Endogenous Anticoagulation during Extracorporeal Perfusion: Mechanisms and Applications.

摘要

The past year's work was devoted to evaluating the percent survival and the responses of the coagulant and fibrinolytic systems to thrombin or saline infusion by infusion of lethal concentrations of endotoxin. Infusions of dogs with thrombin (0.5 microns/kg/min) for 90 minutes significantly increased percent survival following infusion of endotoxin (0.06 mg/kg/min) for 30 minutes. Nine of thirteen dogs infused with thrombin survived seven days (permanent survivors), whereas thirteen of fourteen dogs infused with saline died within 36 hours. Those dogs which survived responded immediately to endotoxin with enhanced anticoagulant and fibrinolytic activity as measured by the Xa one-stage and fibrin degradation product assays respectively. Those dogs receiving saline instead of thrombin did not respond with anticoagulant or fibrinolytic activity until the end of the study. We concluded that thrombin in the correct amounts protected dogs from endotoxin and that this protection was associated with an early anticoagulant and fibrinolytic response to endotoxin infusion.