Prognostic value of assessing contact system activation and factor V in systemic inflammatory response syndrome

R. A. Pixley, S. Zellis, P. Bankes, R. A. Dela Cadena, J. D. Page, C. F. Scott, J. Kappelmayer, E. G. Wyshock, J. J. Kelly, R. W. Colman

Research output: Contribution to journalArticle

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Abstract

Objective: To test if serially sampled determinations of the contact system proteins and factor V have prognostic value for death in patients who develop the systemic inflammatory response syndrome. Design: Prospective, observational study with sequential measurements in an inception cohort. Setting: Medical intensive care unit (ICU) in a community hospital. Patients: Over a 1-yr period, a population base sample of 23 patients was selected from all ICU admissions who met established criteria for the systemic inflammatory response syndrome. Interventions: None. Measurements and Main Results: Components of the contact system, factor XII, prekallikrein, high-molecular- weight kininogen, factor XI, α2-macroglobulin-kallikrein complexes and factor V values were measured in plasma samples collected serially (day of admission, and at 2, 12, 24, 48 and/or 72 hrs or at discharge). Data were analyzed to determine if admission values or serially obtained values within 48 hrs were useful in predicting outcome. Fourteen patients survived and nine died. At admission, in all patients, assay values indicated that prekallikrein, high-molecular-weight kininogen, and factor V were significantly lower than normal (as observed in a range of 20 to 23 healthy adults), α2-macroglobulin-kallikrein complexes were higher than normal, while concentrations of factor XII and factor XI were in the normal range. No differences were detected in the admission values between survivors and nonsurvivors, nor between patients with positive or negative blood cultures. However, subsequent values demonstrated a difference in values between survivors and non-survivors. Survivors showed improvement in high molecular weight kininogen values and higher than normal factor V values, as compared with nonsurvivors. Conclusions: Low or persistently low serial factor XII, high-molecular-weight kininogen and factor V values are associated with a poor prognosis, whereas high or increasing values of factor XII, high- molecular-weight kininogen, prekallikrein, and factor V all correlate with a favorable outcome.

Original languageEnglish
Pages (from-to)41-51
Number of pages11
JournalCritical Care Medicine
Volume23
Issue number1
DOIs
Publication statusPublished - 1995

Fingerprint

Systemic Inflammatory Response Syndrome
High Molecular Weight Kininogens
Factor V
Factor XII
Prekallikrein
Factor XI
Survivors
Tissue Kallikreins
Macroglobulins
Intensive Care Units
Reference Values
Community Hospital
Observational Studies
Prospective Studies
Population
Proteins

Keywords

  • alpha macroglobulin
  • critical illness
  • factor V
  • factor XI
  • factor XII
  • kininogens, high molecular weight
  • patient outcome assessment
  • prekallikrein
  • prognostication
  • sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Pixley, R. A., Zellis, S., Bankes, P., Dela Cadena, R. A., Page, J. D., Scott, C. F., ... Colman, R. W. (1995). Prognostic value of assessing contact system activation and factor V in systemic inflammatory response syndrome. Critical Care Medicine, 23(1), 41-51. https://doi.org/10.1097/00003246-199501000-00010

Prognostic value of assessing contact system activation and factor V in systemic inflammatory response syndrome. / Pixley, R. A.; Zellis, S.; Bankes, P.; Dela Cadena, R. A.; Page, J. D.; Scott, C. F.; Kappelmayer, J.; Wyshock, E. G.; Kelly, J. J.; Colman, R. W.

In: Critical Care Medicine, Vol. 23, No. 1, 1995, p. 41-51.

Research output: Contribution to journalArticle

Pixley, RA, Zellis, S, Bankes, P, Dela Cadena, RA, Page, JD, Scott, CF, Kappelmayer, J, Wyshock, EG, Kelly, JJ & Colman, RW 1995, 'Prognostic value of assessing contact system activation and factor V in systemic inflammatory response syndrome', Critical Care Medicine, vol. 23, no. 1, pp. 41-51. https://doi.org/10.1097/00003246-199501000-00010
Pixley, R. A. ; Zellis, S. ; Bankes, P. ; Dela Cadena, R. A. ; Page, J. D. ; Scott, C. F. ; Kappelmayer, J. ; Wyshock, E. G. ; Kelly, J. J. ; Colman, R. W. / Prognostic value of assessing contact system activation and factor V in systemic inflammatory response syndrome. In: Critical Care Medicine. 1995 ; Vol. 23, No. 1. pp. 41-51.
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AU - Pixley, R. A.

