Effects of surgical trauma and cardiopulmonary bypass on active thrombin concentrations and the rate of thrombin inhibition in vivo

Tomas Velan, Wayne L. Chandler

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The in vivo concentration of active thrombin and the second-order rate constant for the inhibition of thrombin by antithrombin (kinh) were estimated in patients undergoing cardiopulmonary bypass (CPB) based on measured levels of hemostatic markers in combination with a computer model of the patient's hemostatic and vascular systems. At baseline kinh = 0.6 ± 0.1 μM-1 s-1 leaving 270 ± 101 fM of active thrombin in the circulation. These factors were unchanged after sternotomy. Soon after heparin administration and the start of CPB, k inh increased 25-fold resulting in decreased active thrombin. After CPB and heparin neutralization, kinh decreased to 8-fold above baseline allowing active thrombin levels to rise. Both factors had returned to normal 2 h after surgery. We conclude that CPB with heparinization results in a rapid increase in thrombin inhibition leading to decreased active thrombin levels in vivo.

Original languageEnglish (US)
Pages (from-to)144-156
Number of pages13
JournalPathophysiology of Haemostasis and Thrombosis
Volume33
Issue number3
DOIs
StatePublished - 2003

Keywords

  • Acquired coagulation disorders
  • Antithrombin
  • Cardiopulmonary bypass
  • Inhibition kinetics
  • Surgery
  • Thrombin

ASJC Scopus subject areas

  • Hematology

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