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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. Plasma fibronectin, a glycoprotein, is an opsonin of the reticuloendothelial system. 2. In ten healthy volunteers starved for 4.5 d, daily measurements showed a rapid reduction in plasma fibronectin, no alteration in either C3 or plasma transferrin and, at the end of the starvation period, an elevated serum albumin. 3. On refeeding, plasma fibronectin rapidly returned to its prestarvation level but plasma transferrin was significantly reduced and did not recover by the end of the study. 4. Changes in plasma fibronectin may be a sensitive index of nutritional status. The reduction of plasma fibronectin in short-term starvation may compromise host defence tolerance of injury and sepsis.
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PMID:Changes in plasma fibronectin during acute nutritional deprivation in healthy human subjects. 366 79

Critically ill patients have been described as having blood coagulation abnormalities that predispose to bleeding and thrombosis. We have studied plasminogen activators, alpha 2-antiplasmin, X-oligomers fibrin fragments, fibronectin, antithrombin III, fibrinogen, platelets, kaolin-cephalin clotting time and prothrombin time on admission to the intensive care unit and sequentially after 24 and 48 hours in 39 adult patients: ARDS (n = 6), trauma (n = 12), sepsis (n = 8) and a miscellanea (n = 13). A decrease in plasminogen activators associated with an increase in X-oligomers, the earliest form of cross linked fibrin degradation products, indicate that fibrin deposition and the consumption of components of fibrinolysis is a widespread condition in the ICU patients. Low fibronectin levels were related to prognosis. These findings suggest that critically ill patients must be evaluated in respect to fibrinolysis and supported when necessary with prophylactic treatment.
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PMID:Changes in fibrinolysis in the intensive care patient. 367 37

Low plasma levels of the opsonic glycoprotein fibronectin (Fn) have been suggested to imply an impaired host defense against sepsis. However, the mechanism(s) behind Fn depletion in sepsis are obscure. We measured the Fn plasma concentration in 32 patients 12 to 24 h after the diagnosis of septic shock. Although the average plasma level was low (214 +/- 80 [SD] mg/L) compared to that of a reference material (p less than .001), the range was great (60 to 403 mg/L). A multivariate analysis of some possible influencing factors showed significant (p less than .01) positive correlations to the prothrombin level (r = .62) and the amount of insulin infused per 24 h (r = .63). The relationships to disseminated intravascular coagulation-related variables, hemodilution, and outcome were weak. Cryoprecipitate was infused into 16 patients; Fn levels increased by 52 +/- 18% of the expected increase. The most severely ill patients displayed the lowest rates of increase. The postinfusion decrease in Fn plasma concentration indicated that the plasma half-life of cryoprecipitate Fn was about 25 h. The results support the concept that decreased Fn synthesis, probably in the liver, is the major reason for Fn depletion in sepsis, rather than an increased rate of consumption.
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PMID:Plasma fibronectin levels in sepsis: influencing factors. 367 61

The time course of plasma fibronectin (FNp) was evaluated following burn injury in 62 patients during 30 days. Those patients were divided into three groups: A: 36 non septic survivors, B: 7 septic survivors, C: 19 dead patients. Those groups were statistically different if either age or total body surface area burnt (TBSA), or unit burnt standard (UBS) or the percentage or third degree burnt area were considered. The relationship between FNp, UBS or sepsis was studied. No correlation was found between FNp levels and TBSA or UBS for the first three days. After acute depletion on day 2, the FNp level returned to initial values on day 3. That depletion was probably a consequence of resuscitation since both falls in plasma FNp and haematocrit were parallel from day 1 to day 2. When the patients became septic, there was always a drop in FNp level. The depleted level of FNp remained low in the patients who finally died, whereas in those who survived that level had returned to normal. The observation of FNp level could therefore be useful in determining how serious a sepsis is.
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PMID:[Course of plasma fibronectin in burn patients. Its variations during septic episodes]. 370 39

Selected hemodynamic, pulmonary, acid-base, metabolic, hematological, and serum chemistry parameters were monitored for 6 hr in two groups of anesthetized dogs given an intravenous injection of Escherichia coli endotoxin. One group of animals was pretreated with purified human plasma fibronectin, and the other group received an equal volume of saline or dextrose. Between-group analysis showed that the fibronectin-treated group had significantly higher arterial blood pressure and glucose levels, and lower hemoglobin levels, at 4, 5, and 6 hr postendotoxin administration. This group also had higher arterial pH and base excess values at 5 and 6 hr postendotoxin administration. This study, along with others from our laboratory, suggests that exogenous administration of purified plasma fibronectin can be beneficial in the prophylactic treatment of impending sepsis or endotoxemia. However, the amount of benefit appears to be moderate. Whether combining fibronectin with other therapeutic modalities would be additive or synergistic cannot be ruled out and merits investigation.
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PMID:Effects of fibronectin pretreatment on cardiovascular, acid-base, metabolic, and organ function indices during endotoxin shock in the dog. 371 17

