LEVELS OF FIBRINOLYTIC ACTIVATORS AND INHIBITORS IN PLASMA AFTER SEVERE TRAUMA

Levels of tissue plasminogen activator antigen (t-PA:ag), tissue plasm inogen activator inhibitor 1 antigen (PAI-1:ag) and tissue plasminogen activator inhibitor activity (PAI activity), and alpha-2-antiplasmin (AAP) were measured in plasma from 19 patients with severe trauma on a dmission and on days 1, 2, 3 and 7 after the incident. In all patients the Injury Severity Score (ISS) and the number of blood transfusions were recorded. The development of post-traumatic pulmonary dysfunction was observed in four patients. Levels of t-PA:ag, PAI-l:ag and PAI ac tivity were increased, and levels of AAP were low immediately after tr auma. Levels of t-PA:ag normalized during the first week, whereas PAI- l:ag levels decreased gradually from day 1 to day 3. Thereafter a seco ndary increase was observed. A similar trend was observed in levels of PAI activity. Levels of APP increased significantly during the first week. t-PA:ag, PAI-l:ag or PAI activity levels were not correlated wit h the ISS on any day, but levels of AAP showed a weak correlation with the ISS on day 7. Post-traumatic levels of t-PA:ag and PAI-l:ag were higher in patients who had 6 or more units of blood transfusions for r esuscitation. The fibrinolytic markers were not significantly differen t in patients who had pulmonary dysfunction compared with patients wit hout.