Relationship between postsurgical fibrinolytic parameters and deep vein thrombosis in surgical patients treated with compression devices. 1988

L Summaria, and J A Caprini, and R McMillan, and J Sandesara, and C A Axelrod, and M E Mueller, and J P Vagher, and J Walenga, and J Fareed
Department of Surgery, Evanston Hospital, Illinois 60201.

This study consisted of 52 patients admitted for orthopedic surgery and 28 patients admitted for general surgery, who were treated with Sequential Compression Devices (SCD) and Thromboembolic Deterrent Stockings (TEDS) and monitored for the development of deep vein thrombosis (DVT). Coagulation and fibrinolytic profiles were carried out on these patients preoperatively, and on days one, three, and six postoperatively. All patients were followed by I-125-Fibrinogen scanning, Venous Doppler, and Impedance Plethysmography studies for clot detection. In the orthopedic surgery group, six (11.5%) developed DVT, and in the general surgery group, one (3.6%) developed DVT. No patients developed pulmonary embolism. The combined incidence of DVT was 8.8 per cent. A variety of parameters was measured in order to determine whether compression devices prevent a fibrinolytic shut-down commonly seen in the postsurgical patient. A combination of three assays was found to be significant in demonstrating a fibrinolytic response. These parameters were a post-surgical decrease in the plasminogen level, an increase in the level of free protease activity postoperatively, and an increase in the level of tissue plasminogen activator after surgery. 56.3 per cent of all patients treated with SCD and TEDS showed a fibrinolytic response on postoperative day one by a combination of all three of these parameters. In the group of patients that developed DVT none showed an increase in free protease activity, and five of seven showed no significant decrease in plasminogen and no increase in tissue plasminogen activator. Patients who developed thrombosis had measurable differences in their fibrinolytic system compared to those without postoperative thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008297 Male Males
D010450 Endopeptidases A subclass of PEPTIDE HYDROLASES that catalyze the internal cleavage of PEPTIDES or PROTEINS. Endopeptidase,Peptide Peptidohydrolases
D010958 Plasminogen Precursor of plasmin (FIBRINOLYSIN). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. Profibrinolysin,Glu-Plasminogen,Glutamic Acid 1-Plasminogen,Glutamyl Plasminogen,1-Plasminogen, Glutamic Acid,Glu Plasminogen,Glutamic Acid 1 Plasminogen,Plasminogen, Glutamyl
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D003020 Clothing Fabric or other material used to cover the body. Clothes,Garments,Military Uniforms,Nurse Uniforms,School Uniforms,Uniforms,Garment,Military Uniform,Nurse Uniform,School Uniform,Uniform,Uniform, Military,Uniform, Nurse,Uniform, School,Uniforms, Military,Uniforms, Nurse,Uniforms, School
D005260 Female Females
D005342 Fibrinolysis The natural enzymatic dissolution of FIBRIN. Fibrinolyses
D005676 Gravity Suits Double-layered inflatable suits which, when inflated, exert pressure on the lower part of the wearer's body. The suits are used to improve or stabilize the circulatory state, i.e., to prevent hypotension, control hemorrhage, and regulate blood pressure. The suits are also used by pilots under positive acceleration. Anti-Shock Trousers,Antigravity Suits,MAST Suit,Medical Anti-Shock Trousers,Military Anti-Shock Trousers,Pneumatic Suits,Pressure Suits,Antishock Trousers,Military Antishock Trousers,Anti Shock Trousers,Anti-Shock Trouser, Medical,Anti-Shock Trousers, Medical,Anti-Shock Trousers, Military,Antishock Trousers, Military,Gravity Suit,MAST Suits,Medical Anti Shock Trousers,Medical Anti-Shock Trouser,Military Anti Shock Trousers,Pneumatic Suit,Pressure Suit,Suit, Antigravity,Suit, Gravity,Suit, MAST,Suit, Pneumatic,Suit, Pressure,Suits, Antigravity,Trouser, Medical Anti-Shock,Trousers, Anti-Shock,Trousers, Antishock,Trousers, Medical Anti-Shock,Trousers, Military Anti-Shock,Trousers, Military Antishock
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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