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Protein C is a major physiological anticoagulant.
This protein can be regarded as an important physiological anticoagulant, and a decrease in the concentration demonstrated during the present study suggests an increase in coagulation activation following surgery.
Likewise, rapid activation of coagulation may turn into global or selected exhaustion of physiological anticoagulant systems.
The PC pathway is both a major physiological anticoagulant system and a central link between inflammation and coagulation.
Two major physiological anticoagulant systems, the activated protein C (APC -thrombomodulin (TM) system APC -thrombomodulinn (ATM-heparan systemte system, hand been exthesively studied antithrombintAT -heparan
Fibrin deposition is a result of tissue factor/FVIIa complex-mediated thrombin generation and dysfunctional physiological anticoagulant pathways (mainly antithrombin III and protein C) [ 14].
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Although antithrombin deficiency does occur in consumptive coagulopathy, this is not an isolated condition; all coagulation factors and physiological anticoagulants undergo consumption under these circumstances.
Disseminated intravascular coagulation (DIC) is characterized by systemic fibrin formation, resulting from increased generation of thrombin, simultaneous suppression of physiological anticoagulants, and impaired fibrinolysis [ 3].
FFP contains all of the clotting factors, fibrinogen (400 to 900 mg/unit), plasma proteins (particularly albumin), electrolytes, physiological anticoagulants (protein C, protein S, antithrombin, tissue factor pathway inhibitor) and added anticoagulants [ 1, 2].
Plasma levels of physiological anticoagulants such as antithrombin and activated protein C are known to decrease markedly because of their increased consumption, suppressed synthesis, and degradation by neutrophil proteases [ 67].
Before start, the system is primed by physiological saline containing an anticoagulant (Heparin, 5000 IE in 1000 ml of physiological saline) and during extracorporeal circulation Heparin is continually added, (100IE/ml, 15 ml/hour is used).
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