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.