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PubMed1993

Influence of Tołpa Peat Preparation on haemostasis in rats.

The influence of Tołpa Peat Preparation (TPP) on certain parameters of haemostasis was studied. The present results indicate that TPP (100, 200 and 300 mg/kg p.o.) had no influence on the bleeding time, clotting time, thrombin time, prothrombin time, kaolin-kephalin time, euglobulin lysis time, the concentration of fibrinogen, the platelet count and ADP-induced platelet aggregation. No changes in animals after long-term treatment with TPP (100 mg/kg for two weeks) were found either. In in vitro studies TPP given in concentrations 10(-5), 10(-4), 10(-3) and 10(-2) g/cm3 was used and certain changes of the studied parameters, probably caused by the presence of high salt content in this substance, were observed.

Amino Acids↗
PubMed1998

Haemostatic profile of the San (Bushmen) relocated to Schmidtsdrif.

OBJECTIVE: To document the routine haemostatic variables of a group of San relocated from Namibia to South Africa. DESIGN: Cross-sectional study done in two stages. SETTING: Schmidtsdrif military camp in late 1990 and early 1991. SUBJECTS: Healthy adult San volunteers: 31 males and 54 females from the Vasakela and Barakwena groups in 1990; 135 males from the Vasakela group in 1991. The subjects were all soldiers or their dependants. MAIN OUTCOME MEASURES: The following tests were performed: activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen and coagulation factors V, VII, VIII, IX, X, XI and XII. The results were compared with a Western population reference group (N = 50). MAIN RESULTS: Almost all the haemostatic variables were statistically significantly lower than those of the reference group. The mean derived fibrinogen concentration in the plasma in the first stage of the study (1990) was significantly higher, but this reverted to normal during the second stage (1991), perhaps reflecting a general improvement in health. CONCLUSIONS: Even though the San are one of the best studied groups of indigenous people, this is the first published report on their haemostatic condition. The generally lower levels of haemostatic variables may reflect the lower prevalence of cardiovascular disease in the San. The population needs to be followed up as they westernise.

Adult↗
PubMed1989

Evaluation of antithrombin-III activity as a coindicator of disseminated intravascular coagulation in cats with induced feline infectious peritonitis virus infection.

Six adult specific-pathogen-free cats were inoculated intraperitoneally with a cell culture-adapted strain of feline infectious peritonitis virus. Plasma samples were evaluated for antithrombin-III (AT-III) activities at post-inoculation days (PID) 0, 4, and 11 and at termination on PID 16 (1 cat) or 21 (5 cats). Other hemostatic values evaluated were activated partial thromboplastin times, prothrombin times, thrombin times, fibrinogen, platelet counts, and fibrin/fibrinogen degradation products. Antithrombin-III activity remained within normal or above normal range (89 to 246%) in all cats, with the exception of one cat on PID 4 (AT-III, 70%). Mean baseline AT-III activity for 6 cats at PID 0 was 123%. Mean AT-III activity on PID 4, 11, and 16 or 21 was 98, 162, and 130%, respectively. On PID 4 and 16 or 21, results of coagulation screening tests indicated that all cats had disseminated intravascular coagulation. Histologically, cats also had severe fibrinonecrotizing thrombovasculitis.

Acute Disease↗
PubMed2002

Assessment and characterization of degradation effect for the varied degrees of ultra-violet radiation onto the collagen-bonded polypropylene non-woven fabric surfaces.

