Differences in Activation of Coagulation and Fibrinolysis After Polytrauma with Respect to the Development of Adult Respiratory Distress Syndrome
It is well-known that soluble fibrin is found in dissminated intravascular coagulation (DIC) and it has often been described in the microcirculation of polytrauma patients. This proves the role of thrombin in this disease. A lot of changes in hemostatic factors and end products can be explained by excessive production of thrombin leading to an increase in intermediate and end products (fibrinopeptide A, fibrin monomers, and protease inhibitor complexes), and to the consumption of clotting factors and inhibitors (fibrinogen and antithrombin III, AT III) [5, 13, 19, 22, 23]. For this reason thrombin inhibition has played an important role in therapy for many years, but until now no significant improvement using low-dose heparin therapy or substitution with AT III could be demonstrated in randomized and prospective studies.
KeywordsCitrate Heparin Thrombin Fibrinogen Plasminogen
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