Abstract
Ten patients undergoing abdominal aortic repair surgery were enrolled in this study to examine the effect of ischemia followed by aortic cross clamping on local coagulation and endothelium functioning. Blood samples were collected from both upper and lower limbs (relating to ischemic site) simultaneously, and thrombomoduline (TM), tissue plasminogen activator-inhibitor complex (tPAIC), plasmin-α2 plasmin inhibitor complex (PIC), thrombin-antithrombin III complex (TAT) were measured before the induction of anesthesia, after aortic clamping, immediately before releasing the aortic clamp, and 1 hour after releasing the aortic clamp. Local ischemic insult was associated with elevated tPAIC, PIC and TAT levels, although significant correlations were found only between tPAIC levels and ischemic-related parameters (venous oxygen saturation and lactate levels). There were no significant changes in TM levels throughout the study period. These novel results of this study suggest that tPAIC might be the most sensitive marker that refers to the magnitude of ischemic insult during abdominal cross clamping.
