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Complement Activation in Emergency Department Patients With Severe Sepsis

dc.contributor.authorYounger, John G.en_US
dc.contributor.authorBracho, David O.en_US
dc.contributor.authorChung-Esaki, Hangyul M.en_US
dc.contributor.authorLee, Moonseoken_US
dc.contributor.authorRana, Gurpreeten_US
dc.contributor.authorSen, Anandaen_US
dc.contributor.authorJones, Alan E.en_US
dc.date.accessioned2011-01-31T17:56:01Z
dc.date.available2011-06-09T15:09:40Zen_US
dc.date.issued2010-04en_US
dc.identifier.citationYounger, John G.; Bracho, David O.; Chung-Esaki, Hangyul M.; Lee, Moonseok; Rana, Gurpreet K.; Sen, Ananda; Jones, Alan E.; (2010). "Complement Activation in Emergency Department Patients With Severe Sepsis." Academic Emergency Medicine 17(4): 353-359. <http://hdl.handle.net/2027.42/79343>en_US
dc.identifier.issn1069-6563en_US
dc.identifier.issn1553-2712en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/79343
dc.description.abstractThis study assessed the extent and mechanism of complement activation in community-acquired sepsis at presentation to the emergency department (ED) and following 24 hours of quantitative resuscitation.A prospective pilot study of patients with severe sepsis and healthy controls was conducted among individuals presenting to a tertiary care ED. Resuscitation, including antibiotics and therapies to normalize central venous and mean arterial pressure (MAP) and central venous oxygenation, was performed on all patients. Serum levels of Factor Bb (alternative pathway), C4d (classical and mannose-binding lectin [MBL] pathway), C3, C3a, and C5a were determined at presentation and 24 hours later among patients.Twenty patients and 10 healthy volunteer controls were enrolled. Compared to volunteers, all proteins measured were abnormally higher among septic patients (C4d 3.5-fold; Factor Bb 6.1-fold; C3 0.8-fold; C3a 11.6-fold; C5a 1.8-fold). Elevations in C5a were most strongly correlated with alternative pathway activation. Surprisingly, a slight but significant inverse relationship between illness severity (by sequential organ failure assessment [SOFA] score) and C5a levels at presentation was noted. Twenty-four hours of structured resuscitation did not, on average, affect any of the mediators studied.Patients with community-acquired sepsis have extensive complement activation, particularly of the alternative pathway, at the time of presentation that was not significantly reversed by 24 hours of aggressive resuscitation.ACADEMIC EMERGENCY MEDICINE 2010; 17:353–359 © 2010 by the Society for Academic Emergency Medicineen_US
dc.format.extent229128 bytes
dc.format.extent3106 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.publisherBlackwell Publishing Ltden_US
dc.subject.otherComplement Pathway, Alternativeen_US
dc.subject.otherComplement Pathway, Classicalen_US
dc.subject.otherComplement C5aen_US
dc.subject.otherBayesian Statisticsen_US
dc.titleComplement Activation in Emergency Department Patients With Severe Sepsisen_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelMedicine (General)en_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.identifier.pmid20370773en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/79343/1/j.1553-2712.2010.00713.x.pdf
dc.identifier.doi10.1111/j.1553-2712.2010.00713.xen_US
dc.identifier.sourceAcademic Emergency Medicineen_US
dc.identifier.orcid0000-0002-9694-5003
dc.identifier.name-orcidRana, Gurpreet K.; 0000-0002-9694-5003en_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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