caa a22 4500 477112676 CHVBK 20180405111614.0 cr unu---uuuuu 170330e19961101xx s 000 0 eng 10.1007/BF01747190 doi (NATIONALLICENCE)springer-10.1007/BF01747190 Changes in coagulation and fibrinolytic parameters caused by extracorporeal circulation [Elektronische Daten] [R. Grossmann, J. Ebell, M. Misoph, S. Schwender, K. Neukam, Th. Hickethier, O. Elert, F. Keller] Summary: During cardiopulmonary bypass (CPB) mechanical stress and the contact of blood with artificial surfaces lead to the activation of pro- and anticoagulant systems and the complement cascade, and to changes in cellular components. This phenomenon causes the "postperfusion-syndrome”, with leukocytosis, increased capillary permeability, accumulation of interstitial fluid, and organ dysfunction. In this study, we focused on the influence of the extracorporeal circulation, sternotomy, and heparin administration on the activation of coagulation and fibrinolysis. In 15 patients we investigated coagulation parameters before, during and post CPB, i.e., fibrinogen, antithrombin (AT) III, thrombin-antithrombin complex (TAT), prothrombin fragments F1 + 2 (F1 + 2), factor (F) XIIa, tissue factor (TF), and parameters of the fibrinolytic system, i.e., plasmin-antiplasmin-complex (PAP), D-dimer, tissueplasminogen-activator (tPA), urokinase-type plasminogen activator (uPA), and plasminogen-activator inhibitor type 1 (PAI 1). The results demonstrate distinct alterations in the above mentioned parameters. Despite administration of a high dose of heparin (activated clotting time [ACT] > 450s) combined with a low dose of aprotinin, activation of the coagulation and fibrinolytic pathways was observed. We found this activation was mainly caused by CPB and not by sternotomy. The activation of coagulation was due to foreign surface contact (F XII ⇒ F XIIa) as well as to an effect of tissue factor release in the late phase of CPB. The enhanced fibrinolytic activity during CPB was, at least in part, caused by tPA and was followed by PAI 1 release. Springer-Verlag, 1996 Extracorporeal circulation nationallicence Coagulation nationallicence Fibrinolysis nationallicence Aprotinin nationallicence Grossmann R. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Ebell J. Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Misoph M. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Schwender S. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Neukam K. Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Hickethier Th Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Elert O. Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Keller F. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut Heart and Vessels Springer-Verlag 11/6(1996-11-01), 310-317 0910-8327 11:6<310 1996 11 380 https://doi.org/10.1007/BF01747190 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01747190 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Grossmann R. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Ebell J. Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Misoph M. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Schwender S. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Neukam K. Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Hickethier Th Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Elert O. Department of Cardiothoracic Surgery, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 700 1- Keller F. Central Laboratory of the University Medical Centre, University Hospital, Josef Schneider-Strasse 2, D-97080, Würzburg, Germany aut NATIONALLICENCE 773 0- Heart and Vessels Springer-Verlag 11/6(1996-11-01), 310-317 0910-8327 11:6<310 1996 11 380 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer