Secretory phospholipase A(2) activity correlates with postinjury multiple organ failure

Postinjury multiple organ failure (MOF) may result from overwhelming system ic hyperinflammation. Secretory phospholipase A(2) (sPLA(2)) produces many inflammatory lipid mediators, and levels have been correlated with both the severity of patient injury and postinjury mortality. The objective of this study was to characterize the plasma activity of sPLA(2) type IIa in sever ely injured patients and to determine whether the activity of this enzyme c orrelates with the subsequent development of MOF, Patients: Seventeen sever ely injured patients at known risk for MOF had blood sampled on postinjury days 0, 1, 2, 3, and 5, Design: sPLA(2) activity was sequentially measured and correlated with MOF scores. Results:Six patients (35%) developed MOF, In comparison with non-MOP patien ts, MOF patients had elevated sPLA(2) activity be-ginning 36 hrs postinjury (MOF sPLA(2), 2.4 +/- 0.97, vs, non-MOF sPLA(2), 0.86 +/- 0.16 active unit s (AU); p < .05) and continuing over the ensuing 5 days. To rule out the po ssibility that stored blood components required for patient resuscitation w as the source of sPLA(2), the sPLA(2) was measured in packed red blood cell s, platelet concentrates, and fresh frozen plasma over the routine storage time, None of the products tested had elevated levels of sPLA(2) compared w ith fresh plasma from healthy adult volunteers, Conclusions: We conclude that increased sPLA(2) activity is associated with the development of postinjury MOF.