Abstract
We studied blood coagulability of 31 patients with chronic respiratory failure (CRF) in the compensated period and of 13 patients with CRF in the decompensated period by measuring coagulation-fibrinolytic factors. Fibrinogen half-life was also determined in 9 compensated CRF patients as well as in 6 controls by monitoring the survival of 125I-labeled fibrinogen.
1. In compensated CRF patients, although platelet counts and fibrinogen increased, we found prolongation of prothrombin time and activated partial thromboplastin time, and decrease of factor VII, factor X, plasminogen, antithrombin III and fibronectin. The above abnormalities were associated with increase of fibrinogen/fibrin degradation products plus high molecular weight fibrinogen complexes.
2. The fibrinogen half-life was significantly shorter in compensated CRF patients than in controls.
3. The abnormalities of coagulation-fibrinolytic parameters of decompensated CRF patients were patently more evident than those of compensated CRF patients mentioned above.
4. These findings suggest that in CRF, there may be subclinical intravascular formation of fibrin monomer complex in the compensated period and we found that with exacerbation, hypercoagulability becomes evident and in some patients, ultimately may result in disseminated intravascular coagulation.
