Objective: Thrombomodulin is a high-affinity receptor for thrombin on the endothelial cell surface. The aim of our study was to investigate whether plasma thrombomodulin represents a marker of endothelial injury following cardiopulmonary bypass.
Methods: Plasma levels of thrombomodulin were quantitated in 70 plasma samples obtained from 14 adult cardiac patients undergoing hypothermic pulsatile low-flow low-pressure cardiopulmonary bypass. Blood samples were taken before cardiopulmonary bypass (T1), and 15 minutes (T2), 1 hour, 6 hours, and 20 hours after termination of bypass. Plasma thrombomodulin was quantitated with a sandwich enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed by the Friedman and Wilcoxon tests.
Results: Plasma thrombomodulin was significantly elevated 20 hours after discontinuation of cardiopulmonary bypass, when compared with T1 and T2.
Conclusion: We conclude from our results that a moderate elevation of plasma thrombomodulin is seen in adult patients following hypothermic, low-flow low-pressure cardiopulmonary bypass, which may reflect endothelial injury. Circulating thrombomodulin levels are thus possibly useful for assessment of endothelial damage occurring in patients undergoing cardiopulmonary bypass.