Volume 6 Supplement 1

22nd International Symposium on Intensive Care and Emergency Medicine

Open Access

Complement activation in relation to age in patients with severe sepsis

  • G Marx1,
  • B Vangerow2,
  • H Rueckoldt3,
  • M Cobas Meyer2,
  • D Fromann3,
  • T Schuerholz3 and
  • M Leuwer1
Critical Care20026(Suppl 1):P108

DOI: 10.1186/cc1561

Published: 1 March 2002

Objectives

Severe sepsis is still associated with a mortality of 29% [1]. Sepsis mortality is highest in elderly patients [1]. Another factor, which is related to outcome in sepsis is the extent of complement activation [2]. The aim of this study was to evaluate complement activation in relation to age in severe septic patients.

Methods

This observational study was performed in 20 patients with severe sepsis (SOFA-Score = 9 ± 3) and grouped according to age: = 60 years ('adult', n = 10) and > 65 years ('elderly', n = 10). Complement proteins Bb, C3a, C4d were performed by ELISA technique. C1-Inhibitor (C1-Inh) activity was measured by Berichrom® C1-Inactivator, and C1-Inh protein concentration by NOR-Partigen®. To compare values at onset of severe sepsis with those on the 8 th day Friedman test with post-hoc Wilcoxon test was performed. Data are presented as median and range. *P < 0.05 was considered significant.

Results

See Table 1.

Table 1

 

Adult

Elderly

 

Sepsis day 1

Sepsis day 8

Sepsis day 1

Sepsis day 8

C4d (µg/ml)

2.4 (2.0-3.3)

1.7* (3.8-8.3)

3.2 (2.5-7.3)

5.4 (3.9-7.0)

C1-Inh activity (%)

105 (72-132)

148* (128-163)

122 (85-133)

132 (107-156)

C1-Inh protein (%)

136 (107-148)

196* (158-211)

123 (100-154)

147 (120-165)

Bb (µg/ml)

0.55 (0.32-2.74)

0.79 (0.41-1.15)

0.90 (0.68-1.05)

1.03 (0.88-1.25)

C3a (ng/ml)

118 (65-370)

524 (212-689)

204 (102-1129)

372 (187-1154)

*P < 0.05, sepsis day 1 vs sepsis day 8 (Friedman test with post-hoc Wilcoxon).

Conclusions

Activation of the classical pathway of complement was found to be more marked in adult patients than in elderly. Thus, our results suggest age-related differences in the complement activation in severe sepsis.

Authors’ Affiliations

(1)
University Department of Anaesthesia, University of Liverpool
(2)
Eli Lilly GmbH
(3)
Department of Anaesthesia, Hannover Medical School

References

  1. Angus DC, et al.: Crit Care Med 2001, 29: 1303-1310. 10.1097/00003246-200107000-00002View ArticlePubMedGoogle Scholar
  2. Hack CE, et al.: Intensive Care Med 1993,19(suppl 1):19-28. 10.1007/BF01738946View ArticleGoogle Scholar

Copyright

© Biomed central limited 2001

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