Parenteral Nutrition Facilitates Activation of Coagulation but Not of Fibrinolysis during Human Endotoxemia

Venous thrombosis and bacterial infections are common complications of parenteral nutrition. To test the hypothesis that infection facilitates activation of coagulation during parenteral nutrition, healthy subjects were intravenously injected with endotoxin (2 ng/kg) after they had received either 1...

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Bibliographic Details
Published in:The Journal of infectious diseases 1998-03, Vol.177 (3), p.793-795
Main Authors: van der Poll, Tom, Levi, Marcel, Braxton, Carla C., Coyle, Susette M., Roth, Marc, ten Cate, Jan W., Lowry, Stephen F.
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Bacterial infections
Biological and medical sciences
Blood Coagulation
Central venous catheterization
Coagulation
Concise Communications
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
Endotoxemia
Endotoxemia - complications
Endotoxins
Enteral Nutrition
Escherichia coli
Fibrinolysis
Fibrinolytics
Humans
Intensive care medicine
Male
Medical sciences
Parenteral nutrition
Parenteral Nutrition - adverse effects
Thrombophlebitis - complications
Thrombosis
Total parenteral nutrition
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Summary:Venous thrombosis and bacterial infections are common complications of parenteral nutrition. To test the hypothesis that infection facilitates activation of coagulation during parenteral nutrition, healthy subjects were intravenously injected with endotoxin (2 ng/kg) after they had received either 1 week of standard parenteral nutrition (n = 7) or normal enteral feeding (n = 8). Compared with enteral feeding, parenteral nutrition was associated with a selectively enhanced activation of the coagulation system (plasma levels of thrombin-antithrombin III complexes) during endotoxemia. Activation of the fibrinolytic system (plasminogen activator activity, tissue-type plasminogen activator, plasminogen activator inhibitor type 1) proceeded similarly in both study groups. In patients receiving parenteral nutrition, one common complication (bacterial infection) may facilitate the occurrence of another common complication (venous thrombosis) by synergistic stimulation of the coagulation system.
ISSN:0022-1899
1537-6613
DOI:10.1086/517811