Abstract
To evaluate the fibrinolytic activity in a closed surgical wound, in postoperatively drained blood, and during autologous transfusion. Prospective study. National hospital, Norway. 9 patients operated on for thoracic scoliosis. Concentrations of plasmin/antiplasmin (PAP), alpha2-antiplasmin, and D-dimers in drained, arterial, and mixed venous blood before, during, and after infusion of 10 ml/kg body weight of postoperatively drained, untreated blood. In drained blood the concentration of alpha2-antiplasmin was 31% of the preoperative arterial control value. Together with the increased concentrations of PAP to 18076 microg/L and D-dimers to 126 mg/L, this indicates extensive fibrinolytic activity in the closed wound. The postoperative autologous transfusion of drained, untreated blood increased the concentration of PAP from 507 to 2453 microg/L and of D-dimer from 0.7 mg/L to 15.3 mg/L in systemic blood. The systemic concentration of fibrin(ogen) degradation products, indicated by D-dimers, after recirculation of drained, untreated blood might impair coagulation. The extensive activation of plasmin might exhaust available alpha2-antiplasmin in the wound and result in postoperative rebleeding.
References
Jul 1, 1990·Transfusion Medicine Reviews·W H Dzik, B Sherburne
Jun 1, 1986·Thrombosis Research·L I ThorsenN O Solum
Mar 1, 1989·The Annals of Thoracic Surgery·L D GriffithT A Lane
Jun 15, 1988·Thrombosis Research·O E DahlA Vinje
Dec 1, 1986·Thrombosis Research·L I ThorsenN O Solum
Nov 1, 1985·Scandinavian Journal of Clinical and Laboratory Investigation·C KluftA O Aasen
Jul 1, 1985·American Journal of Hematology·L T GoodnoughN Heimburger
Jan 1, 1974·Scandinavian Journal of Haematology·H Arnesen
Jun 1, 1972·British Journal of Haematology·M J LarrieuV J Marder
Jan 1, 1969·Scandinavian Journal of Urology and Nephrology·L Andersson, I M Nilsson
Mar 1, 1970·American Journal of Surgery·J Ygge
Jun 1, 1995·Baillière's Clinical Haematology·H R Lijnen, D Collen
Dec 1, 1994·International Journal of Cardiology·H AramotoT Muto
May 1, 1995·British Journal of Anaesthesia·S HiippalaH Niemelä
Aug 1, 1994·The Journal of Arthroplasty·R L WixsonA M Zimmer
May 1, 1994·The Annals of Thoracic Surgery·J P SchönbergerC R Wildevuur
Jun 15, 1993·Thrombosis Research·O E DahlT Lyberg
Mar 1, 1993·The Journal of Bone and Joint Surgery. American Volume·F T BlevinsJ Hall
Jul 1, 1996·American Journal of Clinical Pathology·A B GelbD T Mangano
Feb 1, 1997·Thrombosis Research·G BenoniH Fredin
Jun 1, 1997·Acta Orthopaedica Scandinavica·M E KristianssonM Blombäck
Apr 16, 1998·The European Journal of Surgery = Acta Chirurgica·C D KrohnA O Aasen
Apr 7, 1999·The European Journal of Surgery = Acta Chirurgica·C D KrohnA O Aasen
Jul 2, 1999·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·C D KrohnF Brosstad
Aug 1, 1965·The American Journal of Physiology·J HIRSHS SHERRY
Citations
May 13, 2004·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·M MuñozC Sebastián
Feb 27, 2007·Transfusion·Jonathan H Waters, Robert M Dyga
May 14, 2004·Thrombosis Research·Dino BiaginiSergio Pagliaricci
Aug 9, 2016·Medicine·Patrick MeybohmDonat R Spahn
Dec 1, 2012·Transfusion Alternatives in Transfusion Medicine : TATM·Gerhardt Konig, Jonathan H Waters
Sep 1, 2012·Transfusion·Gerhardt KonigJonathan H Waters
Nov 15, 2007·Annals of the Royal College of Surgeons of England·Saqeb B MirzaSukhmeet S Panesar
Dec 9, 2004·Transfusion·Ernil Hansen, Michael Pawlik Hansen
Jun 3, 2021·Current Opinion in Anaesthesiology·Jonathan H Waters
Jun 2, 2010·Clinics in Laboratory Medicine·Jonathan H Waters