Low plasma fibronectin indicates septicaemia in major burns

Plasma fibronectin was measured by laser nephelometry in 23 patients with 20--85% burns. Control measurements were made in 118 healthy blood donors aged 18--60 years. The reference level was significantly higher in the 72 males (mean +/- SD = 377 +/- 70 mg/l) than in the 46 females (327 +/- 55 mg/l). In the burn-injured patients the mean fibronectin concentration was significantly lower than the reference values for one week after the injury. All the patients had low concentrations, about 70% of their respective reference means, in the first 24 hours after the injury. When burn treatment was successful, the fibronectin thereafter increased, gradually exceeding the reference level. Patients with septic complications, by contrast, showed further reduction of fibronectin levels. In the patients who died, the fibronectin concentration 6--10 days after burn injury was significantly less than in the patients who survived. On the basis of these results, repeated analysis of plasma fibronectin in the early postburn period is recommended. Persistent fibronectin deficiency then is an indicator of imminent septicaemia, vital organ failure and risk of fatal outcome.