title: Changes in the coagulation and fibrinolytic systems during and after cardiopulmonary bypass surgery.
abstract: Components of the coagulation and fibrinolytic systems were determined in patients undergoing open heart surgery with cardiopulmonary bypass. The variables studied included prothrombin, antithrombin-III, spontaneous plasmin activity, plasminogen and functional antiplasmin activity. The variables were measured using chromogenic peptide substrate assays. A marked, transitory, increase in spontaneous plasmin activity prior to cardiopulmonary bypass, but after heparin injection was found. A decrease in antiplasmin activity during bypass was observed, while actual plasminogen level, when correcting for hemodilution, was unchanged. Both prothrombin and antithrombin-III paralleled the decrease in hemoglobin concentration during bypass. These findings suggest that the injection of heparin induced a transient activation of the fibrinolytic system, whereas no detectable consumption of the measured coagulation variables was observed.
authors.affiliation: Department of Anaesthesia, Rikshospitalet, Oslo, Norway.
authors.forename: U E
authors.initials: UE
authors.lastname: Kongsgaard
authors.forename: N
authors.initials: N
authors.lastname: Smith-Erichsen
authors.forename: O
authors.initials: O
authors.lastname: Geiran
authors.forename: L
authors.initials: L
authors.lastname: Bjørnskau
mesh_terms: D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation; D002315:Cardiopulmonary Bypass; D005341:Fibrinolysin / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D010958:Plasminogen / Q000032:analysis; D011184:Postoperative Period; D011516:Prothrombin / Q000032:analysis; D000979:alpha-2-Antiplasmin / Q000032:analysis
chemical_list: D000979:alpha-2-Antiplasmin; D000990:Antithrombin III; D011516:Prothrombin; D010958:Plasminogen; D005341:Fibrinolysin