Changes in coagulation and fibrinolytic activity associated with tracheal intubation.
This study was carried out to clarify the effect of tracheal intubation on the coagulation and fibrinolytic system. It was performed on 20 patients (ASA class 1-2) undergoing elective surgery. Before and after tracheal intubation, hemodynamics, ACTH, cortisol, catecholamines, and several coagulation and fibrinolytic factors were measured. Tracheal intubation was accompanied by significant increases in the blood pressure, heart rate, and norepinephrine level. No changes were observed in fibrinopetide A, fibrinopeptide B(Beta15-42), tissue plasminogen activator antigen, plasminogen, fibrinogen, and Alpha(2) plasmin inhibitor. Patients exposed to long intubation time (>20 seconds) were found to have a significantly higher level of fibrinopeptide A than patients with short tracheal intubation time (</=20 seconds) ( P < 0.05). It therefore can be concluded that the increase in norepinephrine and changes in the hemodynamics following tracheal intubation have no impact on the coagulation and fibrinolytic activity. Also, if the duration of intubation is prolonged, thrombin activity may be promoted.
Department of Emergency and Critical Care Medicine, Sapporo National Hospital, Sapporo, Japan.
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Gando
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Tedo
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Kubota
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Tujinaga