Exposure to ultra-violet (UV)-C radiation is a frequently used method to prevent bacteria from invasion of blood-contact biomedical products. Potential damage induced by UV radiation to collagen is of concern due to the decay of bioactivity, considerably correlated with structural alterations. Our current investigation studies the collagen-bonded non-woven polypropylene (PP) fabric surface. In this experiment, antenna-coupling microwave plasma is utilized to activate PP fabric and then the sample is grafted with acrylic acid (AAc). Type III collagen is immobilized by using water soluble 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide as coupling agent. The collagen-bonded samples with sample temperature ca. 4 degrees C are then exposed to UV-254nm radiation for different time intervals. By using fourier-transformed infrared with attenuated total reflection (FTIR-ATR) and XPS (X-ray photoelectron spectroscopy), we examine the chemical structures of samples with different treatments. Coomassie brilliant blue G250 method is utilized to quantify the immobilized collagen on the PP fabric surfaces. Blood-clotting effects are evaluated by activated partial thromboplastin time, thrombin time, and fibrinogen concentration tests. By means of cell counter and scanning electron microscopy we count red blood cells and platelets adhesion in the modified porous matrix. Our experimental results have demonstrated that with pAAc-grafting of ca. 173 microg cm(-2) and immobilized collagen of 80.5+/-4.7 microg cm(-2), for human plasma incubated samples of various intervals of UV-254 nm radiation, fibrinogen concentration decreases in human plasma, while platelets and red blood cells adhesions increase before UV radiation. However, the required time for thrombination shows significant change for UV radiation exposure of less than 20 h (alpha = 0.05). The decay of bioactivity for the UV-irradiated, collagen-bonded surfaces is thus evaluated. Surface analyses indicate that the decrease of R-COOH (derivated from grafted-pAAc or de-carboxylation of collagen), amides degradation (broken-NH), and phenylalanine scission (terminated by -OH, tyrosine formation) may gradually damage collagen by increasing the intervals of UV radiation. These effects considerably influence the bioactivity of the collagen-bonded fabric. The XPS measurements of C 1s core levels at 288.4 eV (O = C-NH) and at 289.1 eV (O = C-O) illustrate significant decreases of intensity after radiation time ca. 44 h. It is clear that UV-254 nm radiation exposure for ca. 20 h has the potential impact to moderate the bioactivities of collagen and therefore act as a vital factor to accelerate biodegradation.

Adult↗
PubMed1989

Antithrombogenic surfaces: characterization and bioactivity of surface immobilized PGE1-heparin conjugate.

A covalently bonded conjugate of commercial grade heparin and prostaglandin E1 (PGE1) was synthesized to prevent both fibrin formation and platelet aggregation during thrombus formation. The PGE1-heparin conjugate was immobilized on an imidazole carbamate derivatized sepharose bead surface through hydrophilic spacer groups (diamino-terminated polyethylene oxides). One end of the spacer group was coupled to the derivatized surface through a urethane bond between the amine group of the spacer and the derivatized surface. The free amine group of the immobilized spacers was coupled to a carboxylic group of the PGE1-heparin conjugate through an amide bond. Bioactivity of the immobilized conjugate (heparin activity) was measured in terms of increased clotting times (thrombin time assay) and for the inactivation of Factor Xa. Bioactivity of the immobilized compound (PGE1 activity) was analyzed by platelet adhesion and platelet release reactions using C14-5-hydroxytryptamine (5-HT). The conjugate immobilized via the C2 spacer showed the highest incidence of platelet adhesion, 5-HT released and the lowest activity for coagulation factors. In contrast, the 1000 and 4000 immobilized systems showed a significant reduction in platelet activation, while having the greatest effect on coagulation factors. The results of these experiments imply that the immobilized conjugate is active in preventing both pathways of thrombus formation, and the efficacy is improved through the use of long-chain hydrophilic spacer groups.

Alprostadil↗
PubMed1981

[The in-vitro-effects of loxaglate (Hexabrix) on coagulation, fibrinolysis and complement system (author's transl)].

Ioxaglate causes a dose dependent prolongation of thrombin time, thrombin coagulase time, partial thromboplastin time and calcium thromboplastin time. A substantial activation of fibrinolysis, assayed by a dose dependent decrease of plasminogen concentrations, does not take place. Higher concentration of ioxaglate (more than 25 mg iodine/ml) cause a complement activation. No C-3 split products could be detected by two-dimensional immunoelectrophoresis. Ioxaglate induced changes of global coagulation tests are interpreted as being caused by interference of fibrin polymerization. The demonstration of complement activation by high concentrations of ioxaglate has no practical consequences.

Blood Coagulation↗
PubMed1990

[Multivariate analysis for the understanding of typical diabetic hemostasis criteria. 1: Plasma markers].

In 309 patients investigations were made into the functions of blood coagulation with special consideration of numerous metabolic criteria. They referred to 111 healthy control persons and 198 patients with diabetes mellitus, 67 of them being of type I and 131 of type II. From a variety of metabolic characteristics and haemostasis optimal criteria were determined by means of the statistical method of multivariance analysis, which enables a distinction to be made between diabetics of type I, type II and healthy persons. Among those 13 characteristics detected as optimal amount there were thrombin time, thrombin coagulase time as parameter of haemostasis both before and after venous congestion, reptilase time prior to venous congestion and fibrinogen concentration after it. Thus, these coagulation factors indicate a different behaviour in both types of diabetes and in healthy control persons.