Plasma fibronectin depletion decreases resistance to sepsis. After cardiac surgery, septic complications occur more frequently when the surgical procedure is managed with a cardio-pulmonary bypass than when it is not. To determine whether cardio-pulmonary bypass produces a greater decrease in plasma fibronectin than surgery without cardio-pulmonary bypass, we studied plasma fibronectin concentrations in two groups of children operated for congenital heart diseases. Group I: 10 children undergoing surgery with cardio-pulmonary bypass. Group II: 11 children undergoing surgery without cardio-pulmonary bypass. Plasma fibronectin was monitored pre-operatively (t 1) and post-operatively at the 6th hour (t 2), 1st (t 3) and 7th (t 4) days. In both groups, plasma fibronectin concentration dropped at (t 2) and (t 3) and rose again at (t 4). There was no significant difference in plasma fibronectin levels between the two groups at any time. We conclude that the plasma fibronectin decline alone cannot explain why septic complications after surgery are more frequent with cardio-pulmonary bypass than without.
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PMID:Plasma fibronectin depletion after cardiac surgery in children with or without cardiopulmonary bypass. 373 6

Reticuloendothelial (RE) phagocytic function and plasma fibronectin are altered early after trauma and during septic shock. Since fibronectin-coated particles will tend to aggregate if not efficiently phagocytized, we hypothesized that elevated fibronectin levels during hepatic and/or splenic RE depression could potentiate the lung deposition of blood-borne foreign microparticles. To evaluate this concept, we measured plasma fibronectin, hepatic RE function, and tissue deposition of blood-borne colloids in rats after they were injected with nonbacterial and bacterial particulates. Rats were injected intravenously with gelatin-coated colloids (50 mg/100 gm) to simulate blood-borne collagenous tissue debris after trauma, or with live Pseudomonas aeruginosa (1 X 10(9)/rat) to simulate bacterial entrance into the blood with sepsis, or with both to simulate sepsis after trauma. Phagocytic function was evaluated by liver and spleen uptake of gelatinized 125I RE test emulsion. Fibronectin was quantified by electroimmunoassay. There was an acute 60-80% decrease in plasma fibronectin 2 hr following either colloid or colloid coupled with bacterial infusion. Bacterial infusion alone elicited only a mild 20% decrease in fibronectin by 2 hr. By 24 hr, restoration of fibronectin levels was observed in all groups with hyperfibronectinemia observed in animals challenged with Pseudomonas. Following colloid alone, liver uptake of the RE test particle was acutely depressed at 2 hr in association with an acute depletion of fibronectin, but at 24 hr the RE depression persisted even with normalization of fibronectin. In contrast, with only bacteremia, the rebound elevation of fibronectin was associated with increased hepatic RE function. In rats given both colloid and Pseudomonas, the hyperfibronectinemia (60-100% above controls) at 24 hr coexisted with inadequate liver phagocytic uptake ability. This resulted in a significant 20-fold (P less than 0.05) increment in lung localization of the blood-borne test microparticles. Thus, hyperfibronectinemia without a parallel increase in liver phagocytic ingestive ability may actually enhance lung localization of blood-borne microparticles, which have a high affinity for fibronectin.
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PMID:Comparative effect of circulating bacterial or nonbacterial particulates on plasma fibronectin: relationship to lung deposition of blood-borne foreign particles. 374 38

