XXXX secondary to plasma fibronectin depletion after aortic surgery.

@entity1 @entity1707 @entity409 @entity36304 @entity130
Fibronectin is a plasma opsonin which is depleted after @entity130 or surgery. The effect of major aortic surgery on plasma fibronectin has been studied in @entity1 and in an equivalent experimental model in @entity1707 . On the day after aortic surgery in eleven @entity1 mean fibronectin (+/- s.e.m.) had fallen from 363 +/- 11 mg/l pre-operatively to 179 +/- 19 mg/l (P less than 0.01). No such fall was observed in @entity1 undergoing herniorrhaphy. In fourteen @entity1707 aortic surgery produced reproducible @entity36304 and a fall in plasma fibronectin from 331 +/- 10 mg/l to 43 +/- 13 mg/l after resuscitation (P less than 0.01). Whenever plasma fibronectin fell below 190 mg/l the circulating free fibronectin was consumed in complexes of 1000 kDa containing collagenous debris. More severe depletion of plasma fibronectin was related to higher concentrations of circulating nonopsonized collagenous debris and to subsequent mortality in @entity1707 . The depletion of free fibronectin that occurs following major surgery may produce clinically important @entity409 . The clinical relevance of this fibronectin consumption may be missed if measurement is limited to circulating fibronectin levels without determining that proportion bound in complexes and no longer available as an opsonin.
