Prothrombin Fragment 1+2 Levels Are Associated with Pulmonary and Renal Responses to Cardiopulmonary Bypass

  • B. Dixon
  • J. D. Santamaria
  • D. J. Campbell
Conference paper


Acute inflammation promotes the elimination of invading microorganisms and the repair of damaged tissues. While acute inflammation is clearly beneficial, there is evidence that inflammation may also cause tissue injury [1–4]. How inflammation causes tissue injury is poorly understood. A potential mechanism is cellular hypoxia following microvascular thrombosis. Endothelial cells activated by inflammatory mediators develop increased permeability and flood the interstitial spaces with fluid. With sustained activation, tissue factor and plasminogen activator inhibitor 1 (PAI 1) are expressed on the luminal surface of the endothelial cells [5, 6]. Tissue factor activates the extrinsic clotting cascade resulting in intra-vascular fibrin deposition [7], whereas PAI 1 neutralizes tissue plasminogen activator, thus preventing fibrinolysis of intra-vascular fibrin [8, 9]. Expression of tissue factor and PAI 1 may therefore transform the endothelium from an anti-coagulant to a pro-coagulant surface, thereby inducing the formation of microvascular thrombi. Microvascular thrombosis may result in cellular hypoxia, lactic acidosis and irreversible tissue injury [5, 7, 9–11].


Cardiopulmonary Bypass Tissue Factor Pulmonary Capillary Wedge Pressure Prothrombin Fragment Positive Fluid Balance 


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© Springer-Verlag Italia, Milano 2001

Authors and Affiliations

  • B. Dixon
  • J. D. Santamaria
  • D. J. Campbell

There are no affiliations available

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