SummaryExtrinsic coagulation pathway inhibitor may be an important regulator of haemostasis to prevent thrombosis after tissue damage. The functional activity of this inhibitor was determined using a chromogenic substrate assay, and compared to the activities of anti thrombin, heparin cofactor II and protein C during the perioperative period of elective hip replacement (n = 28), cholecystectomy (n = 11), and vascular surgery (n = 5). Peroperatively, all the inhibitors decreased rather similarly and to the same degree as the decrease in albumin concentration. The decreases during hip surgery were about 2-fold the decreases observed during cholecystectomy. A significant peroperative increase in extrinsic pathway inhibitor activity was observed in vascular surgery, probably due to a bolus injection of heparin. Antithrombin, heparin cofactor II and protein C levels normalized on days 3-5 postoperatively in all three patient groups. Sustained low levels of extrinsic pathway inhibitor were observed on postoperative days 1 to 7 in hip surgery patients. Apparently, extrinsic pathway inhibitor is not an acute phase reactant. In uncomplicated surgery, the decreases of the coagulation inhibitor levels are mainly due to hemodilution.

Patients with IPAA reported slightly lower HRQOL rates than the general population and had an inferior functional outcome.

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Protein C in citrated plasma is found to be specifically activated by the snake venom derivative Protac, and the activator is used in a simple, automated assay method. The activation is completed in less than 120 s and an isolation of protein C from its inhibitor before activation is not necessary. The activated protein C is determined with the chromogenic substrate S-2366. Therapeutic concentrations of heparin in the test sample do not influence the result. A strong positive correlation to immunoassay of protein C was found (r= 0.92). Three cases of probable hereditary protein C deficiency belonging to the same family were discovered during the study.