Coagulation alterations in patients undergoing elective craniotomy.
BACKGROUND
Thromboembolism remains a major problem in patients scheduled for craniotomy. The present study examined parameters of coagulation and fibrinolysis in 15 patients undergoing elective craniotomy in the perioperative period.


METHODS
Plasma concentrations of thrombin antithrombin III complex (TAT), prothrombin fragment 1 + 2 (F1 + 2), and d-dimer were measured before and after induction of anesthesia, 60 minutes and 180 minutes after the beginning of surgery, and on the first postoperative morning.


RESULTS
TAT, a marker of activation of coagulation, increased significantly (p < 0.05) from the preoperative measurements to the data obtained 60 minutes after beginning the surgery, reaching a maximum of 180 minutes after the start of surgery. F1 + 2, also indicating activation, showed a similar concentration time course with an intraoperative maximum. D-dimer, a marker of fibrinolysis, tended to increase slightly beginning 180 minutes after surgery with a maximum on the morning after surgery. Statistical significance for F1 + 2 and d-dimer was not found.


CONCLUSIONS
This study showed a transient activation of coagulation with an intraoperative maximum in patients undergoing craniotomy. This result could be due to a liberation of thromboplastin from brain tissue.
Heesen
M
M
Department of Anesthesiology, Justus-Liebig University Giessen, Germany.
Kemkes-Matthes
B
B
Deinsberger
W
W
Boldt
J
J
Matthes
K J
KJ
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000378:metabolism; D001777:Blood Coagulation; D001932:Brain Neoplasms / Q000097:blood* / Q000601:surgery; D003399:Craniotomy; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011517:Prothrombin Time; D013917:Thrombin / Q000378:metabolism
D000990:Antithrombin III; D013917:Thrombin