Consumption of Serum Factors and Prothrombin During Intravascular Clotting in Rabbits

We have studied the effect of experimental intravascular clotting upon Factors II, VII, IX, and X in rabbits. Animals were given sodium warfarin intravenously to block the synthesis of these factors and, 4 hours later, were infused with either dilute tissue thromboplastin or saline. The tissue thromboplastin induced intravascular clotting extensive enough to halve fibrinogen and platelet levels and to reduce markedly Factor V and Factor VIII levels. These changes resulted from a consumption during clotting of about 10 per cent of the available prothrombin. Each of the serum factors fell further during the infusion of tissue thromboplastin than during the infusion of saline; apparently, serum factors activated during clotting do not circulate in the rabbit. Net losses due to intravascular clotting equalled about 15 to 30 per cent of the Factors VII, IX, and X initially present. These data suggest that consumption during intravascular clotting may account for the low levels of Factors VII, IX, and X described in patients with diffuse intravascular clotting complicating septicaemia. The evidence of consumption of Factor IX raises the possibility that tissue thromboplastin may activate intrinsic clotting during hemostasis in vivo .