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

Sofia Dahlberg, Leon Schurgers, Ulf Schött, Thomas Kander

Journal: Journal of critical care 2020;49():105-109

PMID: 30415179

Full Text on Elsevier Science View on PubMed

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.

Address: Institution of Clinical Sciences Lund, Medical Faculty, Lund University, S-22185 Lund, Sweden.. Electronic address: [email protected].; Department of Biochemistry, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands.. Electronic address: [email protected].; Institution of Clinical Sciences Lund, Medical Faculty, Lund University, S-22185 Lund, Sweden.; Department of Intensive and Perioperative Care, Skane University Hospital, S-22185 Lund, Sweden. Electronic address: [email protected].; Institution of Clinical Sciences Lund, Medical Faculty, Lund University, S-22185 Lund, Sweden.; Department of Intensive and Perioperative Care, Skane University Hospital, S-22185 Lund, Sweden. Electronic address: [email protected].

DOI: 10.1016/j.jcrc.2018.10.022

Link outs

Subscription / membership required

Full Text Sources:

MeSH Terms: Adult, Aged, Aged, 80 and over, Biomarkers, Critical Illness, Female, Heart Arrest, Humans, International Normalized Ratio, Male, Middle Aged, Prospective Studies, Protein Precursors, Prothrombin, Prothrombin Time, Vitamin K Deficiency, Young Adult