The Effect of Defibrinogenation on Pulmonary Embolism in Dogs

Alfred G. Meissner; Gerald O’Sullivan; Robert A. Macbeth

doi:10.1055/s-0038-1648018

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1976; 36(01): 140-149
DOI: 10.1055/s-0038-1648018

Original Article

Schattauer GmbH

The Effect of Defibrinogenation on Pulmonary Embolism in Dogs

Authors

Alfred G. Meissner^*

¹Department of Surgery and the Surgical-Medical Research Institute, The University of Alberta, Edmonton, Canada T6G 2N8
Gerald O’Sullivan

¹Department of Surgery and the Surgical-Medical Research Institute, The University of Alberta, Edmonton, Canada T6G 2N8
Robert A. Macbeth

¹Department of Surgery and the Surgical-Medical Research Institute, The University of Alberta, Edmonton, Canada T6G 2N8

Abstract

Summary

The role of fibrinogen in the pathophysiology of pulmonary embolism is not clearly understood. A study was therefore performed in order to determine the effect of defibrinogenation on the sequelae of experimental pulmonary embolization in the canine model. Total defibrinogenation was achieved by treating 15 dogs with Defibrase over a period of three days, and these were studied and compared with 15 control animals. The embolus was produced by injection of a homologous clot into the superior vena cava. A 27 per cent mortality rate was observed after embolism in the control group, but there were no deaths in the Defibrase-treated animals. Hemodynamic and pulmonary gas exchange disturbances occuring in the control group were more severe than those in the treated group and were associated with marked fibrinogen consumption. It is suggested, therefore, that defibrinogenation reduces the mortality and severity of the pathophysiological changes associated with pulmonary embolization probably by inhibition of pulmonary intravascular coagulation and by changing the rheological properties of the blood.

Full Text

References

References
1 Busch Ch, Lindquist O, Salden T. 1974; Respiratory insufficiency in the dog induced by pulmonary microembolism and inhibition of fibrinolysis. Acta Chirurgica Scandinavica 140: 255.
2 Clauss A. 1957; Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematologica 17: 237.
3 Deal C. W, Warden J. C, Monk I. 1970; Veno-arterial shunting in experimental pulmonary embolism. Journal of Surgical Research 10: 579.
4 Egberg N, Olsson P, Johnsson El. 1975. Studies on the influence of ADP and hypofi-brinogenemia on platelet aggregation and bleeding tendency in dogs. In: Martin M, Schoop W. (Eds.) Aktuelle Probleme in der Angiologie: 26, Defibrinierung mit thrombinähnlichen Schlangengiftenzymen. Verlag Hans Huber; Bern: 96.
5 Egberg N, Johnsson H. 1972; Platelet aggregation induced by ADP and thrombin in Reptilase defibrinated dogs. Thrombosis Research 1: 95.
6 Jones D. R, Ruckley C. V, Owens R, Cash J. D. 1974; Serum fibrin/fibrinogen degradation products after experimental pulmonary embolism. British Journal of Surgery 61: 811.
7 Kanis J. A. 1974; Heparin in the treatment of pulmonary embolism. Thrombosis Diathesis Haemorrhagica 32: 519.
8 Köhler M. 1975. Untersuchungen zur Wirkung einer Defibrinierung mittels Schlangengiftenzymen auf den Stoffwechsel bei chronischer peripherer Arteriopathie. In: Martin M, Schoop W. (Eds.) Aktuelle Probleme in der Angiologie: 26, Defibrinierung mit thrombinähnlichen Schlangengiftenzymen. Verlag Hans Huber Bern; 132.
9 Laver M. B, Austen W. G. 1972. Lung function, physiologic consideration applicable to surgery. In: Sabiston D. C. (Ed.) Davis-Christopher Textbook of Surgery. W. B. Saunders Co.; Philadelphia: 1774.
10 McIntyre K. M, Sasahara A. A. 1974; Hemodynamic and ventricular responses to pulmonary embolism. Progress in Cardiovascular Diseases 17: 175.
11 Meissner A. G, Moscicka B. 1974; Effect of spleen on hemodynamic parameters in experimental pulmonary artery embolism in dogs. Pol. Przeg. Chir 46: 109.
12 Miller G. A. H, Sutton G. C, Kerr I. H, Gibson R. V, Honey M. 1971; Comparison of streptokinase and heparin in treatment of isolated acute massive pulmonary artery embolism. British Medical Journal 2: 681.
13 Olson S, Tangen O. 1972. The effect of defibrination with reptilase on ADP-induced platelet aggregation in the dog. Proceedings of the IIIrd Congress. International Society of Thrombosis and Haemostasis; Washington D.C.:
14 Palmer M. A, Piper P. J, Vane J. R. 1970; Release of vasoactive substances from lungs by injection of particles. British Journal of Pharmacology 40: 547
15 Puckett C. L, Gervin A. S, Rhodes G. R, Silver D. 1973; Role of platelets and serotonin in acute massive pulmonary embolism. Surgical Gynecology and Obstetrics 137: 618.
16 Radegran K, McAslan C. 1972; Circulatory and ventilatory effects of induced platelet aggregation and their inhibition by acetylsalicylic acid. Acta Anaesthesiologica Scandinavica 16: 76.
17 Ray J. F, Thompson S, McAllem S, Sanoudos G. H, Yost L, Goodall C. W, Clauss R. H. 1972; Nomogram for estimating pulmonary arterio-venous shunt during ventilation with room air. Journal of Thoracic and Cardiovascular Surgery 64: 611.
18 Rosoff C. B, Salzman E. W, Gurewich V. 1971; Reduction of platelet serotonin and the response to pulmonary emboli. Surgery 70: 12.
19 Rø J. S, Bergan A, Amundsen E. 1974; Studies on coagulation and fibrinolysis in experimental pulmonary embolism in dogs. Scandinavian Journal of Haematology 12: 213.
20 Sharma G. V, Godin P. F, Belko J. S, Bell W. R, Sasahara A. A. 1973; Arvin therapy in experimental pulmonary embolism. American Heart Journal 85: 72.
21 Stein M, Levy S. E. 1974; Reflex and humoral responses to pulmonary embolism. Progress in Cardiovascular Diseases 17: 167.
22 Swenson E, Lamas R. 1965. Hypoxemia and edema of the lungs in experimental pulmonary embolism. In: Sasahara A. A. (Ed.) Pulmonary Embolic Disease. Grune and Stratton Inc.; New York: 170.
23 Volker D. 1975. Rheologische Veränderungen unter der Therapie mit Defibrase. In: Martin M, Schoop W. (Ed.) Aktuelle Probleme in der Angiologie: 26, Defibrinierung mit thrombinähnlichen Schlangengiftenzymen.. Verlag Hans; Huber Bern: 132.
24 Woolverton W. C, Hyman A. L. 1973; The pulmonary hemodynamic effects of lung thromboemboli in dogs. Surgery 73: 572.