Plasma concentration of Gc-globulin is associated with organ dysfunction and sepsis after injury

Benny Dahl, Frank V. Schiødt, Peter Ott, Frank Wians, William M. Lee, Jody Balko, Grant E. O'Keefe

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Objective: Clinical and experimental studies suggest that the proteins of the extracellular actin scavenger system have a role in the pathophysiological processes taking place in critically ill and injured patients. Circulating levels of Gc-globulin and gelsolin are reduced shortly after severe trauma, and admission levels of Gc-globulin are associated with survival. Herein, we sought to measure the association between admission levels of Gc-globulin and postinjury organ dysfunction and infection. We also wanted to describe the serial changes in Gc-globulin in these severely injured patients. Design: Prospective cohort. Setting: Intensive care unit at a county hospital that serves as a level one trauma center. Patients: Ninety-eight consecutive trauma victims admitted to the intensive care unit for >24 hrs during a 4-month period. Measurements and Main Results: Circulating levels of Gc-globulin were measured by using immunonephelometry. All patients were evaluated daily to obtain the necessary data for assessment of organ dysfunction and sepsis. The median Gc-globulin concentration at admission was 127 mg/L in patients who developed severe multiple organ dysfunction compared with 184 mg/L in patients who did not (p = .001). The admission level of Gc-globulin was comparable to known risk factors such as age and injury severity score, regarding development of organ dysfunction. Plasma concentrations of Gc-globulin remained significantly lower in patients who developed respiratory failure and sepsis, compared with patients who did not develop these complications (p = .02 and p = .015, respectively). Conclusions: Admission plasma concentration of Gc-globulin is lower in patients who develop organ dysfunction and sepsis after traumatic injury. These data, combined with the work of others, support the hypothesis that actin release and depletion of the extracellular actin scavenger system proteins are associated with, and may contribute in part to, the complications of sepsis and organ dysfunction, particularly respiratory failure and thrombocytopenia.

Original languageEnglish (US)
Pages (from-to)152-156
Number of pages5
JournalCritical Care Medicine
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2003

Fingerprint

Vitamin D-Binding Protein
Sepsis
Wounds and Injuries
Actins
Respiratory Insufficiency
Intensive Care Units
Gelsolin
County Hospitals
Injury Severity Score
Trauma Centers
Critical Illness
Thrombocytopenia
Proteins

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Plasma concentration of Gc-globulin is associated with organ dysfunction and sepsis after injury. / Dahl, Benny; Schiødt, Frank V.; Ott, Peter; Wians, Frank; Lee, William M.; Balko, Jody; O'Keefe, Grant E.

In: Critical Care Medicine, Vol. 31, No. 1, 01.01.2003, p. 152-156.

Research output: Contribution to journalArticle

Dahl, Benny ; Schiødt, Frank V. ; Ott, Peter ; Wians, Frank ; Lee, William M. ; Balko, Jody ; O'Keefe, Grant E. / Plasma concentration of Gc-globulin is associated with organ dysfunction and sepsis after injury. In: Critical Care Medicine. 2003 ; Vol. 31, No. 1. pp. 152-156.
@article{c98ff9b8eb1a4b88952aefbd506d00b3,
title = "Plasma concentration of Gc-globulin is associated with organ dysfunction and sepsis after injury",
abstract = "Objective: Clinical and experimental studies suggest that the proteins of the extracellular actin scavenger system have a role in the pathophysiological processes taking place in critically ill and injured patients. Circulating levels of Gc-globulin and gelsolin are reduced shortly after severe trauma, and admission levels of Gc-globulin are associated with survival. Herein, we sought to measure the association between admission levels of Gc-globulin and postinjury organ dysfunction and infection. We also wanted to describe the serial changes in Gc-globulin in these severely injured patients. Design: Prospective cohort. Setting: Intensive care unit at a county hospital that serves as a level one trauma center. Patients: Ninety-eight consecutive trauma victims admitted to the intensive care unit for >24 hrs during a 4-month period. Measurements and Main Results: Circulating levels of Gc-globulin were measured by using immunonephelometry. All patients were evaluated daily to obtain the necessary data for assessment of organ dysfunction and sepsis. The median Gc-globulin concentration at admission was 127 mg/L in patients who developed severe multiple organ dysfunction compared with 184 mg/L in patients who did not (p = .001). The admission level of Gc-globulin was comparable to known risk factors such as age and injury severity score, regarding development of organ dysfunction. Plasma concentrations of Gc-globulin remained significantly lower in patients who developed respiratory failure and sepsis, compared with patients who did not develop these complications (p = .02 and p = .015, respectively). Conclusions: Admission plasma concentration of Gc-globulin is lower in patients who develop organ dysfunction and sepsis after traumatic injury. These data, combined with the work of others, support the hypothesis that actin release and depletion of the extracellular actin scavenger system proteins are associated with, and may contribute in part to, the complications of sepsis and organ dysfunction, particularly respiratory failure and thrombocytopenia.",
author = "Benny Dahl and Schi{\o}dt, {Frank V.} and Peter Ott and Frank Wians and Lee, {William M.} and Jody Balko and O'Keefe, {Grant E.}",
year = "2003",
month = "1",
day = "1",
doi = "10.1097/00003246-200301000-00024",
language = "English (US)",
volume = "31",
pages = "152--156",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Plasma concentration of Gc-globulin is associated with organ dysfunction and sepsis after injury

