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Fibrinolytic Activity and Postoperative Salvaged Untreated Blood for Autologous Transfusion in Major Orthopaedic Surgery

2001; Oxford University Press; Volume: 167; Issue: 3 Linguagem: Inglês

10.1080/110241501750099276

1741-9271

Olav Reikerås Claus Danckert Krohn,

Cardiac and Coronary Surgery Techniques

To evaluate the fibrinolytic activity in a closed surgical wound, in postoperatively drained blood, and during autologous transfusion. Prospective study. National hospital, Norway. 9 patients operated on for thoracic scoliosis. Concentrations of plasmin/antiplasmin (PAP), α2-antiplasmin, and D-dimers in drained, arterial, and mixed venous blood before, during, and after infusion of 10 ml/kg body weight of postoperatively drained, untreated blood. In drained blood the concentration of α2-antiplasmin was 31% of the preoperative arterial control value. Together with the increased concentrations of PAP to 18076 μg/L and D-dimers to 126 mg/L, this indicates extensive fibrinolytic activity in the closed wound. The postoperative autologous transfusion of drained, untreated blood increased the concentration of PAP from 507 to 2453 μg/L and of D-dimer from 0.7 mg/L to 15.3 mg/L in systemic blood. The systemic concentration of fibrin(ogen) degradation products, indicated by D-dimers, after recirculation of drained, untreated blood might impair coagulation. The extensive activation of plasmin might exhaust available α2-antiplasmin in the wound and result in postoperative rebleeding.