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[Anticoagulants and changes in the coagulation status of patients with chronic obstructive lung disease and various degrees of respiratory failure].

The study includes 94 persons: 54 patients with chronic obstructive pulmonary disease and 40 healthy controls. The coagulation indices were followed up dynamically before and after heparin treatment. The patients with chronic obstructive pulmonary disease were classified into 3 groups in relation to the degree of respiratory failure. The results show significant changes in some of the basic hemostatic indices: decreased antithrombin III activity, increased alpha 2-macroglobulin and plasminogen activity, partial thromboplastin time shortening, increased erythrocyte, hemoglobin and hematocrit values. With deterioration of the respiratory failure these changes become more manifested which increases significantly the risk of pulmonary thromboembolism. The values of platelets, fibrinogen, prothrombin time, bleeding time, clotting time, alpha 2-antiplasmin and prekallikrein activity do not show any significant changes and are not reliable indices for hemostatic changes in patients with chronic obstructive pulmonary disease. The administration of heparin improves the changed basic indices. This is best expressed in patients with III degree respiratory failure. The parameters of external respiration and gas exchange improve parallelly with the improvement of the coagulation state.