Adolescent↗
PubMed1985

The anticoagulant effect of Bothrops castelnaudi snake venom (Castelnaud's pit viper).

An inhibitory effect of Bothrops castelnaudi venom was observed on the following systems: prothrombin time, activated partial thromboplastin time, thrombin time, thromboplastin generation time, activation of factor X by Russell's viper venom and Russell's viper venom activated factor X (factor Xa). This effect did not require previous incubation and was prevented by the addition of Bothrops-antivenom. The prolonged activated partial thromboplastin time was not shortened by increased phospholipid concentration (0.5-10 mg/ml), suggesting that the inhibitory effect is not due to an anti-phospholipid activity. No significant fibrinogenolytic activity was detected upon incubation of human fibrinogen with the venom, since physiological levels of thrombin-clottable material were still present. Compared to Bothrops jararaca venom, the proteolytic activity on casein and on azocoll was very low. Thrombin-induced clots of human plasma and fibrinogen were not lysed by the venom within 24 hr. The results indicate that the anticoagulant effect of Bothrops castelnaudi venom is exerted at least at two levels of the blood coagulation mechanism: (1) before prothrombin activation, by inhibiting factor X-activation and factor Xa activity; (2) by direct action on thrombin.

Animals↗
PubMed1985

[Blood coagulation in 222 cases of solid malignant neoplasms].

We have examined 222 patients with nonterminal solid malignant tumors in order to study the possible variations on the hemocoagulation system due to neoplasia. Only patients whose hemocoagulation system could be proven normal by test made before the malignant neoplasia appeared were taken into consideration. Our study was based on the following tests: platelet count, platelet adhesiveness and aggregation, prothrombin time, thrombin time, thrombotest, antithrombin 3, thrombin-coagulase, activity partial thromboplastin time, fibrinogen, reptilase time. Our study showed there was no relevant difference between the results tests of healthy people taken as points or reference and those of our patients. We did find however a slight but diffuse alteration of all, or almost all, the components of the hemostatic and coagulation system. These variations however were not significant enough to enable us to prove any connection between the neoplasia and the whole hemocoagulation system.

Adult↗
PubMed1993

[Minimal heparinization in dialysis patients with increased risk of bleeding].

In 78 patients (47 men, 31 women; mean age 53 [22-78] years) 174 dialyses were undertaken within one week of a bleeding episode or a diagnostic or therapeutic procedure which may cause bleeding. Minimal anticoagulation with low molecular weight heparin (LMWH) was the aim, using a biocompatible dialyser. During the dialysis coagulation was controlled by global tests (Quick value/international normalized ratio [INR], partial thromboplastin time, thrombin time, antifactor Xa activity), by molecular markers of clotting activity (thrombin-antithrombin III complex [TAT], D-dimers), as well as measurement of elastase (elastase-alpha 1-protein inhibitor complex). The LMWH dosage averaged 932 units as an initial bolus and 234 units/h as a continuous infusion. In the group of chronic dialysis patients (n = 72) this meant (standard heparin units = 2/3 LMWH units) a reduction to 45 +/- 11% from the previously used routine heparin dosage for a 4-hour dialysis. All dialyses were completed without bleeding complications. Considerable clotting formation in the extracorporeal circulation occurred in 11 dialyses (6.3%). TAT, D-dimer and elastase values proved to be suitable for determining individual clotting activity and for reducing anticoagulation to the minimum.

Adult↗
PubMed1984

The importance of simple coagulation tests (fibrinogen assays and thrombin coagulase clotting time) in the diagnosis of liver cancer.

Dysfibrinogenemia in 36 patients with primary hepatocarcinoma and in 25 patients with cirrhosis of the liver was studied by means of reptilase time, thrombin coagulase time, fibrin polymerization and fibrinogen assays. Both groups of patients were similar in age, sex and incidence of HBs Ag. No electrolyte or fluid imbalances were present. Prolonged reptilase time and prolonged polymerization time were found in both groups; however, thrombin coagulase time was prolonged in 80% of the hepatocarcinoma group, but was normal in almost all patients with cirrhosis (p less than 0.001). In the hepatocarcinoma group, a difference of more than 100 mg per 100 ml was present between the immunologic and coagulative methods of fibrinogen determination in 36.1% of the cases, but in the cirrhotic group this difference was not present in any of the patients (p less than 0.01). We also found that by simply measuring fibrinogen levels by the Mancini method, we could distinguish hepatocarcinoma from cirrhosis in most cases.

