von Willebrand factor antigen as a prognostic marker in posttraumatic acute lung injury

The specific endothelial cell product von Willebrand factor antigen (vWf:Ag ) was measured in plasma and lung function tests were carried out and the f ollowing lung injury parameters measured: PaO2/FiO2 ratio, static respirato ry compliance and Murray's lung injury score (LIS) in a follow-up study of 36 severely traumatized patients. Injury severity score (ISS) and APACHE II scores were calculated. Patients were classified according to the presence or absence of acute respiratory distress syndrome (ARDS) complications and survival versus death. Data collection was performed on admission to hospi tal and after 1-3, 5, 7, 10 days of ICU stay. On all of the occasions inves tigated, plasma vWf:Ag levels in ARDS patients and nonsurvivors were signif icantly greater than those in patients without ARDS and survivors, respecti vely. Significant correlations were observed between initial vWf:Ag concent ration and ISS, APACHE II, LIS. Our study suggests that increased concentra tions of vWf:Ag in plasma are predictive of the development of ARDS and sig nal poor prognosis in patients following severe trauma. Copyright (C) 2001 S. Karger AG, Basel.