Effects of Major Surgery on Plasmin-Plasminogen Inhibitors

Although alterations in factors influencing blood coagulation have been extensively studied in various disease states,1,2much less is known about fibrinolysis, the processes by which fibrin deposits and blood clots are dissolved in the living organism.3Evidence is accumulating that the latter is one of the fundamental processes in physiology.3,4In recent years highly purified proteolytic and fibrinolytic enzymes have been used by clinicians in the therapeutic management of thromboembolic disorders.5-8New and more powerful techniques have also become available to study various phases of clot dissolution.9-16These developments have stimulated a growing interest in the fibrinolytic processes and their modifications by disease. Increased fibrinolytic activity has been reported in various pathologic states: conditions of stress, such as acute febrile infections,17electroshock and anoxia,18obstetrical complications, such as premature separation of the placenta,19after pulmonary surgery,4and after extensive carcinoma of