title: Platelet-activating factor and phospholipase A2 in patients with septic shock and trauma.
abstract: OBJECTIVE
  To study blood and bronchoalveolar lavage (BAL) fluid levels of platelet activating factor (PAF-acether) and phospholipase A2 (PLA2) in patients with septic shock or following severe trauma.
  
  
  METHODS
  Prospective controlled clinical study.
  
  
  METHODS
  An intensive care unit (ICU) of a university hospital.
  
  
  METHODS
  The study comprised 12 patients, 8 with septic shock and 4 with trauma, consecutively admitted to the ICU. Healthy volunteers were used as controls.
  
  
  RESULTS
  Blood PAF-acether and plasma PLA2 levels were measured within 24 h after the patients arrival to the ICU. The Apache II score and outcome were registered. Median values for PAF-acether and PLA2 in the septic shock patients were 10.5 x 10(-10) M and 5300 units/ml, respectively, whereas corresponding values in the trauma patients were 1.3 x 10(-10) M and 770 units/ml. Normal healthy individuals had no detectable PAF-acether in the circulating blood (< 0.5 x 10(-10) M), and normal plasma PLA2 activity was < 300 units/ml. Moreover, both PLA2 and PAF-acether levels correlated well with the severity of the disease as assessed by the Apache II scoring system (p < 0.01 for PLA2 and p < 0.05 for PAF-acether). In addition, PAF-acether and PLA2 were determined in BAL fluid of patients with septic shock (n = 5) and trauma (n = 3); increased PAF-acether levels were found in four patients with septic shock and one patient with trauma.
  
  
  CONCLUSIONS
  These results demonstrate a significant increase of both PLA2 and PAF-acether in the circulation of trauma patients, and a further increase in septic shock patients. It is possible that PAF-acether and PLA2 can be used as markers for the severity of the disease in septic shock and following severe trauma.
authors.affiliation: Department of Anesthesiology, University Hospital, Linköping, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Sörensen
authors.forename: B
authors.initials: B
authors.lastname: Kald
authors.forename: C
authors.initials: C
authors.lastname: Tagesson
authors.forename: M
authors.initials: M
authors.lastname: Lindahl
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood* / Q000201:enzymology; D010741:Phospholipases A / Q000097:blood*; D054467:Phospholipases A2; D010972:Platelet Activating Factor / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012772:Shock, Septic / Q000097:blood* / Q000201:enzymology
chemical_list: D010972:Platelet Activating Factor; D010741:Phospholipases A; D054467:Phospholipases A2