Plasma fibronectin level and clinical status in cardiac surgery patients

To determine whether changes in plasma fibronectin concentration were related to the development of postoperative complications, we studied both plasma fibronectin concentration and the postoperative clinical course for 41 patients undergoing elective cardiopulmonary bypass surgery. Patients were divided retrospectively into three groups based on their hospital course. Group I (n = 21) had mild complications, group II (n = 15) had moderate complications, and group III (n = 5) had severe complications. Fibronectin was monitored preoperatively, intraoperatively, and postoperatively until discharge. Although fibronectin levels were unaffected by induction of anesthesia, a decrease in fibronectin concentration was seen after bypass in all patients. This decline was transient, however, and fibronectin concentration rose within 4 to 5 hr after the end of surgery. A subsequent fall to a level below the lower limit of normal (less than 180 micrograms/ml) was consistently seen only in critically ill (group III) patients and coincided with adverse changes in their clinical status.