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April 1959

Clinical Determination of Fibrinolytic Activity: An Evaluation of Some Methods

Author Affiliations

West Roxbury, Mass.
From the Surgical Services, West Roxbury Veterans Administration Hospital and the Department of Surgery, Harvard Medical School.; Fellow in Vascular Surgery, Peter Bent Brigham and West Roxbury Veterans Administration Hospitals (Dr. Villavicencio). Clinical Professor of Surgery, Harvard Medical School (Dr. Warren). Research Chemist, West Roxbury Veterans Administration Hospital (Mr. Belko).

AMA Arch Surg. 1959;78(4):639-646. doi:10.1001/archsurg.1959.04320040133027

Introduction  The need for an accurate method for the determination of fibrinolytic activity in blood has been felt by many workers. The occurrence of increased fibrinolysis in shock1 and in hemorrhagic states in surgical2-7 and nonsurgical8 patients has been reported. The advent of improved preparations of fibrinolysin for the treatment of intravascular clotting17-19 has increased the need for a means of measuring the effects of the therapy. Methods which have been used have involved four principles:1. Lysis of a fibrin clot created by union of fibrinogen with thrombin(a) Methods in which the action of the test material is on an unaltered fibrin clot9,11(b) Methods in which the action of the test material is on modified or denatured fibrin (stained, heated, acidified, containing radioactive material, etc.)10,202. Splitting of an artificial substrate14,21(a) Lysine ethyl ester (LEE method)(b) Tosylarginine methyl