Adult↗
PubMed1974

Coagulation studies and correlative histology during experimental hemoglobinemia in rabbits.

Evidence of disseminated intravascular coagulation (DIC) was sought in New Zealand white rabbits infused with autologous, hemolyzed whole blood. Hemoglobinemia was induced in 17 rabbits by rapid intravenous injection of frozenthawed whole blood. Three dose regimens yielded mean peak plasma hemoglobin concentrations of 325, 615 and 860 mg/100 ml respectively (range 260 to 1050 mg/100 ml). Eleven control animals were infused with autologous, nonhemolyzed whole blood in similar doses. Rabbits were killed at either 15, 60, 120 or 180 minutes following infusion and multiple organ biopsies obtained immediately post-mortem. Coagulation studies demonstrated no significant alterations in prothrombin time, partial thromboplastin time, thrombin time or fibrinogen. Fibrin degradation products were not found. Histologic examination of lung, heart, liver, spleen and kidney revealed no fibrin deposition, thrombus formation or other abnormalities. We conclude from our study that induction of brief, experimental hemoglobinemia in New Zealand white rabbits, utilizing moderately large doses of autologous, hemolyzed whole blood, does not result in the development of DIC.

Animals↗
PubMed1993

[Normal values for hematological and hemostatic parameters in the rabbit. Determination of new parameters for experimental models of thrombosis and hemostasis].

PURPOSES: Assessment of normal haematological values in the rabbit using a semi-automatic analyser. Evaluation of new haemostatic parameters necessary for experimental models in thrombosis and haemostasis. MATERIAL AND METHODS: 20 New Zealand male rabbits of 2-2.5 kg were anaesthetized and blood was collected from the jugular vein. The following haematological determinations were carried out using a semi-automatic analyser: red blood cells count, haemoglobin, haematocrit, indexes, white blood cells count, platelet count and mean platelet volume. The parameters used to assess the physiological haemostasis in rabbit were: bleeding time, fibrinogen, prothrombin time, activated partial thromboplastin time, thrombin time; and others not yet determined in the rabbit: antithrombin III, thrombin-antithrombin complexes and F1+2 fragments to measure the basal thrombin-formation activity, and fibrin D-dimer and fibrinogen degradation products for fibrinolysis activity. RESULTS: The haematological results obtained were similar than with other techniques, but with no stress influence. Normal values for haemostatic parameters studied are shown, including the parameters for the determination of physiological thrombin-formation and fibrinolysis activity. F1+2 fragments and fibrinogen degradation products could not be evaluated. CONCLUSIONS: The haematological results obtained were completely normal. All the haemostatic parameters studied were found useful to determine the physiological activity of coagulation and fibrinolysis in the rabbit, and specially for experimental models of hypercoagulability and hyperfibrinolisys states.

Animals↗
PubMed1992

[Measures for reducing the use of homologous blood. Effects on blood coagulation during total endoprosthesis].

The influence of two different methods of autologous transfusion, preoperative donor plasmapheresis (Abbott Autotrans) and postoperative autotransfusion (intraoperative blood salvage, Dideco Autotrans), on the intravascular hemostatic system was investigated. Forty-two patients undergoing total hip surgery and preoperative donor plasmapheresis were prospectively randomized into three groups. For substitution of blood loss, patients in group 1 (control group, n = 12) received in addition to cristalloids and colloids only homologous blood, group 2 (n = 14) autologous blood, and group 3 (n = 16) additionally intra- and postoperative autologous fresh frozen plasma (FFP). The investigation included blood parameters (hemoglobin, hematocrit, thrombocytes), clotting status (prothrombin time, plasma thromboplastin time, thrombin time, fibrinogen, plasminogen, and antithrombin III), and immunological methods such as fibrinopeptide A (FPA), thrombin-antithrombin III (TAT), and protein C. No significant difference was found with respect to total amount of infusion, intraoperative blood loss, autologous transfusion, and blood parameters. Excellent quality of the autologous FFP was demonstrated by investigation of the specimens before administration. The autologous packed red cells showed high levels of TAT and FPA as an indicator of thrombin generation. Their administration caused a significant increase in TAT and FPA levels in groups 2 and 3 compared to group 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

[Thrombocyte dysfunction in children with albinism].

