Induction of Fibrinolysis By Hyperventilation With Oxygen and Carbon Dioxide

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Abstract
Significant fibrinolytic activity can be produced in humans by inducing hyperventilation preferably with 100% O2, but also with CO2 and O2. This activation is greatest when the hyperventilation is forced rapidly and with 100% O2. Perhaps of most significance is the fact that the activity persists for at least 1 hour, and in 3 of the 4 observations made for at least 2 hours. In most cases where fibrinolytic activity is produced by agents such as pyrogens or nicotinic acid the activity is transient. For the dissolution of intravascular thrombi, prolonged activity as obtained with continuous infusions of fibrinolytic agents is necessary in both experimental animals and patients. The mechanism of activation by hyperventilation is not known, but it is presumed that it may be related to changes in pH, pCO2 or pO2. This mechanism may be responsible for the production of excessive bleeding due to fibrinolysis in patients undergoing surgery. This syndrome has been noted to occur at times of stress in the operating room when sudden changes in ventilation might occur.