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

• Published in: The Journal of infectious diseases Vol. 177; no. 3; pp. 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: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.03.1998; University of Chicago Press; Oxford University Press
• 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; Human; Blood coagulation; Experimental disease; Nutrition; Complication; Fibrinolysis; Endotoxemia; Comparative study; Enteral administration; Parenteral administration
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/517811

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.