engleski

Monitoring of fibrinolysis parameters during myocardial revascularization according to type of procedure

The aim of the study was to assess the effect of cardiothoracic surgery on the dynamics of plasminogen, D-dimers and PAI-1 during first 24 hours after surgery. Study included 14 patients operated with (on-pump) and 14 without (off-pump) the use of ECC. Blood sampling was performed upon induction of anesthesia (1), introduction of heparine (2) and protamine (3), at the end of surgery (4), and next morning (5). // Relative to point 1, the utilization of plasminogen at point 2 was 24% and 17% in the on-pump and off-pump group, respectively (p=0.001 both). Increased D-dimer connectration from baseline was more pronounced in the on-pump group (p=0.001). At point 5, D-dimer concentrations were comparable in both groups and different from baseline levels. PAI-1 activity showed within group differences from baseline at point 5 in the off-pump group (p=0.001), and at point 3 and 5 in the on-pump group (p=0.002 ; p=0.001, respectively). At point 5, the activity of PAI-1 was comparable in both groups, yielding p=0.001 versus baseline. //Fibrinolysis was more pronounced and more dynamic in on-pump group due to systemic inflammatory response induced by the use of ECC. In off-pump group, fibrinolysis was a normal physiologic response to surgery procedure.

cardiopuilmonary bypass; D-dimers; fibrinolysis; PAI-1; plasminogen

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