Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The newborn infant, particularly when premature, has a haemostatic mechanism which may not be entirely capable of withstanding the onslaughts of trauma, infection, asphyxia or other complications of the neonatal period. He is at risk of local or diffuse haemorrhage, which may at times be serious or even life-threatening. The cause of haemorrhage during the newborn period can generally be ascertained by a careful history and brief physical examination directed toward recognition of any predisposing factors or underlying diseases. Screening laboratory tests can usually be correctly interpreted as long as certain laboratory artifacts and physiological peculiarities of the neonatal coagulation mechanism are kept in mind. Diagnosis of and therapy for vitamin K deficiency and haemophilia in the healthy-appearing neonate is generally carried out with little difficulty. The seriously ill neonate with bacterial sepsis, respiratory distress syndrome, or extreme immaturity presents greater problems, for laboratory tests may be more difficult to obtain and interpret and underlying conditions may be untreatable. DIC occurs commonly in such neonates, and transfusion therapy, with or without heparin, is often unsuccessful. A persistent dilemma are those neonates with fatal intravascular haemorrhage, in whom definable haemostatic abnormalities are few and transfusion therapy is futile.
 ...
PMID:Neonatal coagulation: normal physiology and pathophysiology. 35 Apr 67

A 70-year-old woman was admitted for evaluation of hepatosplenomegaly, fever and elevated serum LDH levels. A biopsy specimen of the liver revealed histiocytic proliferation at the portal triad, and a mild degree of hepatitis. A bone marrow biopsy specimen showed proliferation of histiocytes with minimal immaturity and atypism, and haemophagocytosis by the proliferated histiocytes. Fever, hepatosplenomegaly and elevation of LDH levels all disappeared spontaneously, and presumptive diagnosis of benign reticulosis with haemophagocytosis was made. One year later, fever, hepatosplenomegaly and elevation of LDH levels redeveloped, and the liver and bone marrow biopsy specimen showed proliferation of unequivocally malignant histiocytes. The patient died as a result of disseminated intravascular coagulation with shock 20 d later. We concluded that, in this case, malignant histiocytosis first presented as benign haemophagocytic reticulosis and, 1 year later, there was a typical malignant presentation.
 ...
PMID:Unusual clinical presentation of malignant histiocytosis in a 70-year-old woman. 206 13

During an 11-year period we encountered 16 pregnancies in which one twin died in utero and the pregnancy continued. Eight of these twin pregnancies were monochorionic. None of the women developed severe disseminated intravascular coagulation. The fetal outcome indicates that the prognosis for a surviving dichorionic twin is relatively good, with immaturity the main hazard. By contrast the surviving monochorionic twin has a poor prognosis with a high frequency of neurological damage. This damage is not related to intrapartum or neonatal problems and at present cannot be diagnosed before birth. There is no evidence that birth of the surviving twin by caesarean section will improve the prognosis. Early diagnosis of monochorionic twins and subsequent ultrasound follow up should identify fetal growth discrepancy and possible twin to twin transfusion requiring early delivery.
 ...
PMID:Twin pregnancy complicated by single intrauterine death. Problems and outcome with conservative management. 219 20

In 46 newborn calves with and without respiratory distress syndrome which had been delivered prematurely by caesarean section a blood coagulation profile was established. These animals were compared with 26 healthy, 5- to 8-day-old calves. Prematurely delivered calves showed a lower average plasma fibrinogen concentration than animals delivered in due time. Calves which developed a respiratory distress syndrome had a slightly prolonged prothrombin time and partial thromboplastin time as well as a lower antithrombin III activity already immediately postnatum compared with healthy prematures and some-day-old calves. It has to be assumed that in calves with respiratory distress syndrome--in analogy to pulmonary immaturity--the blood clotting mechanism is not yet fully developed. In healthy prematures and surviving asphyctic calves hemostasis remains largely stable during the first day of life, whereas plasma fibrinogen concentration increases. In the calves not surviving the examination period prothrombin time and partial thromboplastin time postnatum became significantly longer. Only in these severely asphyctic calves the presence of a consumption coagulopathy seems likely. A secondary reactive fibrinolysis was not observed.
 ...
PMID:[Changes in the blood coagulation potential of premature calves with and without respiratory distress syndrome]. 271 60

To clarify the hemocoagulative and fibrinolytic dynamics of the perinatal period and also to seek the cause of SGA (small for gestational age) baby birth, the coagulation and fibrinolysis of the cord blood were examined, and moreover a comparison with the maternal blood, discussion on the difference in birth weight, and an examination of the difference due to the sex of babies were made in 68 cases with full-term, vaginal, spontaneous delivery, and the following conclusions were reached. In comparison with maternal blood, cord blood significantly showed any of the following: Prolongations of the prothrombin time, and the activated partial thromboplastin time, a decrease in fibrinogen, and a decrease in the platelet aggregation, antithrombin III, and plasminogen. In addition, high values for thromboxane B2 and 6-ketoprostaglandin F1 alpha were observed. In the SGA group, significant decreases were observed in the platelet count, antithrombin III, plasminogen, and alpha 2-plasmin inhibitor as compared with the AGA (appropriate for gestational age) and LGA (large for gestational age) baby groups. No sex difference was observed in the hemocoagulative and fibrinolytic capacities of the cord blood. These hemocoagulative and fibrinolytic capacities, particularly changes in the fibrinolytic system observed in the SGA group, seem to be attributable to chronic DIC (disseminated intravascular coagulation) and mild acidosis due to various stresses during pregnancy and at parturition, in turn due to immaturity of the liver in babies.
 ...
PMID:[Blood coagulation and fibrinolysis in cord blood with reference to birth weight]. 405 31

