The effect of pneumoperitoneum on intravascular fibrinolytic system in rats

Aim: The etiological differences in thromboembolism and intravascular fibrinolysis in pneumoperitoneum is stil unclear. In the present study; it is aimed to investigate the role of intraabdominal pressure and coagulation cascade and fibrinolysis in pneumoperitoneum. Materials and Methods: 30 rats were divided in to 5 groups. Low pressure pneumoperitoneum group (8 mmHg), conventional pressure pneumoperitoneum group (12 mmHg) in 30 and 60 minutes. Group 1 did not undergo any procedure. At the end of designated time intervals blood samples were drawn to determine fibirnogen, D-dimer, tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) and thrombin activating fibrinolysis inhibitor antigen (TAFI) levels. Results: tPA was significantly higher in standart pressure short duration group when compared to standart pressure long duration group (p=0.04). TAFI was reduced in all groups but was especially reduced in the group with standart pressure long duration (p<0.05). There were no significant difference among the groups in terms of D-dimer, PAI-1 and fibrinogen levels among the groups (p>0.05). Discussion: Finally effects on the caogulation system of pneumoperitoneum which is conducted by the pressure applied and time variants have been identified. Time delay even under standart pressures, could raise up fibrinolysis related complications. Pneumoperitoneum of the coagulation system can be changed by duration of time and pressure.