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Early depletion of ...
Early depletion of contact system in patients with sepsis : a prospective matched control observational study
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- Berkestedt, Ingrid (author)
- Lund University,Lunds universitet,Kritiska infektioner,Forskargrupper vid Lunds universitet,Critical infections,Lund University Research Groups,Skåne University Hospital
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- Andersson, Pia (author)
- Lund University,Lunds universitet,Host parasite interactions,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital
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- Herwald, Heiko (author)
- Lund University,Lunds universitet,Host parasite interactions,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital
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- Valik, John Karlsson (author)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
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- Sörensen, Ola (author)
- Lund University,Skåne University Hospital
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- Bodelsson, Mikael (author)
- Lund University,Lunds universitet,Kritiska infektioner,Forskargrupper vid Lunds universitet,Critical infections,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2018-11-05
- 2018
- English.
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In: APMIS. - : Wiley. - 0903-4641 .- 1600-0463. ; , s. 892-898
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Activation of the contact system generates bradykinin from high-molecular-weight kininogen and has been suggested to participate in the pathophysiology of sepsis. To test this, we prospectively measured bradykinin and high-molecular-weight kininogen levels in a cohort of sepsis patients requiring intensive care. From 29 patients meeting criteria for sepsis or septic shock according to Sepsis-3, blood was sampled within 24 h and on the fourth day following admittance to intensive care. Patients planned for neurosurgery served as matched controls. Sequential organ failure assessment score and 90-day mortality was registered. Bradykinin levels (median [interquartile range]) were lower in sepsis patients (79 [62–172] pg/ml) compared to controls (130 [86–255] pg/ml, p < 0.025) and did not correlate with mortality or severity of circulatory derangement. High-molecular-weight kininogen levels were lower in sepsis patients (1.6 [0.8–4.8] densitometry units) compared to controls (4.4 [2.9–7.7] densitometry units, p < 0.001), suggesting previous contact system activation. High-molecular-weight kininogen levels were lower in non-survivors than survivors (p = 0.003) and negatively correlated to severity of circulatory derangement. We conclude that a role for bradykinin in later stages of severe sepsis must be challenged. Low high-molecular-weight kininogen concentrations suggest that the decrease in bradykinin is due to substrate depletion.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- Bradykinin
- contact system
- high-molecular-weight
- kininogen
- sepsis
Publication and Content Type
- art (subject category)
- ref (subject category)
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