Platelet-activating factor and phospholipase A2 in patients with septic shock and trauma.
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.
Sörensen
J
J
Department of Anesthesiology, University Hospital, Linköping, Sweden.
Kald
B
B
Tagesson
C
C
Lindahl
M
M
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
D010972:Platelet Activating Factor; D010741:Phospholipases A; D054467:Phospholipases A2