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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of infants with shock are presented. Cardiac output was determined in both with dilution dye using an auricular oxymeter, with three determinations: at 0, 30 and 60 minutes while receiving intranvenous fluids. At the same time, blood gases and blood lactatewere determined. The first case showed hypodynamic shock secondary to hypovolemia due to severe dehydration, associated to low central venous pressure, low arterial tension, increased peripheral resistance and increased arteriovenous difference of oxygen. The second case was a newborn with sepsis and disseminated intravascular coagulation with hyperdynamic shock with very high cardiac output, low peripheral resistance and low arteriovenous difference of oxygen. Both cases had an initial increase of lactate and a mild decrease at the end of the period of clinical observation.
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PMID:[Hemodynamometabolic changes in shock in infants. Report of 2 cases]. 62 52

With improving standards of antenatal care, severe pre-eclampsia dn eclampsia are becoming less common and experience in the management of these conditions is lessening. Co-ordinated plans for the care of patients should be established by obstetricians and anaesthetists working as a team. A suitable regime for drug therapy in severe pre-eclampsia or eclampsia is the following: Initial management Diazepam 10 mg slowly i.v. Pethidine 100-150 mg i.m. or i.v. in incremental dosage, or extradural blocks, if analgesia is also required. Hydrallazine 20 mg i.v. initially, followed by 5 mg at intervals of 20 min until the diastolic pressure is less than 110 mm Hg. Then, preferably by syringe pump in a concentration of 2 mg/ml, at a rate of 2-20 mg/h. If vomiting occurs this can be controlled by administration of atropine. Subsequent management Sedation and anticonvulsant therapy. Continue diazepam and, in severe cases, institute chlormethiazole infusion. Continue analgesia with pethidine or extradural block. Control of hypertension by adjusting the dose of hydrallazine. If tachycardia exceeds 120 beat/min give propanolol 2-4 mg i.v. Plasma protein depletion with groww oedema is treated by administration of salt-free albumin or plasma protein fraction. Diuretic therapy is indicated if there is gross oedema or signs suggestive of acute renal failure. Oliguria associated with increased blood urea may be a result of renal failure or dehydration. The latter should be evident from the patient's condition and central venous pressure, but i.v. fluids and frusemide 20-40 mg can be used as a therapeutic test. Mannitol reduces cerebral oedema and may be given if diuresis has been first produced with frusemide. Potassium chloride is given if the plasma potassium decreases to less than 3 mmol/litre. Heparin therapy is considered if there is clinical evidence of disseminated intravascular coagulation.
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PMID:The management of severe pre-eclampsia and eclampsia. 83 44

Severe hypertonic dehydration with hyperglycemia developed in a 7-week-old infant girl after she was fed an overconcentrated milk formula for five days. Renal failure,disseminated intravascular coagulation, gangrene of the legs, and coma were added complications. Intravenous rehydration, peritoneal dialysis, and heparin administration corrected the metabolic and coagulation derangements, and renal function returned to normal. Bilateral below-the-knee amputations were performed and the child subsequently learned to walk with artificial limbs. The dangers of overconcentrated formulas in infant feeding should be widely publicized through warnings printed on all commercial milk preparations.
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PMID:Hazards of overconcentrated milk formula. Hyperosmolality, disseminated intravascular coagulation and gangrene. 117 15

Gangrene of the extremities complicating diarrhoea and severe hypernatraemic dehydration occurred in 6 infants. This is a rare complication of gastroenteritis, and its association with hypernatraemia does not seem to have previously been emphasized. The increased blood viscosity resulting from serum hyperosmolarity may have been responsible for the gangrene, and studies in our patients suggested that disseminated intravascular coagulation was present. In addition to fluid and electrolyte replacement, the infants were treated with heparin with some recovery of the affected extremities.
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PMID:Peripheral gangrene in hypernatraemic dehydration of infancy. 120 Jun 77

An infant, aged seven months, developed toxic shock with acute renal failure as a sequel to the development of hypertonic dehydration. The anuric phase persisted despite treatment of the dehydration and diuretic infusions. The coagulation tests showed signs of disseminated intravascular coagulation and so the child was given fibrinolytic therapy for 36 hours following initial heparinization. Excretion of urine recommenced 8 hours after the initiation of fibrinolytic therapy. Peritoneal dialysis was carried out in parallel with the fibrinolytic treatment without haemorrhagic complications. It was possible to terminate dialysis on the fourth day already and renal function subsequently recovered completely.
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PMID:[Disseminated intravascular coagulation and acute renal failure in an infant. Treated with streptokinase and peritoneal dialysis (author's transl)]. 121 46

