The Hemostatic Mechanism after Open-Heart Surgery

E R Cole; F Bachmann; C A Curry; D Roby

doi:10.1055/s-0038-1646707

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1978; 39(02): 474-487
DOI: 10.1055/s-0038-1646707

Original Article

Schattauer GmbH Stuttgart

The Hemostatic Mechanism after Open-Heart Surgery

III. Correlation between the Appearance of an Abnormal Protein Demonstrated by Gel Electrophoresis and of an Inhibitor of the Extrinsic Coagulation System (PEC)

E R Cole

The Rush-Presbyterian-St. Luke’s Medical Center, Coagulation Laboratories, Hematology Section, Department of Medicine, Chicago, Illinois, U.S.A.

,

F Bachmann

The Rush-Presbyterian-St. Luke’s Medical Center, Coagulation Laboratories, Hematology Section, Department of Medicine, Chicago, Illinois, U.S.A.

,

C A Curry

The Rush-Presbyterian-St. Luke’s Medical Center, Coagulation Laboratories, Hematology Section, Department of Medicine, Chicago, Illinois, U.S.A.

,

D Roby

The Rush-Presbyterian-St. Luke’s Medical Center, Coagulation Laboratories, Hematology Section, Department of Medicine, Chicago, Illinois, U.S.A.

› Institutsangaben

Abstract

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Summary

A prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

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Referenzen

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