Skip to main content

Urokinase-induced fibrinolysis in thromboelastography (UKIF-TEG) to assess fibrinolysis in critically ill patients


Coagulopathy, particularly a trend toward hypercoagulability and hypofibrinolysis, is common in critically ill patients and correlates with worse outcome. Available laboratory coagulation tests to assess fibrinolysis are expensive and time demanding. We investigated whether a modified thromboelastography with the plasminogen activator urokinase (UKIF-TEG) [1] may be able to evaluate fibrinolysis in a population of critically ill patients.


UKIF-TEG was performed as follows: first urokinase was added to citrate blood to give final concentrations of 160 UI/ml, then thromboelastography (TEG) analysis was started after kaolin activation and recalcification with calcium chloride. Basal TEG (no addition of urokinase) was also performed. Fibrinolysis was determined by the loss of clot strength after the maximal amplitude (MA), and recorded as Ly30 (percentage lysis at 30 minutes after MA) and as Ly60 (percentage lysis at 60 minutes after MA).


UKIF-TEG was performed on 17 healthy volunteers and 18 critically ill patients. Ly60 was predicted by Ly30 according to an exponential function, so we used Ly30 as an indicator of clot lysis. Basal TEG showed increased coagulability and a trend toward less fibrinolysis in critically ill patients compared with healthy volunteers (reaction time 8.7 ± 3.4 minutes vs. 12.2 ± 1.9 minutes, P < 0.001; α-angle 59.7 ± 9.4 vs. 47.2 ± 11.8, P < 0.01). This reduction of fibrinolysis was more evident at a urokinase concentration of 160 UI/ml (Figure 1).


UKIF-TEG could be a feasible point-of-care method to evaluate fibrinolysis in critically ill patients.

Figure 1

(abstract P357


  1. 1.

    Gallimore MJ, et al.: J Thromb Haemost. 2005, 3: 2506-2513. 10.1111/j.1538-7836.2005.01615.x

    Article  CAS  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to L Zacchetti.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Zacchetti, L., Panigada, M., Cressoni, M. et al. Urokinase-induced fibrinolysis in thromboelastography (UKIF-TEG) to assess fibrinolysis in critically ill patients. Crit Care 17, P357 (2013).

Download citation


  • Healthy Volunteer
  • Plasminogen
  • Urokinase
  • Exponential Function
  • Kaolin