Changes in fibrinolysis in the intensive care patient

Critically ill patients have been described as having blood coagulation abnormalities that predispose to bleeding and thrombosis. We have studied plasminogen activators. α-antiplasmin, X-oligomers fibrin fragments, fibronectin, antithrombin III, fibrinogen, platelets, kaolin-cephalin clotting time and prothrombin time on admission to the intensive care unit and sequentially after 24 and 48 hours in 39 adult patients: ARDS (n=6), trauma (n=12), sepsis (n=8) and a miscellanea (n=13) A decrease in plasminogen activators associated with an increase in X-oligomers, the earliest form of cross linked librin degradation products, indicate that fibrin deposition and the consumption of components of fibrinolysis is a widespread condition in the ICU patients. Low fibronectin levels were related to prognosis. These findings suggest that critically III patients must be evaluated in respect to fibrinolysis: and supported when necessary with prophylactic treatment