Observations on the Fibrinolytic Response in Two Models of the Baboon in Response to E.Coli: Consumptive and Thrombotic Coagulopathies

This chapter presents a new way of looking at the hemostatic system. It reviews two models of Escherichia coli sepsis in the baboon, with emphasis on the response of the fibrinolytic system. The first model is one in which a classic consumptive coagulopathy, Disseminated Intravascular Coagulation (DIC), follows infusion of LD100Escherichia coli. The second model is one in which the animal survives this DIC response only to succumb to a microvascular thrombotic coagulopathy, microvascular thrombosis or Microvascular Thrombosis, 2 to 5 days later. The host’s regulatory factors all are operative, resulting in a compensated response to the stress of the infused factor Xa plus phosphati-dylcholine/phosphatidylserine vesicles (XaPC/PS). This includes the generation of some fibrin and fibrin degradation products, and a balanced output of both tissue plasminogen activator and plasminogen activator inhibitor, as well as an increased generation of activated protein C in response to infused factor XaPC/PS.