Plasma fibrinolysis is related to the SOFA score but not to the von Willebrand factor on ICU admission

Introduction

Endothelial cell activation and injuries are important causes of multiorgan failure. Altered fibrinolysis promotes fibrin deposition and may create microvascular alterations during inflammation. C-reactive protein (CRP) is correlated with an increased risk of MOF [1] and CRP may inhibit fibrinolysis [2]. We aimed to determine whether plasma fibrinolysis is related to the SOFA score and von Willebrand factor (vWF antigen), as a marker of endothelium dysfunction, in critically ill patients at ICU admission.

Methods

A cross-sectional study in an adult medicosurgical ICU. Patients were 49 consecutive patients (31 nonseptic and 18 septic). Plasma fibrinolysis was assessed by the euglobulin clot lysis time (ECLT) at ICU admission [3].

Results

The ECLT was significantly longer in septic than in nonseptic patients (1,219 ± 574 min versus 701 ± 224 min, P = 0.001). Significant correlation between the ECLT and CRP (R = 0.67, P < 0.001) and between the ECLT and SOFA score (R = 0.36, P = 0.009) were observed. CRP was weakly correlated with vWF (R = 0.29; P = 0.04). The vWF was not correlated either with the ECLT (R = -0.06, P = 0.65) or the SOFA score (R = -0.02, P = 0.88).

Conclusion

The ECLT measurement could be a marker of organ dysfunction and a prognosis factor in critically ill patients. Further studies with measurement of plasma fibrinolysis by the ECLT should be investigated in ICU patients.