Factor V and VIII activation "in vivo" during bleeding. Evidence of thrombin formation at the early stage of hemostasis.

Factor V and VIII activity was measured by a one-stage assay on capillary blood issuing from a skin cut. This activity increases during bleeding. The phenomenon is suppressed by a previous injection of a low dose of heparin. These data give evidence of a very early local formation of thrombin during hemostasis. The study of this activation process in patients with congenital deficiency of blood clotting factor allows to investigate the mechanism of thrombin formation in vivo. This demonstrates the preeminence of the tissue factor pathway and the need of factor VIII for factor X activation in the extrinsic system.