Studies on pathological plasma proteolysis in severely burned patients using chromogenic peptide substrate assays: a preliminary report.

Changes in components of the plasma proteolytic enzyme systems were studied in nine patients with severe burns using chromogenic peptide substrate assay technique. All patients were critically ill and five died during a four week observation period. Plasma prekallikrein, plasminogen, prothrombin and platelet values decreases regularly in all patients after the injury. These changes were seen together with a high frequency of increases serum FDP values and presence of soluble fibrin. During critical illness extensive plasma proteolysis occurred, indicated by elevated plasma kallikrein and plasmin activities combined with lowered functional plasma kallikrein inhibition, prekallikrein and plasminogen values. The study confirms that plasma pathological proteolysis occurs in patients with severe burns, and indicates that close monitoring of components of the plasma proteolytic enzyme systems can give information of prognostic and therapeutic value in the severely burned patient.