Utility of clot formation and lysis assay to monitor global coagulation state of patients with severe acute pancreatitis.
BACKGROUND
Systemic inflammation affects hemostasis during severe acute pancreatitis (SAP). A hypercoagulable state occurs more frequently in SAP, which is not fully detected by traditional coagulation testing.


OBJECTIVE
The aim of this study was to evaluate the contribution of clot formation and lysis (CloFAL) assay to improve monitoring of global coagulation in patients with SAP.


METHODS
Twenty-five patients with SAP who were treated from December 2009 to April 2011 were studied. Plasma was collected at the time of admission, and CloFAL was measured using the CloFAL analyzer. The parameters evaluated include coagulation time (CT), fibrinolysis time (FT), and maximum amplitude (MA), from which the accelerating coagulation extent (ACE, MA/CT), accelerating fibrinolytic extent (AFE, MA/FT), and balance level exponent (BLE, ACE/AFE) were calculated. In addition, laboratory values for the traditional coagulation testing were measured. Values were compared to a control group of 20 healthy subjects.


RESULTS
The MA, FT, ACE, and BLE values of the CloFAL assay were significantly increased in the SAP group compared to the control group (p\0.05 for all measurements). For the traditional coagulation testing, fibrinogen, plasminogen, and D-dimer levels were higher in patients in the SAP group compared to the control group (p\0.05).


CONCLUSIONS
Our findings using the CloFAL analyzer indicate that the hypercoagulable state was due to increased fibrin generation and invariable fibrinolysis in patients with SAP. CloFAL assay is a simple and useful global coagulation assay to monitor hypercoagulable states during SAP.
Chongqing Key Laboratory of Hepatobiliary Surgery and Department of Hepatobiliary Surgery, Second Affiliated Hospital, Chongqing Medical University, 74 Linjiang Road, Yuzhong district, Chongqing 400010, China. qiuzrt@163.com
Rongtao
R
Zhu
Sidong
S
Wei
Chuanxin
C
Wu
Shengwei
S
Li
Jianping
J
Gong
D000328:Adult; D000368:Aged; D001780:Blood Coagulation Tests / Q000379:methods / Q000592:standards; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D005260:Female; D005337:Fibrin / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards; D010195:Pancreatitis / Q000097:blood / Q000150:complications*; D010958:Plasminogen / Q000032:analysis; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005337:Fibrin; D005340:Fibrinogen; D010958:Plasminogen