Complement Activation in Emergency Department Patients With Severe Sepsis

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dc.contributor.author Younger, John G. en_US
dc.contributor.author Bracho, David O. en_US
dc.contributor.author Chung-Esaki, Hangyul M. en_US
dc.contributor.author Lee, Moonseok en_US
dc.contributor.author Rana, Gurpreet en_US
dc.contributor.author Sen, Ananda en_US
dc.contributor.author Jones, Alan E. en_US
dc.date.accessioned 2011-01-31T17:56:01Z
dc.date.available 2011-06-09T15:09:40Z en_US
dc.date.issued 2010-04 en_US
dc.identifier.citation Younger, 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.issn 1069-6563 en_US
dc.identifier.issn 1553-2712 en_US
dc.identifier.uri http://hdl.handle.net/2027.42/79343
dc.description.abstract This 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 Medicine en_US
dc.format.extent 229128 bytes
dc.format.extent 3106 bytes
dc.format.mimetype application/pdf
dc.format.mimetype text/plain
dc.publisher Blackwell Publishing Ltd en_US
dc.subject.other Complement Pathway, Alternative en_US
dc.subject.other Complement Pathway, Classical en_US
dc.subject.other Complement C5a en_US
dc.subject.other Bayesian Statistics en_US
dc.title Complement Activation in Emergency Department Patients With Severe Sepsis en_US
dc.rights.robots IndexNoFollow en_US
dc.subject.hlbsecondlevel Medicine (General) en_US
dc.subject.hlbtoplevel Health Sciences en_US
dc.description.peerreviewed Peer Reviewed en_US
dc.identifier.pmid 20370773 en_US
dc.description.bitstreamurl http://deepblue.lib.umich.edu/bitstream/2027.42/79343/1/j.1553-2712.2010.00713.x.pdf
dc.identifier.doi 10.1111/j.1553-2712.2010.00713.x en_US
dc.identifier.source Academic Emergency Medicine en_US
dc.identifier.orcid 0000-0002-9694-5003
dc.owningcollname Interdisciplinary and Peer-Reviewed
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