Back to Search
Start Over
Hypercoagulation and Hypermetabolism of Fibrinogen in Severely Burned Adults.
- Source :
- Journal of Burn Care & Research; Jan/Feb2020, Vol. 41 Issue 1, p23-29, 7p
- Publication Year :
- 2020
-
Abstract
- This study investigated changes in plasma fibrinogen metabolism and changes in coagulation in severely burned adults. Ten patients (27 ± 3 years; 91 ± 6 kg) with 51 ± 3% TBSA were consented and enrolled into an institutional review board-approved prospective study. On the study day, stable isotope infusion of 1-13C-phenylalanine and d5-phenylalanine was performed to quantify fibrinogen production and consumption. During the infusion, vital signs were recorded and blood samples were drawn every hour. Coagulation was measured by thromboelastograph (TEG). Ten normal healthy volunteers (37 ± 7 years; 74 ± 4 kg) were included as the control group. Burned adults had elevated heart rates (120 ± 2 vs 73 ± 5 [control] beats/minute), respiration rates (23 ± 2 vs 15 ± 1 breaths/minute), plasma glucose (127 ± 10 vs 89 ± 2 mg/dl), and fibrinogen levels (613 ± 35 vs 239 ± 17 mg/dl); and decreased albumin (1.3 ± 0.2 vs 3.7 ± 0.1 g/dl) and total protein (4.4 ± 0.2 vs 6.8 ± 0.1 g/dl, all P < .05). Fibrinogen breakdown was elevated in the burn group (2.3 ± 0.4 vs. 1.0 ± 0.3 µmol/kg/minute); and fibrinogen synthesis was further enhanced in the burn group (4.4 ± 0.7 vs 0.7 ± 0.2 µmol/kg/minute, both P < .05). Clotting speed (TEG-alpha) and clot strength (TEG-MA) were increased in the burn group (62 ± 4 vs 50 ± 4°, and 76 ± 2 vs 56 ± 2 mm, respectively, both P < .05). Fibrinolysis of TEG-LY60 was accelerated in the burn group (16 ± 6 vs 3 ± 1) and so was the increase in D-dimer level in the burn group (4.5 ± 0.4 vs 1.9 ± 0.3 mg/l, both P < .05). The hypercoagulable state postburn is in part a result of increased fibrinogen synthesis, over and above increased fibrinogen breakdown. [ABSTRACT FROM AUTHOR]
- Subjects :
- FIBRINOGEN
STABLE isotopes
HEART beat
ADULTS
ALBUMINS
BURNS & scalds complications
LENGTH of stay in hospitals
RESEARCH
BLOOD coagulation tests
BURNS & scalds
RESEARCH methodology
RESPIRATORY measurements
BLOOD sugar
CASE-control method
MEDICAL cooperation
EVALUATION research
SERUM albumin
COMPARATIVE studies
BLOOD diseases
LACTIC acid
Subjects
Details
- Language :
- English
- ISSN :
- 1559047X
- Volume :
- 41
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Burn Care & Research
- Publication Type :
- Academic Journal
- Accession number :
- 141565989
- Full Text :
- https://doi.org/10.1093/jbcr/irz147