Splenectomized patients are predisposed toward developing overwhelming bacterial infections. Administration of heparin is known to improve the survival of animals with intraabdominal sepsis and endotoxemia. The present study evaluates the effect of splenectomy and heparin administration on survival and plasma fibronectin (FN) levels in rats during acute bacterial peritonitis. Peritonitis was induced by cecal ligation and puncture (CLP) in 48 male Sprague-Dawley rats divided into four equal groups (12 each). Eight rats (66.7%) survived 10 days following CLP. When splenectomy was performed simultaneously (CLPS), the survival rate declined to 16.7% (P less than 0.05). Twenty units of heparin given subcutaneously daily for 5 days improved the survival rate to 66.7% following CLPS (P less than 0.05). When heparin was administered following CLP, the survival rate improved to 83.3% (not significantly higher than CLP alone). Plasma FN levels were measured by enzyme-linked immunosorbent assay (ELISA) on Days 0, 1, 2, 4, 7, and 10 following surgery. The plasma FN levels in splenectomized rats (CLPS +/- heparin) and nonsplenectomized rats (CLP +/- heparin) peaked on the first and second postoperative days, respectively. In comparing FN levels, no significant differences were found between the groups except on the second day--the CLPS + heparin group had a significantly lower FN level on Day 2 than CLP +/- heparin. This suggests that heparin confers protection from intraabdominal sepsis not only in animals with normal spleens but also in splenectomized animals. Plasma FN levels are not strongly influenced by heparin administration and concomitant splenectomy.
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PMID:The effects of heparin and splenectomy on survival and plasma fibronectin levels in rat peritonitis. 374 93

Trauma is known to result in depression of opsonic fibronectin levels as well as abnormalities in neutrophil function. Neutrophil oxidative metabolism, important for bactericidal activity, has not been investigated following injury. Since fibronectin has been reported to increase neutrophil chemiluminescence (CL), we examined the relationship between neutrophil oxidative metabolism (as measured by chemiluminescence) and opsonic fibronectin levels following blunt trauma. Sera from 11 nonseptic and 9 eventually septic-trauma patients were studied. Normal neutrophils incubated in septic-trauma serum had decreased CL responses compared to incubation in nonseptic serum (P less than 0.0001). This difference was apparent immediately after injury, prior to the onset of sepsis. This depression was due to the presence of a serum suppressor of neutrophil chemiluminescence and not to the absence of a serum factor. This suppressor has been partially characterized as a protein of greater than 30,000 Da. Opsonic fibronectin levels were also depressed in septic-trauma sera compared to nonseptic-trauma sera (P less than 0.0001). However, no correlation could be demonstrated between the CL response and opsonic fibronectin levels. Addition of fibronectin to buffer increased the CL response, while addition of fibronectin to nonseptic-trauma serum had no effect. In contrast, addition of fibronectin to septic-trauma sera actually decreased the CL response (P less than 0.05), perhaps by forming complexes with abnormal proteins and interfering with membrane-particle interaction.
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PMID:Neutrophil chemiluminescence and opsonic fibronectin levels following blunt trauma. 376 32

Fibronectin is a glycoprotein found in a soluble form in plasma and in an insoluble form in many tissues. We evaluated the influence of postoperative intraperitoneal sepsis on the clearance, tissue distribution, and synthesis of plasma fibronectin in rats (300-400 g). Experimental sepsis was induced by cecal ligation following laparotomy, whereas control animals underwent laparotomy (5 cm) alone. At 24 and 48 h after laparotomy, plasma fibronectin levels were normal. After laparotomy plus cecal ligation, plasma fibronectin increased by 47% at 24 h and remained elevated (52% above 0 time) at 48 h. At 24 h postsurgery the disappearance and tissue distribution of 75Se-plasma fibronectin and 75Se-plasma albumin was evaluated. Tissue distribution was quantified at 2 and 24 h after intravenous injection of both tracer proteins in separate groups. Both fibronectin and albumin demonstrated an initial distribution between vascular and extravascular sites and then a progressive decrease in plasma. In control (laparotomy) rats the half-life (t1/2) for plasma clearance of 75Se-plasma fibronectin was 25.33 +/- 2.53 h compared with 13.21 +/- 0.78 h in the septic rats. Septic rats manifested decreased sequestration of 75Se-fibronectin at the area of surgical incision (laparotomy), increased sequestration at the focus of intraperitoneal infection, and increased uptake in the nonviable portion of the cecum. The synthetic rate for plasma fibronectin in laparotomized control rats was 3.03 +/- 0.29 mg X 100 g-1 X 24 h-1, whereas after laparotomy plus cecal ligation the synthetic rate increased to 4.58 +/- 0.35 mg X 100 g-1 X 24 h-1. In contrast the synthetic rate for albumin decreased from 84.70 +/- 1.66 mg X 100 g-1 X 24 h-1 in controls to 52.38 +/- 1.77 mg X 100 g-1 X 24 h-1 in the septic animals. Thus intraperitoneal sepsis in the rat will enhance the vascular clearance, alter the distribution, and increase the synthetic rate for plasma fibronectin.
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PMID:Clearance and tissue distribution of fibronectin in septic rats: relationship to synthetic rate. 376 72


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