Fibrinolysis Following Surgery

Abstract

To the Editor:— The article by Pison and associates ( JAMA 191 : 1026-1027 [March 22] 1965) discusses the increased fibrinolytic activity in anesthetized patients during surgical trauma. From their graphs one might conclude that this fluctuation of fibrinolysis ends even before the operation is completed, and it is stated that within one hour after the operation was completed, the incidence of increased fibrinolysis was the same as that found preoperatively. Our observations of the dynamic changes in the clotting mechanism following surgical stress (de Takats and Marshall: Surgery 31 :13, 1952) showed a triphasic reaction of eosinophils and sensitized clotting times in several hundred operations, corresponding to Selye's adaption syndrome. This response lasts about a week, sometimes longer. The accompanying graph indicates that this is also true of the fibrinolytic mechanism (Figure). It should be noted that 10% fibrinolysis was measured on the second postoperative day, which might lead to the