Twenty cases of children with Sclerema observed at a Pediatric Service during five years are presented. Their clinical and laboratory traits are integrated in a dermatosis appearing after various and usually serious complications. In the children observed the most frequent finding was represented by sepsis, some of them with disseminated intravascular coagulation syndrome, diarrhoea with dehydration. The therapy applied, fundamentally was based on parenteral solutions, antibiotics and corticoids, was directed by those diseases and not by the presence of sclerema, which however appeared influenced by the supply of the latterly mentioned medicaments. Microscopic disturbances are discussed too, and a reference is made to the incriminabea pathogenic mechanisms.
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PMID:[Sclerema (clinical review apropos of 20 cases)]. 124 Oct 81

Neuroleptic malignant syndrome (NMS) has come to be recognized as one of the most serious adverse reactions to neuroleptic therapy. Complications may include cardiopulmonary failure, rhabdomyolysis and renal failure, disseminated intravascular coagulation, infection, dehydration, and shock. This article points out the need for intensive medical management for patients with NMS and questions whether private psychiatric hospitals are adequate to the task.
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PMID:Should neuroleptic malignant syndrome be treated in a private psychiatric hospital or a general hospital? 219 98

Problems encountered regarding the examination in forensic pathology are variable, even if the field of interest in limited to trauma alone. The most important problem appears to be the establishment of a causal relationship between the trauma and the death of the victim. From the materials I have contributed concerning examinations in forensic medicine, the problems inherent in the examination of the victim of traumatic shock may be introduced. The results from animal studies, which have been attempted to provide an experimental background to support the observations, are also discussed. My personal opinions on several trial cases in which there was a disagreement of opinion regarding the examination results will also be expressed. 1. Distinguishing death due to traumatic shock from death due to disease In the "Yacht school" incident, children with emotional disturbances and youths with a history of misconduct were treated with training which included physical punishment. Autopsy findings were compared between a 13-year old boy who was concluded to have died of traumatic shock from numerous beatings and a 21-year old youth who died of hemorrhagic pneumonia. In my opinion, a causative role of injury in the death was found in both cases. 2. Shock due to tourniquet This autopsy case concerns a 23-year-old male who entered a yoga training center, was tightly bound with a rope and died on the 8th day. Histological examination revealed thrombus formation in the small blood vessels and leukocyte agglutination within the blood vessels of the alveolar wall, suggesting DIC. While these findings were thought to be almost indistinguishable from those found in traumatic shock, the background conditions, including hunger, dehydration and hypothermia cannot be neglected in the evaluation. 3. Child abuse In one incident, a mother and her lover beat a 25-month old girl every day until her death. The original examination concluded that the cause of death was traumatic shock due to multiple trauma over the entire body caused by both adults. A second examination concluded that the cause of death was delayed suffocation due to binding of the chest and compression against a mattress. Based on an overall evaluation of the circumstances at the time of detection (including photographic evidence) as well as the contents of the statement made by the lover, I inferred that the head-down hanging of the child in the bathtub by the lover was directly related to the cause of death. In my opinion, the liability of the two adults in the crime was not the same.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Problems regarding the examination in forensic medicine]. 262 31

A full-term male neonate, weighing 2540 g at birth, was admitted to hospital on day 2 because of vomiting and severe dehydration. Duodeno-duodenostomy was performed on day 5 for congenital duodenal atresia. The child was well postoperatively until day 9, when he developed fever. Intermittent fever continued despite treatment with several antibiotics. He became seriously ill on day 15 and developed disseminated intravascular coagulation. Treatment with antifungal drugs (amphotericin B and 5-flucytosine) was effective for systemic candidiasis, but candida endophthalmitis developed. There was a persistent vitreous lesion in the left eye, which after cessation of therapy has been improving gradually. Systemic candidiasis and candida endophthalmitis should be considered in neonates who develop signs of sepsis postoperatively.
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PMID:Systemic candidiasis with DIC and candida endophthalmitis in a postoperative neonate. 269 30

A 6-year-old male Doberman Pinscher developed multiple organ infarctions secondary to vegetative endocarditis. Clinical signs included fever, nystagmus, head-tilt, inappetence, dehydration, hematuria, and dysuria. The dog was azotemic and anemic and had a high WBC count and high liver enzyme activities. Disseminated intravascular coagulation was diagnosed on the basis of thrombocytopenia and prolonged activated clotting times. Vegetative mitral valvular lesions were evident on M-mode echocardiography. The dog underwent diuresis with physiologic saline solution and was treated parenterally with antibacterial and anticoagulant agents. Surgery was performed to remove an infarcted kidney and an infarcted spleen and to relieve urethral obstruction caused by a large blood clot. Gram-positive cocci were noticed in the biopsy specimens. Mortality associated with organ infarctions secondary to bacterial endocarditis is high, and combined medical and surgical therapy is rarely reported. This dog survived and was alive 38 months after surgery.
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PMID:Medical and surgical management of multiple organ infarctions secondary to bacterial endocarditis in a dog. 320 56


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