AU - Zellis, S.

AU - Bankes, P.

AU - Dela Cadena, R. A.

AU - Page, J. D.

AU - Scott, C. F.

AU - Kappelmayer, J.

AU - Wyshock, E. G.

AU - Kelly, J. J.

AU - Colman, R. W.

PY - 1995

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N2 - Objective: To test if serially sampled determinations of the contact system proteins and factor V have prognostic value for death in patients who develop the systemic inflammatory response syndrome. Design: Prospective, observational study with sequential measurements in an inception cohort. Setting: Medical intensive care unit (ICU) in a community hospital. Patients: Over a 1-yr period, a population base sample of 23 patients was selected from all ICU admissions who met established criteria for the systemic inflammatory response syndrome. Interventions: None. Measurements and Main Results: Components of the contact system, factor XII, prekallikrein, high-molecular- weight kininogen, factor XI, α2-macroglobulin-kallikrein complexes and factor V values were measured in plasma samples collected serially (day of admission, and at 2, 12, 24, 48 and/or 72 hrs or at discharge). Data were analyzed to determine if admission values or serially obtained values within 48 hrs were useful in predicting outcome. Fourteen patients survived and nine died. At admission, in all patients, assay values indicated that prekallikrein, high-molecular-weight kininogen, and factor V were significantly lower than normal (as observed in a range of 20 to 23 healthy adults), α2-macroglobulin-kallikrein complexes were higher than normal, while concentrations of factor XII and factor XI were in the normal range. No differences were detected in the admission values between survivors and nonsurvivors, nor between patients with positive or negative blood cultures. However, subsequent values demonstrated a difference in values between survivors and non-survivors. Survivors showed improvement in high molecular weight kininogen values and higher than normal factor V values, as compared with nonsurvivors. Conclusions: Low or persistently low serial factor XII, high-molecular-weight kininogen and factor V values are associated with a poor prognosis, whereas high or increasing values of factor XII, high- molecular-weight kininogen, prekallikrein, and factor V all correlate with a favorable outcome.

AB - Objective: To test if serially sampled determinations of the contact system proteins and factor V have prognostic value for death in patients who develop the systemic inflammatory response syndrome. Design: Prospective, observational study with sequential measurements in an inception cohort. Setting: Medical intensive care unit (ICU) in a community hospital. Patients: Over a 1-yr period, a population base sample of 23 patients was selected from all ICU admissions who met established criteria for the systemic inflammatory response syndrome. Interventions: None. Measurements and Main Results: Components of the contact system, factor XII, prekallikrein, high-molecular- weight kininogen, factor XI, α2-macroglobulin-kallikrein complexes and factor V values were measured in plasma samples collected serially (day of admission, and at 2, 12, 24, 48 and/or 72 hrs or at discharge). Data were analyzed to determine if admission values or serially obtained values within 48 hrs were useful in predicting outcome. Fourteen patients survived and nine died. At admission, in all patients, assay values indicated that prekallikrein, high-molecular-weight kininogen, and factor V were significantly lower than normal (as observed in a range of 20 to 23 healthy adults), α2-macroglobulin-kallikrein complexes were higher than normal, while concentrations of factor XII and factor XI were in the normal range. No differences were detected in the admission values between survivors and nonsurvivors, nor between patients with positive or negative blood cultures. However, subsequent values demonstrated a difference in values between survivors and non-survivors. Survivors showed improvement in high molecular weight kininogen values and higher than normal factor V values, as compared with nonsurvivors. Conclusions: Low or persistently low serial factor XII, high-molecular-weight kininogen and factor V values are associated with a poor prognosis, whereas high or increasing values of factor XII, high- molecular-weight kininogen, prekallikrein, and factor V all correlate with a favorable outcome.

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KW - factor XII

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KW - patient outcome assessment

KW - prekallikrein

KW - prognostication

KW - sepsis

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