Protein C - a novel use for a routine test

Use of Protein C as a measure of the risk of organ dysfunction or death in intensive care patients

The results of a recent study suggest that there may be a new purpose for measuring protein C levels in the blood. The study, published in the July 2007 issue of Anesthesiology, investigated the correlation between low levels of protein C in surgical patients admitted to the intensive care unit (ICU) and the risk of organ dysfunction/failure and/or death. The authors of the study proposed that the test would help in the evaluation of critically ill patients by identifying those who would benefit most from early treatment and appropriate therapy.

Protein C occurs naturally in the body and is an important component of the body’s internal regulation of the coagulation system. When protein C levels are low, life-threatening blood clots may form. The protein C test is most often used to evaluate a patient’s risk of developing a blood clot in the veins of the pelvis or legs, otherwise known as a thrombus. However, low levels of protein C are also associated with inflammatory conditions and have been found to be significantly decreased in patients with sepsis. Septic and other seriously ill patients admitted to ICUs, including those with traumatic injuries and those who have undergone surgery are often at risk for major organ failure and worsening conditions. In this study, researchers explored the possibility that decreased concentrations of protein C would be a key indicator for identifying those ICU patients at risk of developing more serious complications.

Dr. Frank Brunkhorst and his colleagues studied patients admitted to a surgical intensive care unit over a course of several weeks. Protein C levels were measured within 24 hours of admission and then on a daily basis. About half the patients in the study had lower than normal levels when first tested and levels continued to drop for about 2-3 days until rising back to normal after two weeks. The authors of the study observed that the most critically ill patients who had multiple organ failure and those who died had the lowest levels of protein C. The researchers concluded that the study showed a general decrease of protein C concentrations in critically ill patients and an even greater decrease in those with sepsis. In addition, they said it demonstrated an important link between low protein C levels and patients with failing organs and those at risk of dying.

A commentary in the same issue of the journal agreed with the conclusions from the study but pointed out that additional investigations are needed to confirm the findings. Further research may show similar results and monitoring protein C in critically ill patients may become a useful tool for ICU doctors. The commentary also raised the possibility that further studies may lead to doctors intervening earlier and treating these patients with recombinant forms of protein C in order to improve their condition and better their chances of survival.

Source: Lab Tests Online-US



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