Neutrophil elastase may play a key role in developing symptomatic disseminated intravascular coagulation and multiple organ failure in patients with head injury.
OBJECTIVE
To study the mechanism associated with the development of symptomatic disseminated intravascular coagulation (DIC) after head injury.


METHODS
Plasma parameters were analyzed in patients with symptomatic (group A, n = 10) and asymptomatic DIC (group B, n = 15) induced by head injury, and in patients in whom DIC was caused by sepsis (group C, n = 10).


RESULTS
Levels of fibrinogen, alpha2PI-plasmin complex and platelets in group A (58.1 mg/dL, 22.4 microg/mL, 16.0 x 10(4)/ mm3) and group B (98.3, 22.1, 16.6 x 10(4)) were comparable, but differed significantly from those in group C (297.4, 2.4, 6.3 x 10(4)). Significant differences were observed between groups A and B in both neutrophil-elastase (1,528 vs. 293 microg/ml) and D-dimer (42.1 vs. 17.6 microg/mL).


CONCLUSIONS
Neutrophil elastase may be implicated in the development of symptomatic DIC after head injury, whose characteristics include "enhanced fibrinolysis with minimal platelet loss."
Department of Neurosurgery, Fujinomiya City General Hospital, Shizuoka-ken, Japan.
H
H
Takahasi
T
T
Urano
N
N
Nagai
Y
Y
Takada
A
A
Takada
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000150:complications* / Q000201:enzymology / Q000401:mortality; D004211:Disseminated Intravascular Coagulation / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005342:Fibrinolysis; D015600:Glasgow Coma Scale; D006801:Humans; D019272:Leukocyte Elastase / Q000097:blood*; D008297:Male; D009102:Multiple Organ Failure / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D012772:Shock, Septic / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D013997:Time Factors
D019272:Leukocyte Elastase