title: Plasma fibrinolysis is related to the degree of organ dysfunction but not to the concentration of von Willebrand Factor in critically ill patients.
abstract: BACKGROUND
  Endothelial cell dysfunction, by promoting fibrin deposition, has been implicated in the development of multiple organ failure. Altered fibrinolysis during inflammation may participate in microvascular alterations. We sought to determine whether plasma fibrinolysis was related to the severity of organ dysfunction and/or to the levels of von Willebrand factor (vWF antigen), as a marker of endothelium dysfunction, in critically ill patients.
  
  
  METHODS
  Forty-nine consecutive patients admitted to an adult medico-surgical intensive care unit (ICU) with (18) or without sepsis (31) were included. C-reactive protein and vWF levels were measured on ICU admission and plasma fibrinolysis was assessed by the Euglobulin Clot Lysis Time (ECLT). The sequential organ failure assessment (SOFA) score and the simplified acute physiology score (SAPS) II were calculated on admission.
  
  
  RESULTS
  ECLT was significantly longer in septic than in non-septic patients [1033 min (871-1372) versus 665 min (551-862), p = 0.001]. There were significant correlations between ECLT and C-reactive protein (CRP) concentrations (r = 0.78, p < 0.001) and the Sequential Organ Failure Assessment (SOFA) score (r = 0.39, p = 0.006). The level of vWF was not correlated with the ECLT (r = -0.06, p = 0.65) or the SOFA score (r = -0.02, p = 0.88).
  
  
  CONCLUSIONS
  ECLT measurement at admission could be a marker of organ dysfunction and a prognostic indicator in critically ill patients.
authors.affiliation: Experimental Medicine Laboratory (ULB 222 Unit), CHU-Charleroi, Vesale Hospital, 6110-Montigny-le-Tilleul, Belgium. kaveroes@hotmail.com.
authors.forename: Karim Zouaoui
authors.initials: KZ
authors.lastname: Boudjeltia
authors.forename: Sandra
authors.initials: S
authors.lastname: Ollieuz
authors.forename: Michael
authors.initials: M
authors.lastname: Piagnerelli
authors.forename: Patrick
authors.initials: P
authors.lastname: Biston
authors.forename: Philippe
authors.initials: P
authors.lastname: Cauchie
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Dany
authors.initials: D
authors.lastname: Brohee
authors.forename: Michel
authors.initials: M
authors.lastname: Vanhaeverbeek