Intensity of thrombin activity and surgical trauma

Increased level of in vivo thrombin activity represents the essential mark of prethrombotic state. In order to assess the influence of surgical trauma on the constitution of prethrombotic state immediately after the surgical intervention, dynamic estimations of fibrinopeptide A (FPA) have been done in a group of 18 patients who had undergone abdominal surgery and in the group of 25 patients who underwent the replacement of artificial hip, and who were on preventive treatment with subcutaneous heparin. At the same time the presence of soluble fibrinmonomer complex and, in the group of patients on heparin treatment, the concentration of plasma heparin were examined. The investigations were done before the surgical intervention and on the first, third and seventh postoperative day. Our dynamic study showed the existence of certain relation between the surgical trauma and values of FPA which were the expression of intensity of in vivo thrombin activity. The mean values of FPA increased markedly on the first postoperative day in comparison with the preoperative levels. On the third postoperative day significant reduction of FPA was observed and on the seventh day marked increase was found only in patients who were not on heparin prevention. Although preventive application of subcutaneous heparin did not affect the whole blood coagulability it showed a suppressive impact on the thrombin activity level in examined surgical patients.(ABSTRACT TRUNCATED AT 250 WORDS)