Alterations in homeostasis after open surgery. A prospective randomized study

Dedej, T. and Lamaj, E. and Marku, N. and Ostreni, V. and Bilali, S. (2013) Alterations in homeostasis after open surgery. A prospective randomized study. Il giornale di chirurgia, 34 (7/8). pp. 202-209. ISSN 1971-145X

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Introduction. Alterations in homeostasis, and a subsequent increased risk for postoperative thromboembolic complications, are observed as a result of open surgery. Additionally, the stress response to surgical trauma precipitates a transient hypercoagulable state as well as inflammation. This study was conducted to evaluate the patterns in postoperative alterations of blood coagulation, and to detect their correlations with inflammatory markers. Patients and methods. The study included 50 patients with comparable demographic data, who were randomly assigned to undergo abdominal surgery. No previous coagulation disorders were noted. Blood samples were collected preoperatively and 72 h postoperatively. The following parameters were measured: prothrombin time (PT) and activated partial thromboplastin time (APTT); fibrinogen (FIB), D-dimer (D-D), and C-reactive protein (CRP) levels; and platelet (PLT) count. Prophylactic doses of low molecular weight heparin were administered to all patients. Results. The PT mean value significantly changed from 90.38% before surgery to 81.25% after surgery. No statistical difference was observed between APTT values before and after surgery. FIB levels significantly increased from 381.50 mg/dL preoperatively to 462.57 mg/dL postoperatively. Mean D-D levels also significantly increased from 235.54 μg/L preoperatively to 803.59 μg/L postoperatively. PLT count significantly declined after surgery. Mean CRP levels significantly increased from 12.33 mg/L preoperatively to 44.28 mg/L postoperatively. A strong correlation was observed between D-D and C-RP levels after surgery.Conclusion. These results indicate that, despite administering antithromboembolic prophylaxis, a hypercoagulable state was observed following surgery. This state was enhanced by inflammation.

Item Type: Article
Additional Information: Coagulation alteration, Surgical trauma, Inflammation
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 13 Sep 2019 08:15
Last Modified: 13 Sep 2019 08:15

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