Depressed plasma activity of plasminogen or alpha 2 plasmin inhibitor is not due to consumption coagulopathy in septic patients with disseminated intravascular coagulation

We have attempted to determine whether depressed plasma plasminogen and alp ha2 plasmin inhibitor (or alpha2 antiplasmin) activity is, as a result of c onsumption coagulopathy, a specific finding of disseminated intravascular c oagulation (DIC) in septic patients. The hemostatic parameters of 139 septi c patients (68 with DIC and 71 without DIG) were analyzed. Among the group as a whole, plasma activities of plasminogen and alpha2 plasmin inhibitor w ere significantly depressed in septic patients with DIC relative to those w ithout DIC (P < 0.01 and P < 0.05, respectively). Notably, a significant co rrelation was observed between plasma levels of albumin and plasminogen act ivity, as well as between plasma levels of albumin and alpha2 plasmin inhib itor activity both in septic patients with DIC and those without DIG. Howev er, no significant correlation was observed between plasma levels of plasmi n-alpha2 plasmin inhibitor complex (PIC) and plasminogen activity, nor betw een PIC and alpha2 plasmin inhibitor activity either in septic patients wit h DIC or those without DIG. We concluded that depressed activity of plasmin ogen or alpha2 plasmin inhibitor is not as a result of consumption coagulop athy, but rather a result of low synthetic function of the liver in septic patients with DIG. (C) 2001 Lippincott Williams & Wilkins.