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Thromb Haemost 1986; 55(01): 104-107
DOI: 10.1055/s-0038-1661457
Original Article
Schattauer GmbH Stuttgart

Intra-Operative Activation of Coagulation - A Stimulus to Thrombosis Mediated by Vasopressin?

P J Grant
The University Departments of Medicine, The General Infirmary, Leeds, UK
,
G M Tate
The University Departments of Medicine, The General Infirmary, Leeds, UK
,
J A Davies
The University Departments of Medicine, The General Infirmary, Leeds, UK
,
N S Williams
*   The University Departments of Surgery, The General Infirmary, Leeds, UK
,
C R M Prentice
The University Departments of Medicine, The General Infirmary, Leeds, UK
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Publikationsverlauf

Received 22. August 1985

Accepted 14. November 1985

Publikationsdatum:
19. Juli 2018 (online)

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Summary

Vasopressin infusions in normal volunteers that produce concentrations in plasma comparable to those seen during stress, cause an increase in plasma factor VIII and shortening of the euglobulin clot lysis time (ECLT). We have investigated the relationship between endogenous vasopressin (aVP) release and haemostatic function in 7 patients undergoing major abdominal surgery. Blood samples were taken at nine intervals during the operative procedure. Plasma aVP levels peaked at median values of 51 pg/ml during bowel manipulation and remained elevated on the first post-operative day. Following, and in close temporal relationship with the rise in aVP there were increases in factor VIII coagulant activity, the ristocetin co-factor, von Willebrand antigen, plasminogen activator activity (106/ECLT2) and fibrinopeptide A concentrations with shortening of the activated partial thromboplastin time. The relationship was similar to that seen following infusion of a VP in human volunteers. The results are consistent with the hypothesis that aVP is an important mediator of changes in haemostatic function which accompany stress and might contribute to the thrombotic risk associated with surgical operations.

