PARENTERAL-NUTRITION FACILITATES ACTIVATION OF COAGULATION BUT NOT OFFIBRINOLYSIS DURING HUMAN ENDOTOXEMIA

Venous thrombosis and bacterial infections are common complications of parenteral nutrition. To test the hypothesis that infection facilitat es activation of coagulation during parenteral nutrition, healthy subj ects were intravenously injected with endotoxin (2 ng/kg) after they h ad received either 1 week of standard parenteral nutrition (n = 7) or normal enteral feeding (n = 8). Compared with enteral feeding, parente ral nutrition was associated with a selectively enhanced activation of the coagulation system (plasma levels of thrombin-antithrombin III co mplexes) during endotoxemia. Activation of the fibrinolytic system (pl asminogen activator activity, tissue-type plasminogen activator, plasm inogen activator inhibitor type 1) proceeded similarly in both study g roups, In patients receiving parenteral nutrition, one common complica tion (bacterial infection) may facilitate the occurrence of another co mmon complication (venous thrombosis) by synergistic stimulation of th e coagulation system.