PMID: 9161901May 1, 1997Paper

The role of the pulmonary circulation in the regulation of coagulation and fibrinolysis in relation to major surgery

Journal of Cardiothoracic and Vascular Anesthesia
O E Dahl

Abstract

Cardiac surgery and hip replacement surgery (HRS) are associated with serious cardiorespiratory and vascular complications. Activation of blood coagulation and fibrinolysis in the lung vasculature seem to play a key role in the pathophysiology of this process. This article reviews the results of several experimental and clinical studies within this field. Animal studies have shown that bone traumatization induces a marked local activation of coagulation and fibrinolysis in femoral vein blood draining from the surgical area as shown by a 2.5-fold increase in plasma levels of thrombin-antithrombin complexes (TAT) and a seven-fold increase in tissue plasminogen activator (tPA) activity. A slight increase in TAT in femoral vein blood on the unoperated side has also been found and indicates increased activation of coagulation in recirculated blood, which had passed the pulmonary microvasculature. In addition, human studies have shown that bone preparation induced a 200-fold increase in systemic circulating fibrinopeptide-A during surgery and a five-fold increase in TAT (when thromboprophylaxis was stopped 1 week after surgery). Both increases are markers of thrombin generation. Furthermore, cellular studies have shown that thrombin ...Continue Reading

References

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Citations

Sep 22, 2012·Archives of Orthopaedic and Trauma Surgery·Ove TalsnesOlav Reikerås
Apr 19, 2002·Biomaterials·Elisabetta CenniLeo Alessandro Di
Feb 23, 2005·Occupational and Environmental Medicine·P S GilmourW MacNee
May 11, 2002·Journal of Biomaterials Science. Polymer Edition·E CenniA Pizzoferrato
Oct 26, 2000·Anesthesia and Analgesia·G EkbäckU Schött
Mar 11, 2016·Indian Journal of Anaesthesia·Atul P KulkarniJigeeshu V Divatia
Jun 14, 2015·The Veterinary Clinics of North America. Small Animal Practice·Lisa J Bazzle, Benjamin M Brainard
Apr 28, 2001·The Journal of Thoracic and Cardiovascular Surgery·R Cartier, D Robitaille
Nov 3, 1998·Acta Orthopaedica Scandinavica·O E Dahl
Jan 29, 2002·Hospital Medicine·K K Hampton
Apr 5, 2005·The Journal of Bone and Joint Surgery. American Volume·Satoshi YamasakiTakeshi Fuji
Feb 10, 2012·Journal of Biosocial Science·M Mazharul Islam
Jun 2, 2009·The Journal of Bone and Joint Surgery. British Volume·K RajesparanR E Field
Nov 9, 2010·Clinical Orthopaedics and Related Research·Edwin P SuNigel E Sharrock
Sep 1, 2015·Journal of Orthopaedic Surgery·J Y ChenS J Yeo

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