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Surgical stress ind...
Surgical stress induces acute coronary release of tissue-type plasminogen activator in the pig
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- Österlund, Barbro (author)
- Umeå universitet,Anestesiologi och intensivvård
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- Holmgren, Anders (author)
- Umeå universitet,Kirurgi
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- Häggmark, Sören (author)
- Umeå universitet,Anestesiologi och intensivvård
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Jern, Christina (author)
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- Johansson, Göran (author)
- Umeå universitet,Anestesiologi och intensivvård
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Seeman-Lodding, Helen (author)
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- Biber, Björn (author)
- Umeå universitet,Anestesiologi och intensivvård
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(creator_code:org_t)
- 2000
- 2000
- English.
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In: Acta Anaesthesiol Scand. ; 44:10, s. 1226-31
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http://www.ncbi.nlm....
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https://urn.kb.se/re...
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Abstract
Subject headings
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- BACKGROUND: Tissue-type plasminogen activator (t-PA) is an endothelium derived key enzyme in the initiation of endogenous fibrinolysis. Acute regulated release of active t-PA occurs within minutes in response to threatening thrombotic vessel occlusion. The aim of this study was to investigate the impact of surgical stimulation on the kinetics of t-PA release in the coronary vascular bed in the pig. METHODS: In anaesthetised pigs (n=16), arterio-venous concentration gradients of t-PA, and plasma flows (retrograde thermodilution) were obtained across the coronary vascular bed before (control) and at 1, 3, 5 and 10 min after sternotomy. RESULTS: At control, no significant coronary net flux (release or uptake) of t-PA was observed, while sternotomy induced a rapid net release of total t-PA (132.6 ng x min(-1)), with an associated increase in active t-PA (93.6 ng x min(-1)). This response, evident already after 1 min, showed a peak at 5 min and returned towards baseline levels within 10 min. No concurrent alterations in aortic levels of active t-PA were found and haemodynamic variables were unaltered. CONCLUSION: The rapidly increasing and transient net coronary release of t-PA after sternotomy suggests that the endothelium actively promotes local endogenous fibrinolysis during surgery. Such events could reflect a dynamic responsiveness to protect the coronary circulation during stress.
Keyword
- Animals
- Coronary Vessels/*secretion
- Sternum/*surgery
- Swine
- Tissue Plasminogen Activator/blood/*secretion
Publication and Content Type
- ref (subject category)
- art (subject category)
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