Seven children with albinism were examined for haemorrhagic diathesis. In 6 patients coagulation screening tests (prothrombin time, activated partial thromboplastin time, thrombin time) were normal, in 1 patient prolongation of activated partial thromboplastin time due to mild factor XI deficiency was found. Platelet counts were in the reference range, however, the template bleeding time of 6 out of 7 patients was prolonged. Evaluation of platelet aggregation and secretion in a lumi-aggregometer demonstrated that only the child with normal bleeding time had normal platelet function, and 6 children with prolonged bleeding time had impaired aggregation and release reaction. Five out of these 6 patients had severe decrease of ATP secretion even when high dose of thrombin was used as agonist. The number of dens granules in the platelets of these patients, as measured by the uptake of mepacrine, was significantly less than in normal controls. These findings clearly suggested storage pool deficiency. In one of these patients storage pool deficiency was associated with mild factor XI deficiency. The high frequency of haemorrhagic diathesis in albino children emphasizes, the importance of the screening of patients with albinism for bleeding diathesis.

Adolescent↗
PubMed1994

[Intracranial hemorrhage and hemostasis. Monitoring patients after intracranial hemorrhage by determination and follow-up of activation products of blood coagulation].

OBJECTIVE: The aim of the study was to improve the detection of small hemorrhages with minimal symptoms and of unruptured aneurysms after a subdural and subarachnoid bleeding by the control of the intravascular hemostatic system. DESIGN: Prospective, open study. SETTING: Neurosurgical intensive care unit of a university hospital. PATIENTS: 44 patients undergoing a cranial trepanation. Patients of group 1 (control n = 11) had an intrasellar hypophysoma, patients of group 2 (n = 12) a chronic subdural hematoma without a previous traumatic incident and patients of group 3 (n = 15) a subarachnoid hemorrhage caused by an intracranial aneurysm. INTERVENTIONS: After cranial trepanation changes of plasmatic hemostasis have been assessed by means of immunologically determined parameters of coagulation. The investigation included blood parameters (hemoglobin, hematocrit, thrombocytes), clotting status (prothrombin time, partial thromboplastin time, thrombin time, fibrinogen, plasminogen, antithrombin III [AT III] activity and proteinase inhibitors), as well as immunological methods such as fibrinopeptide A (FPA), thrombin-antithrombin III (TAT), protein C and factor XIII activity (F XIII activity). RESULTS: In comparison to group 1 (control) a significant difference (p < 0.001) was seen in groups 2 and 3 for thrombin-antithrombin III (TAT), fibrinopeptide A (FPA), protein C, and the antithrombin III activity. Intra- and postoperatively increased TAT levels in groups 2 (16.9 ng/ml) and 3 (21.1 ng/ml) and decreased protein C levels (group 2: 61% and group 3: 58%) demonstrated an intravascular thrombin generation. On account of the elevated FPA levels in groups 2 (6.5 ng/ml) and 3 (5.7 ng/ml) and decreased AT III activity in groups 2 (58%) and 3 (62%), this thrombin generation was only incompletely compensated. Caused by proteolytic thrombin effects, another sign for a thrombin-induced turnover of clotting factors is the significant reduction (p < 0.001) of F XIII activity in groups 2 (40%) and 3 (44%). In comparison to group 1 this significantly reduced F XIII activity in groups 2 and 3 was correlated (r = 0.99) to changes in FPA and TAT plasma levels, an indication of latent chronic clotting activity. No significant difference was found concerning total amount of infusion, intra- and postoperative blood loss and blood parameters. Eight patients (group 2: 5 patients, group 3: 3 patients) showed a rebleeding episode without operative interventions. In these patients increased clotting activity (TAT, FPA, protein C) caused by proteolytic thrombin effects was combined with a factor XIII activity smaller than 40%. CONCLUSION: The results of the recent study indicated that immunologically determined TAT, FPA, protein C, factor XIII and AT III activities might serve to improve management in patients with intracranial bleeding events. In view of these parameters the evaluation of risks for a rebleeding is improved. A decrease of the plasma factor XIII activity under 40% associated with a latent clotting activity induced by a thrombin generation caused a higher risk of rebleeding after an initial intracranial bleeding event. The necessity of substituting factor XIII in such cases should be elucidated to minimize risks of rebleeding.

