Effect of Plasma Exchange Therapy on Circulating Fibronectin in Burned Patients

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The effect of plasma exchange therapy during burn shock on circulating fibronectin levels was studied in 11 severely burned patients. The mean plasma fibronectin level in patients considered resuscitation failures (those requiring>1.5–2 times the calculated fluid requirement at six to eight hours postburn) was lower than in 20 patients undergoing normal resuscitation and having about the same percent TBSA (P<0.05). Plasma exchange with fresh frozen plasma (mean fibronectin content 287 ± 25 [SEM] µg/ml) replacement resulted in an increase— but not to “normal” levels of circulating fibronectin—of from 91 ± 69 to 204 ± 127 (SEM) µg/ml after the procedure. Plasma fibronectin levels remained lower than those in the control group and did not differ from the mean values in patients undergoing a routine uncomplicated resuscitation. These data suggest that removal of burn patients' plasma and its replacement with fresh frozen plasma during the burn shock period results in an increase in circulating fibronectin level but still does not prevent fibronectin deficiency in the overall postburn course.

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