Cargando…

Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit

Trauma patients admitted to an intensive care unit (ICU) may potentially experience a deficiency of coagulation factor thirteen (FXIII). In this retrospective cohort study conducted at a specialized trauma center, ICU patients were studied to determine the dependency of FXIII activity levels on clin...

Descripción completa

Detalles Bibliográficos
Autores principales: Katzensteiner, Moritz, Ponschab, Martin, Schöchl, Herbert, Oberladstätter, Daniel, Zipperle, Johannes, Osuchowski, Marcin, Schlimp, Christoph J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317588/
https://www.ncbi.nlm.nih.gov/pubmed/35887938
http://dx.doi.org/10.3390/jcm11144174
_version_ 1784755093384462336
author Katzensteiner, Moritz
Ponschab, Martin
Schöchl, Herbert
Oberladstätter, Daniel
Zipperle, Johannes
Osuchowski, Marcin
Schlimp, Christoph J.
author_facet Katzensteiner, Moritz
Ponschab, Martin
Schöchl, Herbert
Oberladstätter, Daniel
Zipperle, Johannes
Osuchowski, Marcin
Schlimp, Christoph J.
author_sort Katzensteiner, Moritz
collection PubMed
description Trauma patients admitted to an intensive care unit (ICU) may potentially experience a deficiency of coagulation factor thirteen (FXIII). In this retrospective cohort study conducted at a specialized trauma center, ICU patients were studied to determine the dependency of FXIII activity levels on clinical course and substitution with blood and coagulation products. A total of 189 patients with a median injury severity score (ISS) of 25 (16–36, IQR) were included. Abbreviated injury scores for extremities (r = −0.38, p < 0.0001) but not ISS (r = −0.03, p = 0.45) showed a negative correlation with initial FXIII levels. Patients receiving FXIII concentrate presented with a median initial FXIII level of 54 (48–59)% vs. 88 (74–108)%, p < 0.0001 versus controls; they had fewer ICU-free days: 17 (0–22) vs. 22 (16–24), p = 0.0001; and received higher amounts of red blood cell units: 5 (2–9) vs. 4 (1–7), p < 0.03 before, and 4 (2–7) vs. 1 (0–2), p < 0.0001 after FXIII substitution. Matched-pair analyses based on similar initial FXIII levels did not reveal better outcome endpoints in the FXIII-substituted group. The study showed that a low initial FXIII level correlated with the clinical course in this trauma cohort, but a substitution of FXIII did not improve endpoints within the range of the studied FXIII levels. Future prospective studies should investigate the utility of FXIII measurement and lower threshold values of FXIII, which trigger substitution in trauma patients.
format Online
Article
Text
id pubmed-9317588
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93175882022-07-27 Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit Katzensteiner, Moritz Ponschab, Martin Schöchl, Herbert Oberladstätter, Daniel Zipperle, Johannes Osuchowski, Marcin Schlimp, Christoph J. J Clin Med Article Trauma patients admitted to an intensive care unit (ICU) may potentially experience a deficiency of coagulation factor thirteen (FXIII). In this retrospective cohort study conducted at a specialized trauma center, ICU patients were studied to determine the dependency of FXIII activity levels on clinical course and substitution with blood and coagulation products. A total of 189 patients with a median injury severity score (ISS) of 25 (16–36, IQR) were included. Abbreviated injury scores for extremities (r = −0.38, p < 0.0001) but not ISS (r = −0.03, p = 0.45) showed a negative correlation with initial FXIII levels. Patients receiving FXIII concentrate presented with a median initial FXIII level of 54 (48–59)% vs. 88 (74–108)%, p < 0.0001 versus controls; they had fewer ICU-free days: 17 (0–22) vs. 22 (16–24), p = 0.0001; and received higher amounts of red blood cell units: 5 (2–9) vs. 4 (1–7), p < 0.03 before, and 4 (2–7) vs. 1 (0–2), p < 0.0001 after FXIII substitution. Matched-pair analyses based on similar initial FXIII levels did not reveal better outcome endpoints in the FXIII-substituted group. The study showed that a low initial FXIII level correlated with the clinical course in this trauma cohort, but a substitution of FXIII did not improve endpoints within the range of the studied FXIII levels. Future prospective studies should investigate the utility of FXIII measurement and lower threshold values of FXIII, which trigger substitution in trauma patients. MDPI 2022-07-19 /pmc/articles/PMC9317588/ /pubmed/35887938 http://dx.doi.org/10.3390/jcm11144174 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Katzensteiner, Moritz
Ponschab, Martin
Schöchl, Herbert
Oberladstätter, Daniel
Zipperle, Johannes
Osuchowski, Marcin
Schlimp, Christoph J.
Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
title Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
title_full Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
title_fullStr Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
title_full_unstemmed Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
title_short Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
title_sort factor xiii measurement and substitution in trauma patients after admission to an intensive care unit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317588/
https://www.ncbi.nlm.nih.gov/pubmed/35887938
http://dx.doi.org/10.3390/jcm11144174
work_keys_str_mv AT katzensteinermoritz factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit
AT ponschabmartin factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit
AT schochlherbert factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit
AT oberladstatterdaniel factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit
AT zipperlejohannes factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit
AT osuchowskimarcin factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit
AT schlimpchristophj factorxiiimeasurementandsubstitutionintraumapatientsafteradmissiontoanintensivecareunit