HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Knobl, P. N. Articles by Vukovich, T. C. Search for Related Content PubMed PubMed Citation Articles by Knobl, P. N. Articles by Vukovich, T. C.

The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 600-605, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The protein C system in patients undergoing cardiopulmonary bypass

PN Knobl, P Zilla, R Fasol, MM Muller and TC Vukovich
Department of Medical Physiology, University of Vienna, Austria.

Fifteen men undergoing extracorporeal circulation for aorta-coronary bypass grafting were investigated for alterations of the plasma levels of cross-linked fibrin degradation products, protein C, free protein S, coagulation factor II, immunoglobulin G, and albumin. Although all patients were given heparin, a progressive increase of cross-linked fibrin degradation products was recorded during extracorporeal circulation, which indicates an activation of the plasmatic coagulation system. This increase was most pronounced in the late phase of extracorporeal circulation after reperfusion of the lung and in the early postoperative period. The levels of all other investigated plasma proteins decreased drastically after the patient was connected to the bypass circuit, which was primed with saline solution. These levels increased after termination of extracorporeal circulation and administration of fresh-frozen plasma. To study the consumption of protein C, protein S, and factor II during extracorporeal circulation, we formed ratios of the values of these parameters to the value of immunoglobulin G. After this volume correction, protein C was found to decrease significantly in the late phase of extracorporeal circulation, remaining low in the early postoperative period; protein S increased significantly soon after the onset of extracorporeal circulation and decreased after termination of extracorporeal circulation; factor II was unaffected by extracorporeal circulation, showing only a slight, insignificant increase in the postoperative phase. These results suggest a disturbance of the protein C system by extracorporeal circulation, which is possibly linked to the reported high bleeding tendency in patients undergoing operations with extracorporeal circulation.

This article has been cited by other articles:

				M. Czerny, H. Baumer, J. Kilo, A. Lassnigg, A. Hamwi, T. Vukovich, E. Wolner, and M. Grimm Inflammatory response and myocardial injury following coronary artery bypass grafting with or without cardiopulmonary bypass Eur. J. Cardiothorac. Surg., June 1, 2000; 17(6): 737 - 742. [Abstract] [Full Text] [PDF]

				J. Petaja, E. Pesonen, J. A. Fernandez, A. E. Vento, O. J. Ramo, and J. H. Griffin CARDIOPULMONARY BYPASS AND ACTIVATION OF ANTITHROMBOTIC PLASMA PROTEIN C J. Thorac. Cardiovasc. Surg., September 1, 1999; 118(3): 422 - 429. [Abstract] [Full Text] [PDF]

				C. R. Smith and T. B. Spanier Aprotinin in deep hypothermic circulatory arrest Ann. Thorac. Surg., July 1, 1999; 68(1): 278 - 286. [Abstract] [Full Text] [PDF]

				M. Ando, S. Takamoto, Y. Okita, R. Matsukawa, N. Nakanishi, S. Kyotani, and T. Satoh Operation for chronic pulmonary thromboembolism accompanied by thrombophilia in 8 patients Ann. Thorac. Surg., December 1, 1998; 66(6): 1919 - 1924. [Abstract] [Full Text] [PDF]

				R. G.H. Speekenbrink, R. M. Bertina, F. Espana, C. R.H. Wildevuur, and L. Eijsman Activation of the protein C system during cardiopulmonary bypass with and without aprotinin Ann. Thorac. Surg., December 1, 1998; 66(6): 1998 - 2002. [Abstract] [Full Text] [PDF]

				J. Boldt, B. Zickmann, E.Schindler, A. Welters, F. Dapper, and G. Hempelmann Influence of aprotinin on the thrombomodulin/ protein C system in pediatric cardiac operations J. Thorac. Cardiovasc. Surg., May 1, 1994; 107(5): 1215 - 1221. [Abstract] [Full Text]