Key words

Abdominal surgery - Vasopressin - Factor VIII - Fibrinolysis - Fibrinopeptide A
 

  • References

  • 1 Carter C, Gent M. The epidemiology of venous thrombosis. In: Haemostasis and Thrombosis Coleman RW, Hirsh J, Marder VJ, Salzman EW. (eds.) J B Lippincott Company; Philadelphia Pennsylvania: 1982: 805-819
  • 2 Hume M, Sevitt S, Thomas DP. Venous thrombosis and pulmonary embolism. Cambridge: Mass Harvard University Press; 1970
    Suche in Google Scholar
  • 3 Lowe GD O, Osborne DH, McArdle BM, Smith A, Carter DC, Forbes CD, McLaren D, Prentice CRM. Prediction and selective prophylaxis of venous thrombosis in elective gastrointestinal surgery. Lancet 1982; 1: 409-412
    PubMedSuche in Google Scholar
  • 4 Mellbring G, Dahlgren S, Reiz S, Wiman B. Fibrinolytic activity in plasma and deep vein thrombosis after major abdominal surgery. Thromb Res 1983; 32: 575-584
    CrossrefPubMedSuche in Google Scholar
  • 5 Gallus AS, Hirsh J, Gent M. Relevance of pre-operative and postoperative blood tests to post operative leg vein thrombosis. Lancet 1973; 2: 910-912
    PubMedSuche in Google Scholar
  • 6 Grant PJ, Davies JA, Tate GM, Boothby M, Prentice CRM. Effects of physiological concentrations of vasopressin on haemostatic function in man. Clin Sci 1985; 69: 471-476
    CrossrefPubMedSuche in Google Scholar
  • 7 Hardisty RM, MacPhearson JC. A one stage FVIII AHG assay and its use on venous and capillary plasma. Thrombos Diathes Haemorrh 1962; 7: 215-229
    PubMedSuche in Google Scholar
  • 8 Laurell CB. Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Anal Biochem 1966; 15: 45-52
    CrossrefPubMedSuche in Google Scholar
  • 9 Zuzel M, Nilsson IM, Aberg M. A method for measuring plasma ristocetin co-factor activity. Thromb Res 1978; 12 (05) 745-754
    CrossrefPubMedSuche in Google Scholar
  • 10 Nilsson IM, Hedner U, Pandolfi M. The measurement of fibrinolytic activities. Fibrinolytes and antifibrinolytes Markwardt F. (Ed.) Springer Verlag; Berlin: 1978: 107-134
  • 11 Woodhams BJ, Kernoff P BA. Rapid radioimmunoassay for fibrinopeptide A in human plasma. Thromb Res 1981; 22: 407-416
    CrossrefPubMedSuche in Google Scholar
  • 12 Thomas TH, Lee MR. The specificity of antisera for the radioimmunoassay of arginine vasopressin in human plasma and urine during water loading. Clin Sci Mol Med 1976; 51: 525-536
    PubMedSuche in Google Scholar
  • 13 Hawkey CJ, Stirling Y, Chakrabarti R, Brozovic M, Cox AG, Meade TW. Haemostatic changes following surgery. Thromb Res 1983; 32: 223-227
    CrossrefPubMedSuche in Google Scholar
  • 14 Sautter RD, Myers WO, Ray III JF, Wenzel FJ. Relationship of the fibrinolytic system to post-operative thrombotic phenomena. Arch Surg 1973; 107: 292-296
    CrossrefPubMedSuche in Google Scholar
  • 15 Melissari E, Scully MF, Paes T, Kakkar VV. The influence of LMW heparin on the coagulation and fibrinolytic response to surgery. Thromb Res 1985; 37: 115-126
    CrossrefPubMedSuche in Google Scholar
  • 16 McLoughlin GA, Grindlinger GA, Manny J, Valer CR, Lipinski B, Mannick JA, Hechtman HB. Intrapulmonary clotting and fibrinolysis during abdominal aortic aneurysm surgery. Ann Surg 1979; 190 (05) 623-630
    CrossrefPubMedSuche in Google Scholar
  • 17 Jennings S, Cass AJ, Heather BP, Greenhalgh RM. Coagulation changes during major surgery and relationship to post-operative deep vein thrombosis. J Cardiovasc Surg 1981; 22: 327-329
    PubMedSuche in Google Scholar
  • 18 Davies AJ, Strachan C JL, Hurlow RA, Stuart J. Fibrinolytic activity of tissue surfaces during surgery. J Clin Pathol 1979; 32: 822-825
    CrossrefPubMedSuche in Google Scholar
  • 19 Lowe G DO, Middleton SM, Hay ID, Beastall GH, Singaraveloo M, Cohen HN, Thomson JA, Forbes CD, Prentice CRM. Effects of growth hormone, glucose and insulin on the factor VIII complex. Thromb Res 1982; 28: 201-211
    CrossrefPubMedSuche in Google Scholar
  • 20 Brown JE, Baugh RF, Hougie C. Effect of exercise on the Factor VIII complex A correlation of the von Willebrand antigen and Factor VIII coagulant antigen increase. Thromb Res 1979; 15: 61-67
    CrossrefPubMedSuche in Google Scholar
  • 21 Cannon WB, Gray H. Factors affecting the coagulation time of blood II: The hastening or retarding of coagulation by adrenalin injections. Am J Physiol 1914; 24: 232-242
    PubMedSuche in Google Scholar
  • 22 Ingram G IC, Vaughan JonesR. The rise in clotting factor VIII induced in man by adrenaline: effect of a and β-blockers. J Physiol 1966; 187: 447-454
    CrossrefPubMedSuche in Google Scholar
  • 23 Swedenborg J, Olsson P. Activation of plasma coagulation in vivo by epinephrine and platelet release reaction. Thromb Res 1978; 13: 37-45
    CrossrefPubMedSuche in Google Scholar
  • 24 Well RT, Counts RB, Harker LA, Striker GE. Binding and release of FVIII/von Willebrand factor by human endothelial cells. Br J Haematol 1980; 46: 287-298
    CrossrefPubMedSuche in Google Scholar
  • 25 Sarji KE, Levine JH, Nair R MG, Sagel J, Corwell JA. Relation between growth hormone levels and von-Willebrand factor activity. J Clin Endocrinol Metabol 1977; 45: 853-856
    CrossrefPubMedSuche in Google Scholar
  • 26 Beller FK, Ebert C. Endocrine effects on blood coagulation and fibrinolysis. In: The thromboembolic disorders Van de Loo J, Prentice CRM, Beller FK. Schattauer Verlag; Stuttgart - New York: 1983: 493-500
  • 27 Cash JD, Gader A MA, DaCosta J. The release of plasminogen activator and factor VIII by lysine vasopressin, arginine vasopressin, 1 desamino-8-d-arginine vasopressin, angiotensin and oxytocin in man. Br J Haematol 1974; 27: 363-364
    PubMedSuche in Google Scholar
  • 28 Baylis PH, Zerbe RL, Robertson GL. Arginine vasopressin response to insulin induced hypoglycaemia in man. J Clin Endocrinol Metab 1981; 53 (05) 935-940
    CrossrefPubMedSuche in Google Scholar
  • 29 Robertson GL. The regulation of vasopressin function in health and disease. Recent Prog Horm Res 1977; 33: 333-385
    PubMedSuche in Google Scholar
  • 30 Le Quesne LP, Lewis A AG. Postoperative water and sodium retention. Lancet 1953; 1: 153-158
    PubMedSuche in Google Scholar
  • 31 Spruce BA, McCulloch AJ, Burd J, Orskov H, Heaton A, Baylis PH, Alberti K GG M. The effect of vasopressin infusion on glucose metabolism in man. Clin Endocrinol 1985; 22 (04) 463-468
    CrossrefPubMedSuche in Google Scholar
  • 32 Share L, Crofton JT. The role of vasopressin in hypertension. Fed Proc 1984; 43 (01) 103-105
    PubMedSuche in Google Scholar
  • 33 Barnhart MI, Chen S, Lusher JM. DDAVP: Does the drug have a direct effect on the vessel wall?. Thromb Res 1983; 31: 239-253
    CrossrefPubMedSuche in Google Scholar
  • 34 Cort JH, Fischman AJ, Dodds WJ, Rand JH, Schwartz IL. New category of vasopressin receptor in the central nervous system. Int J Pept Protein Res 1981; 17: 14-22
    PubMedSuche in Google Scholar