This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Gabriele Sganga, MD; John H. Siegel, MD; Glenn Brown, PhD; Bill Coleman, PhD; Charles E. Wiles, III, MD; Howard Belzberg, MD; Suzanne Wedel, MD; Robert Placko

Arch Surg. 1985;120(2):187-199.

Abstract
• We studied the temporal pattern of seven hepatic synthesized plasma proteins in 26 severely injured patients beginning in the immediate posttrauma period. Clinical sepsis developed in ten patients between three and eight days after injury, and 16 patients had nonseptic courses. In the initial five days after injury, except for albumin, all acute-phase protein levels rose. However, if sepsis developed, C-reactive protein, fibrinogen, ceruloplasmin, and ₁-antitrypsin levels continued to be elevated after the initial five posttrauma days, while transferrin, albumin, and ₂-macroglobulin levels fell. This differential response became more extreme as sepsis progressed. Covariance analysis of the regression of the five true acute-phase hepatic proteins on C-reactive protein showed that, when sepsis occurred after major traumatic injury, the C-reactive protein rise was associated with a significant reprioritization of hepatic acute-phase plasma protein release. This reprioritization response seems to be both a predictor of sepsis as well as a measure of the adequacy of the host response to trauma and sepsis.

(Arch Surg 1985;120:187-199)

Author Affiliations
From the University of Maryland: Maryland Institute for Emergency Medical Services Systems (Drs Siegel, Coleman, Wiles, Belzberg, and Wedel, and Mr Placko) and the University of Maryland Cancer Center (Dr Brown), Baltimore; and the Centro di Studio per La Fisiopatologica dello Shock, Catholic University Rome (Dr Sganga). Dr Sganga is a CNR fellow.

Footnotes
Accepted for publication Aug 14, 1984.

Read before the Fourth Annual Meeting of the Surgical Infection Society, Montreal, April 30, 1984.

Reprint requests to University of Maryland Hospital, MIEMSS, 22 S Greene St, Baltimore, MD 21201 (Dr Siegel).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lipopolysaccharide-Binding Protein Is Vectorially Secreted and Transported by Cultured Intestinal Epithelial Cells and Is Present in the Intestinal Mucus of Mice
Vreugdenhil et al.
J. Immunol. 2000;165:4561-4566.
ABSTRACT | FULL TEXT  

Accelerated Nitrogen Loss After Traumatic Injury Is Not Attenuated by Achievement of Energy Balance
Frankenfield et al.
JPEN J Parenter Enteral Nutr 1997;21:324-329.
ABSTRACT  

Alanyl-Glutamine-Supplemented Total Parenteral Nutrition Improves Survival and Protein Metabolism in Rat Protracted Bacterial Peritonitis Model
Naka et al.
JPEN J Parenter Enteral Nutr 1996;20:417-423.
ABSTRACT  

Hypoalbuminemia in Hospitalized Patients With Community-Acquired Pneumonia
Hedlund et al.
Arch Intern Med 1995;155:1438-1442.
ABSTRACT  

On "Down-Regulation of Albumin Synthesis in the Rat by Human Recombinant Interleukin-1{beta} or Turpentine and the Response to Nutrients"
Hasselgren
JPEN J Parenter Enteral Nutr 1995;19:257-257.
 

Physiological classification and stratification of illness severity of posttrauma 'sepsis' patients as a basis for randomization of clinical trials
Siegel et al.
Innate Immunity 1995;2:177-188.
 

The Role of the Imino Transporter Protein in Sepsis-Impaired Intestinal Proline Absorption
Gardiner and Barbul
JPEN J Parenter Enteral Nutr 1993;17:507-512.
ABSTRACT  

Review: Intestinal Amino Acid Absorption During Sepsis
Gardiner and Barbul
JPEN J Parenter Enteral Nutr 1993;17:277-283.
ABSTRACT  

Nitric Oxide May Upregulate In Vivo Hepatic Protein Synthesis During Endotoxemia
Frederick et al.
Arch Surg 1993;128:152-157.
ABSTRACT  

Does Portal Nutrition Benefit Liver Protein Synthesis?
Bozzetti et al.
JPEN J Parenter Enteral Nutr 1993;17:20-24.
ABSTRACT  

The Prognostic Inflammatory and Nutritional Index in Traumatized Patients Receiving Enteral Nutrition Support K. L. VEHE, R. O. BROWN, D. A. KUHL, ET AL Journal of The American College of Nutrition 10:355-363, 1991
Claxton
JPEN J Parenter Enteral Nutr 1992;16:85-86.
ABSTRACT  

Anergic Patients Before Elective Surgery Have Enhanced Nonspecific Host-Defense Capacity
Tellado et al.
Arch Surg 1990;125:49-53.
ABSTRACT  

Determinants of Urea Nitrogen Production in Sepsis: Muscle Catabolism, Total Parenteral Nutrition, and Hepatic Clearance of Amino Acids
Pittiruti et al.
Arch Surg 1989;124:362-372.
ABSTRACT  

Current Concepts of Protein Turnover and Amino Acid Transport in Liver and Skeletal Muscle During Sepsis
Hasselgren et al.
Arch Surg 1988;123:992-999.
ABSTRACT  

Sepsis Score and Acute-Phase Protein Response as Predictors of Outcome in Septic Surgical Patients
Dominioni et al.
Arch Surg 1987;122:141-146.
ABSTRACT  

Kupffer Cell Modulation of the Systemic Immune Response
Marshall et al.
Arch Surg 1987;122:191-196.
ABSTRACT  

Multiple-Organ-Failure Syndrome
Carrico et al.
Arch Surg 1986;121:196-208.
ABSTRACT  

Host-Opportunist Interactions in Surgical Infection: Presidential Address
Pruitt
Arch Surg 1986;121:13-22.
ABSTRACT