title: Plasma protein C levels in patients with acute lung injury: prognostic significance.
abstract: Decreased circulating protein C is a marker of a prothrombotic state that has been associated with poor clinical outcomes in sepsis. However, protein C has not been measured in patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS). In this study, we measured circulating and intra-alveolar concentrations of protein C in 45 patients with ALI/ARDS from septic and nonseptic causes. Plasma protein C levels were lower in ALI/ARDS compared with normal controls. Lower levels of plasma protein C were associated with worse clinical outcomes, including death, fewer ventilator-free days, and more nonpulmonary organ failures, even when only patients without sepsis were analyzed. In summary, the protein C system is markedly disrupted in patients with ALI/ARDS from both septic and nonseptic causes. The protein C system may be a therapeutic target in patients with ALI/ARDS.
authors.affiliation: Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Matthay
authors.forename: Lorraine B
authors.initials: LB
authors.lastname: Ware
mesh_terms: D000328:Adult; D006801:Humans; D011379:Prognosis; D011486:Protein C / Q000032:analysis*; D012128:Respiratory Distress Syndrome / Q000097:blood*
chemical_list: D011486:Protein C