Plasma fibronectin in medical ICU patients.

Plasma fibronectin levels in 66 medical ICU (MICU) patients were measured daily. Mean values of initial levels were significantly higher in survivors (266 +/- 14 mg/L) than nonsurvivors (179 +/- 13 mg/L; p less than .0003). There was extensive overlap between survivors and nonsurvivors. The clinical categories of sepsis, disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), and hepatic failure with GI bleeding were associated with low fibronectin levels. Within all diagnostic categories the mean initial fibronectin level of the survivors was higher than that of nonsurvivors. This difference was significant only in the septic group (p less than .02). Patients with minimum fibronectin levels less than 195 mg/L had a 65% mortality rate; patients with minimum levels greater than or equal to 195 mg/L had a 17% mortality rate. Fibronectin, via its role in reticuloendothelial system (RES) function, may have a pathophysiologic role in a variety of medical illnesses.