AU - Dahl, Benny

AU - Schiødt, Frank V.

AU - Ott, Peter

AU - Wians, Frank

AU - Lee, William M.

AU - Balko, Jody

AU - O'Keefe, Grant E.

PY - 2003/1/1

Y1 - 2003/1/1

N2 - Objective: Clinical and experimental studies suggest that the proteins of the extracellular actin scavenger system have a role in the pathophysiological processes taking place in critically ill and injured patients. Circulating levels of Gc-globulin and gelsolin are reduced shortly after severe trauma, and admission levels of Gc-globulin are associated with survival. Herein, we sought to measure the association between admission levels of Gc-globulin and postinjury organ dysfunction and infection. We also wanted to describe the serial changes in Gc-globulin in these severely injured patients. Design: Prospective cohort. Setting: Intensive care unit at a county hospital that serves as a level one trauma center. Patients: Ninety-eight consecutive trauma victims admitted to the intensive care unit for >24 hrs during a 4-month period. Measurements and Main Results: Circulating levels of Gc-globulin were measured by using immunonephelometry. All patients were evaluated daily to obtain the necessary data for assessment of organ dysfunction and sepsis. The median Gc-globulin concentration at admission was 127 mg/L in patients who developed severe multiple organ dysfunction compared with 184 mg/L in patients who did not (p = .001). The admission level of Gc-globulin was comparable to known risk factors such as age and injury severity score, regarding development of organ dysfunction. Plasma concentrations of Gc-globulin remained significantly lower in patients who developed respiratory failure and sepsis, compared with patients who did not develop these complications (p = .02 and p = .015, respectively). Conclusions: Admission plasma concentration of Gc-globulin is lower in patients who develop organ dysfunction and sepsis after traumatic injury. These data, combined with the work of others, support the hypothesis that actin release and depletion of the extracellular actin scavenger system proteins are associated with, and may contribute in part to, the complications of sepsis and organ dysfunction, particularly respiratory failure and thrombocytopenia.

AB - Objective: Clinical and experimental studies suggest that the proteins of the extracellular actin scavenger system have a role in the pathophysiological processes taking place in critically ill and injured patients. Circulating levels of Gc-globulin and gelsolin are reduced shortly after severe trauma, and admission levels of Gc-globulin are associated with survival. Herein, we sought to measure the association between admission levels of Gc-globulin and postinjury organ dysfunction and infection. We also wanted to describe the serial changes in Gc-globulin in these severely injured patients. Design: Prospective cohort. Setting: Intensive care unit at a county hospital that serves as a level one trauma center. Patients: Ninety-eight consecutive trauma victims admitted to the intensive care unit for >24 hrs during a 4-month period. Measurements and Main Results: Circulating levels of Gc-globulin were measured by using immunonephelometry. All patients were evaluated daily to obtain the necessary data for assessment of organ dysfunction and sepsis. The median Gc-globulin concentration at admission was 127 mg/L in patients who developed severe multiple organ dysfunction compared with 184 mg/L in patients who did not (p = .001). The admission level of Gc-globulin was comparable to known risk factors such as age and injury severity score, regarding development of organ dysfunction. Plasma concentrations of Gc-globulin remained significantly lower in patients who developed respiratory failure and sepsis, compared with patients who did not develop these complications (p = .02 and p = .015, respectively). Conclusions: Admission plasma concentration of Gc-globulin is lower in patients who develop organ dysfunction and sepsis after traumatic injury. These data, combined with the work of others, support the hypothesis that actin release and depletion of the extracellular actin scavenger system proteins are associated with, and may contribute in part to, the complications of sepsis and organ dysfunction, particularly respiratory failure and thrombocytopenia.

UR - http://www.scopus.com/inward/record.url?scp=0037251539&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037251539&partnerID=8YFLogxK

U2 - 10.1097/00003246-200301000-00024

DO - 10.1097/00003246-200301000-00024

M3 - Article

C2 - 12545009

AN - SCOPUS:0037251539

VL - 31

SP - 152

EP - 156

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 1

ER -