Paradoxical Hypotension after Volume Expansion with Plasma Protein Fraction

Abstract

The enormous growth of knowledge of the kallikrein-kinin system has resulted from advances in the detailed protein chemistry of these proteolytic enzymes, cofactors and substrates. Equally important in the development of this understanding have been careful investigation of the three congenital disorders of the system (deficiencies of Hageman factor, prekallikrein and high-molecular-weight kininogen) and delineation of the role of the kinins in a wide variety of diseases. The formation of bradykinin is initiated in plasma by conversion of Hageman factor (molecular weight of 85,000) from its precursor form to an activated molecule (factor XIIa) that triggers the intrinsic coagulation cascade. . . .