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Vitamin K deficiency in critical ill patients; a prospective observational study

Dahlberg, Sofia LU ; Schurgers, Leon; Schött, Ulf LU and Kander, Thomas LU (2019) In Journal of Critical Care 49. p.105-109
Abstract
Background: Vitamin K is a cofactor for proteins involved in cardiovascular health, bone metabolism and cancer. Measuring uncarboxylated prothrombin, also termed as “protein induced by vitamin K absence or antagonism for factor II (PIVKA-II)”, has been used to assess vitamin K status. High levels may indicate vitamin K deficiency. The aim of this study was to measure PIVKA-II and prothrombin time (PT-INR) in intensive care (ICU) patients and correlate vitamin K status with mortality. Methods: Ninety-five patients admitted to the ICU had blood samples taken near admission and every third day. In addition to PIVKA-II and PT-INR, critical-care severity scores were computed. Results: The median baseline PIVKA-II was 4.97 μg/L compared to the... (More)
Background: Vitamin K is a cofactor for proteins involved in cardiovascular health, bone metabolism and cancer. Measuring uncarboxylated prothrombin, also termed as “protein induced by vitamin K absence or antagonism for factor II (PIVKA-II)”, has been used to assess vitamin K status. High levels may indicate vitamin K deficiency. The aim of this study was to measure PIVKA-II and prothrombin time (PT-INR) in intensive care (ICU) patients and correlate vitamin K status with mortality. Methods: Ninety-five patients admitted to the ICU had blood samples taken near admission and every third day. In addition to PIVKA-II and PT-INR, critical-care severity scores were computed. Results: The median baseline PIVKA-II was 4.97 μg/L compared to the upper reference of 2.0 μg/L. PIVKA-II further increased at days 3 and 6, (median 7.88 μg/L, p = .047 and median 8.14 μg/L, p = .011) predominantly in cardiac arrest patients (median 21.4 μg/L, day 3). Conclusion: Intensive care patients have increased PIVKA-II levels at admission, which increases during the ICU stay, especially in cardiac arrest patients. There were no correlations between PIVKA-II and PT-INR, SOFA score or mortality. Further studies are needed to determine why PIVKA-II increases and whether high PIVKA-II levels in ICU patients affect long-term mortality or morbidity.

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published
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in
Journal of Critical Care
volume
49
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:85056191765
ISSN
1557-8615
DOI
10.1016/j.jcrc.2018.10.022https://doi.org/10.1016/j.jcrc.2018.10.022
language
English
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yes
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ee753646-3754-4046-b848-e292db71d46e
date added to LUP
2018-11-13 16:19:20
date last changed
2019-03-08 03:17:50
@article{ee753646-3754-4046-b848-e292db71d46e,
  abstract     = {Background: Vitamin K is a cofactor for proteins involved in cardiovascular health, bone metabolism and cancer. Measuring uncarboxylated prothrombin, also termed as “protein induced by vitamin K absence or antagonism for factor II (PIVKA-II)”, has been used to assess vitamin K status. High levels may indicate vitamin K deficiency. The aim of this study was to measure PIVKA-II and prothrombin time (PT-INR) in intensive care (ICU) patients and correlate vitamin K status with mortality. Methods: Ninety-five patients admitted to the ICU had blood samples taken near admission and every third day. In addition to PIVKA-II and PT-INR, critical-care severity scores were computed. Results: The median baseline PIVKA-II was 4.97 μg/L compared to the upper reference of 2.0 μg/L. PIVKA-II further increased at days 3 and 6, (median 7.88 μg/L, p = .047 and median 8.14 μg/L, p = .011) predominantly in cardiac arrest patients (median 21.4 μg/L, day 3). Conclusion: Intensive care patients have increased PIVKA-II levels at admission, which increases during the ICU stay, especially in cardiac arrest patients. There were no correlations between PIVKA-II and PT-INR, SOFA score or mortality. Further studies are needed to determine why PIVKA-II increases and whether high PIVKA-II levels in ICU patients affect long-term mortality or morbidity.<br/><br/>    Previous article in issue},
  articleno    = {0883-9441},
  author       = {Dahlberg, Sofia and Schurgers, Leon and Schött, Ulf and Kander, Thomas},
  issn         = {1557-8615},
  language     = {eng},
  pages        = {105--109},
  publisher    = {Elsevier},
  series       = {Journal of Critical Care},
  title        = {Vitamin K deficiency in critical ill patients; a prospective observational study},
  url          = {http://dx.doi.org/10.1016/j.jcrc.2018.10.022https://doi.org/10.1016/j.jcrc.2018.10.022},
  volume       = {49},
  year         = {2019},
}