Key result
Administration of urokinase as a sole anticoagulant with left ventricular assist devices induces disseminated intravascular coagulation and is inadequate without other antithrombin agents.
Why the study?
Does urokinase as a sole anticoagulant cause disseminated intravascular coagulation in patients with left ventricular assist devices?
Does urokinase as a sole anticoagulant cause disseminated intravascular coagulation in patients with left ventricular assist devices?
Urokinase is inadequate as a sole anticoagulant for LVAD patients because it induces disseminated intravascular coagulation; it must be combined with antithrombin agents.
Urokinase monotherapy may induce DIC in LVAD patients; hypothesis-generating and should not change practice without prospective confirmation.
The sole administration of urokinase causes no initial prolongation of activated partial thromboplastin time (A-PTT), but thereafter produces serious progressive prolongation of A-PTT; it also causes a progressive, severe decrease in fibrinogen levels and alpha 2-plasmin inhibitor activity by depletion. The antithrombogenicity of urokinase is not caused by prevention of blood coagulation system activation by antithrombin effect, but by secondary fibrinolysis by plasmin. Consequently, the administration of urokinase as a sole anticoagulant results in activation of coagulation and fibrinolysis, and, as a result, induces disseminated intravascular coagulation. Therefore, it is concluded that administration of urokinase is an inadequate anticoagulation therapy unless it is combined with other antithrombin agents.
No takes yet. Share an insight, caveat, or question.
Takahama et al. (1995) studied Left Ventricular Assist Devices. Urokinase was evaluated on Coagulation and fibrinolysis parameters (A-PTT, fibrinogen levels, alpha 2-plasmin inhibitor activity). Administration of urokinase as a sole anticoagulant with left ventricular assist devices induces disseminated intravascular coagulation and is inadequate without other antithrombin agents.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: