Cleavage of plasma high molecular weight kininogen in surgical ICU patients

Objective

To characterize kininogens in plasma from surgical patients in the intensive care unit (ICU).

Design

Prospective study.

Setting

Surgical ICU.

Patients

35 patients aged 19–79 years, divided into two groups: sepsis (defined by standard criteria) and nonsepsis.

Measurements and results

Studies of proteolytic degradation of H-kininogen showed degradation in both patient groups compared to healthy controls. Functional quantification of prekallikrein showed a reduction of prekallikrein in plasma from both patients groups. Functional quantification of kininogens by a cysteine proteinase inhibitor assay showed no significant differences between the patients and the controls. Immunological levels of H-kininogen and total kininogen were not significantly different from normal plasma. No differences could be detected between the two patient groups in any of the parameters studied.

Conclusions

This study showed that contact activation took place in surgical ICU patients: partial kinin release and consumption of prekallikrein took place in vivo.