subdivided into LR,HS and ALB groups).ELISA was used to measure the concentration of sICAM-1.Western blot was used to measure the expression of p38 MAPK. Results:Compared with LR group,the transfusion volume needed for maintaining systolic blood pressure≥90 mm Hg was significantly decreased in HS and ALB groups (P<0.05).Compared with the control group,the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups(P<0.05 -0.01).At 4,12,and 24 hours,there was significant correlation between the expression of p38 MAPK and sICAM-1(P<0.01). Compared with LR group,sICAM-1 and p38 MAPK in HS and ALB groups were decreased(P<0.05).sICAM-1 and p38 MAPK were significantly higher in the group of ISS>25 than that of ISS≤25(P<0.05).MODS incidence and mortality were significantly higher in the group of ISS>25 than that of ISS≤25(P<0.05).MODS incidence and mortality were lower in HS and ALB groups than LR group (P<0.05). Conclusions:The up-regulation of polymorphonuclear neutrophil-endotheliocytes(PMN-EC)adhesion may be due to the increased sICAM-1 expression during severe trauma.The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK.During severe trauma,the levels of sICAM-1 and p38 MAPK,as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used. Objective: To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of lactated Ringer’s solution (LR), 7.5% sodium chloride (HS) and 20% albumin injection (ALB) on the incidence and mortality of multiple organ dysfunction syndrome (MODS). Methods: Seventy-two severe trauma patients (ISS score 16-43) were divided into ISS ≤ 25 and ISS> 25 groups (each group was subdivided into LR, HS and ALB groups). ELISA was used to measure the concentration of sICAM-1. Western blot was used to measure the expression of p38 MAPK. Results: Compared with LR group, the transfusion volume needed for maintaining systolic blood pressure ≥90 mm Hg was significantly decreased in HS and ALB groups (P <0.05) .Compared with the control group, the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups (P <0 .05 -0.01) .At 4,12, and 24 hours, there was a significant correlation between the expression of p38 MAPK and sICAM-1 (P <0.01). Compared with LR group, sICAM-1 and p38 MAPK in HS and ALB groups were decreased (P <0.05) .SICAM-1 and p38 MAPK were significantly higher in the group of ISS> 25 than that of ISS≤25 (P <0.05) .MODS incidence and mortality were significantly higher in the group of ISS> 25 than that of ISS ≤ 25 (P <0.05) .MODS incidence and mortality were lower in HS and ALB groups than LR group (P <0.05). Conclusions: The up-regulation of polymorphonuclear neutrophil-endotheliocytes may be due to the increased sICAM-1 expression during severe trauma. The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK. Fluid severe trauma, the levels of sICAM-1 and p38 MAPK, as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used.