Aneurysm, Ruptured↗
PubMed2003

Comparison of general and spinal anesthesia and their influence on hemostatic markers in patients undergoing total hip arthroplasty.

STUDY OBJECTIVE: To evaluate the profile of molecular hemostatic markers in patients receiving either spinal or balanced general anesthesia for total hip arthroplasty. DESIGN: Open, randomized, observational study. SETTING: Orthopedic unit and central laboratory of a university hospital. PATIENTS: 26 consenting ASA physical status II and III inpatients undergoing total hip arthroplasty with general balanced anesthesia (n = 10) or spinal (regional) anesthesia (n = 16). INTERVENTIONS: The time course of seven procoagulatory and fibrinolytic parameters was examined during and after surgery in both groups of patients (general and regional). Blood samples were drawn on the day before surgery, directly before induction of general anesthesia or regional anesthesia, respectively, intraoperatively (before bone manipulation), at the end of surgery, and on the mornings of postoperative days 1 and 5. MEASUREMENTS AND MAIN RESULTS: The coagulation samples were centrifuged within 1 hour of collection at 2,300 g for 15 minutes at 4 degrees C. Hemoglobin, hematocrit, platelets, fibrinogen, prothrombin time, thrombin time, activated partial thromboplastin time, antithrombin, and protein C were measured immediately on arrival at the laboratory. Specimens were then aliquoted and stored at -70 degrees C. Within 2 weeks, samples were thawed and prepared for the following assays: thrombin-antithrombin complexes (TAT complexes), D-dimers, plasminogen activator inhibitor type 1 (PAI-1), and plasminogen and plasmin inhibitor. Maximum activation of coagulation was not reached until 2 hours postoperatively and then slowly decreased until normal values were reached around the fifth postoperative day. Parameters displaying the greatest changes were antithrombin and D-dimers. No statistically significant differences were found between the two groups at the individual time points. CONCLUSION: Our initial hypothesis that the lesser risk of postoperative DVT in patients undergoing total hip arthroplasty in regional anesthesia is reflected in the course of the plasmatic molecular markers of hemostasis could not be verified. There were no significant differences in the timely course of the markers at any given time point.

Aged↗
PubMed1999

Course of molecular hemostatic markers during and after different surgical procedures.

STUDY OBJECTIVE: To establish the most vulnerable time of thrombi formation with regard to the plasmatic (noncellular) part of the coagulatory and fibrinolytic systems. DESIGN: Nonrandomized observational study. SETTING: A surgical and an orthopedic unit and the central laboratory of a university hospital. PATIENTS: 61 consenting ASA physical status I and II inpatients undergoing four different types of surgery: total hip replacement (THR): 16 patients; hemicolectomy: 15 patients; endoscopic cholecystectomy: 15 patients; subtotal thyroid resection: 15 patients. INTERVENTIONS: The time course of 11 procoagulatory and fibrinolytic parameters was examined during the different types of surgery. Blood samples were drawn on the day before surgery, directly before the induction of general anesthesia, 1 to 2 hours postoperatively, and on the mornings of postoperative days 1, 2, 3, 4, and 5. MEASUREMENTS AND MAIN RESULTS: The coagulation samples were centrifuged within 1 hour of collection at 2,300 g for 15 minutes at 4 degrees C. Hemoglobin, hematocrit, platelets, fibrinogen, prothrombin time, activated partial thromboplastin time, thrombin time, antithrombin III, and protein C were determined immediately on laboratory arrival of the samples. The samples were aliquoted at -70 degrees C. They were thawed within 2 weeks and prepared for the following assays: thrombin-antithrombin III complexes (TAT-complexes), D-dimers, and plasminogen activator inhibitor type 1. Maximum activation of coagulation is not reached until 2 hours postoperatively and slowly decreases until normal values are reached around the fifth postoperative day. Parameters displaying the greatest changes are TAT-complexes and D-dimers. The type of surgery with the most pronounced changes was total hip replacement, followed by hemicolectomy, cholecystectomy, and subtotal thyroid resection. CONCLUSION: The total hip replacement and hemicolectomy groups show similar and strong activation of the procoagulatory and fibrinolytic systems. Much less pronounced are the changes during endoscopic cholecystectomy and subtotal thyroid resection. Maximum activation occurs 1 to 2 hours postoperatively.

Adult↗