Reduced serum Gc-globulin concentrations in patients with fulminant hepatic failure: association with multiple organ failure
| Autor: | Niels Tygstrup, Frank V. Schiødt, Stig Bondesen, Peter Ott |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Vitamin D-binding protein Fulminant Multiple Organ Failure Critical Care and Intensive Care Medicine Infections Gastroenterology Severity of Illness Index Pathogenesis Fulminant hepatic failure Predictive Value of Tests Intensive care Internal medicine medicine Humans In patient Child Aged Retrospective Studies Heart Failure Pseudotumor Cerebri business.industry Vitamin D-Binding Protein Respiratory disease Reproducibility of Results Serum concentration Middle Aged medicine.disease Prognosis Surgery Hepatic Encephalopathy Female business Respiratory Insufficiency |
| Zdroj: | Critical care medicine. 25(8) |
| ISSN: | 0090-3493 |
| Popis: | To evaluate the association between admission serum concentrations of the actin-scavenger, Gc-globulin, and the subsequent development of multiple organ failure in patients with fulminant hepatic failure.Retrospective study.A hepatologic intensive care unit.Seventy-nine patients with hepatic encephalopathy grade 3 or 4.None.Serum admission concentrations of both total and nonactin-complexed (free) Gc-globulin were determined. The development of cardiovascular failure, renal failure, pulmonary failure, intracranial hypertension, and infections were recorded in each patient. Both total and free Gc-globulin values were significantly lower in the patients, compared with normal controls. The Gc-globulin values were significantly reduced in patients who subsequently developed cardiovascular failure (p.01), intracranial hypertension (p.001), and infections (p.001), compared with those patients who did not. No differences were found between patients with and without pulmonary or renal failure. Patients with total Gc-globulin values in the lowest quintile had on average 2.6 organ failures, whereas patients with Gc-globulin concentrations in the highest quintile had 0.9 organ failures. The corresponding figures for the lowest and highest quintiles of free Gc-globulin were 3.0 and 1.1 organ failures, respectively. Both total and free Gc-globulin were inversely correlated to the number of organ failures (p.005 in both cases). Patients with multiple organ failure (or = 2 organ failures) had significantly reduced Gc-globulin values compared with patients without multiple organ failure (p.0001).In patients with fulminant hepatic failure, the lowest admission Gc-globulin concentrations were associated with the subsequent development of cardiovascular failure, intracranial hypertension, and infections. Lack of Gc-globulin correlated significantly with the development of multiple organ failure and may be pathogenetically involved in this condition. |
| Databáze: | OpenAIRE |
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