The process of adaptation for extrauterine life can be easily disturbed by respiratory insufficiency. The surfactant deficiency as well as anatomical and physiological immaturity of a newborn can be considered as etiological factors in some diseases, such as respiratory distress syndrome (RDS), transient tachypnoea (TT) syndrome, segmental atelectasis or pneumonia complicated by atelectasis. The widespread used method of treatment is based on mechanical increase of difference between alveolar and atmospheric pressure. So-called constant distending pressure (CDP) increases functional residual capacity (FRC), keeps alveoli open and finally increases oxygenation of arterial blood. During 3 years period continuous positive airway pressure by nasal route (n-CPAP) was used as only one method in 26 newborns. The newborns were treated because of RDS (15 cases) and pneumonia with atelectasis (11 cases). n-CPAP was starting with pressure 8 cm H2O (0.8 kPa) and FIO2 0.5, if atelectasis with severe dyspnea, hypoxia and forced hyperventilation were found. This method was very well tolerated. 22 newborns treated for 2-7 days--survived, 4 small-for-date babies--died. The most common cause of death was septicaemia complicated by disseminated intravascular coagulation. The moderate hyperbilirubinemia, oliguria with tissue oedema was observed in many cases. The light nostril decubitus were only complications. No pneumothorax was detected. We found n-CPAP as a simple, safe method in treatment of atelectasis in newborns.
 ...
PMID:[Continuous positive pressure respiration by nasal route (n-CPAP) as a preferred treatment method in various types of acute respiratory insufficiency in newborn infants]. 637 92

Recent studies have suggested that postoperative bleeding is decreased in pediatric heart operations if fresh whole blood instead of blood component therapy is used for postoperative transfusions. Because this is in contrast to our practice to use whole blood for only the priming of the cardiopulmonary bypass circuit and then to use blood components for additional transfusion requirements, it was our interest to analyze the bleeding complications and the use of blood products after heart operations in infants. The patient records of the 73 infants operated on in 1992 were reviewed. The chest tube drainage varied from 3 to 51 ml/kg per 6 hours (mean 10 ml/kg) and it did not correlate with any of the tested clinical or laboratory parameters. One infant underwent reoperation because of surgical bleeding. Disseminated intravascular coagulation developed in another patient. Sixty-eight patients (93%) needed red blood cell supplementation. Sixty-eight percent of patients between 1 month and 1 year old could be treated without any other postoperative transfusion except for red blood cell supplementation. In contrast, in the neonates, platelet concentrates or fresh frozen plasma, or both, were used in 61% of the patients. In addition to the known immaturity of the hemostatic system, the increased need for platelet concentrates in the neonates was attributed to longer cardiopulmonary bypass time, deeper hypothermia in association with circulatory arrest, larger dosages of heparin, and more extensive plasma dilution during cardiopulmonary bypass. In conclusion, a low rate of bleeding complications and acceptably low general blood loss can be achieved postoperatively with blood component therapy.
 ...
PMID:Bleeding and use of blood products after heart operations in infants. 787 14

The HELLP syndrome is a severe and life-threatening form of preeclampsia associated with typical laboratory findings. The major problems are the fluctuating course of the disease, the unpredictable occurrence of severe maternal complications and the high maternal and perinatal mortality. Time-limited reversal of the laboratory parameters has been observed in 20-40% of cases; however, the majority of patients shows a deterioration of the disease within 1-10 days. As no reliable clinical and laboratory indicators exist, as well as no precisely defined cut-off values in predicting the course and prognosis, the outcome of the HELLP syndrome is unpredictable. The high maternal morbidity and mortality are mainly due to the development of disseminated intravascular coagulation (DIC); the frequency of DIC has been shown to increase significantly with the time interval between diagnosis and delivery. The management of the HELLP syndrome has been controversial, with some authors recommending a conservative approach to induce fetal maturity in pregnancies below the 32nd (34th) week of gestation, whereas the majority recommend immediate delivery by Caesarean section in patients with an unfavourable cervix irrespective of the gestational age. It is generally agreed that early diagnosis by laboratory screening methods is mandatory and that patients with the HELLP syndrome should be transferred to a perinatal centre. A literature review since 1990 clearly demonstrates that aggressive management is associated with a significant reduction in maternal and perinatal mortality. We believe that conservative management is only justified in cases of fetal immaturity under the following conditions: no evidence of progression of the disease, no suspected or manifest DIC, fetal wellbeing and intensive monitoring of the patient in a specialised obstetric care unit cooperating closely with experienced neonatologists and anaesthesiologists.
 ...
PMID:[Aggressive versus conservative management of HELLP syndrome--a status assessment]. 876 81

Kasabach-Merritt syndrome is characterized by thrombocytopenia and bleeding tendency leading to disseminated intravascular coagulation with giant hemangiomas. We present a very low birth weight infant with this syndrome who underwent four operations. A male baby (1179 g, 37 cm) was born at a gestational age of 28 weeks and 6 days by caesarean section. A large hemangioma, 7 x 8 cm in size, was recognized on the left thigh. As associated consumption coagulopathy (Kasabach-Merritt syndrome) was diagnosed with platelet count 5.1 +/- 10(4) mm-3 and fibrinogen 49 mg.dl-1. Despite treatment with liniac X-ray radiation, systemic steroid and component transfusion, coagulopathy became worse with extremely low platelet count of 1.1 x 10(4) mm-3. Infusion of dopamine and dobutamine was necessary for high output cardiac failure. On day 9, PDA ligation was performed. Cerebro-ventricular drainage, ventricuro-peritoneal shunt and shunt revision were required on day 15, 49 and 88, respectively, for hydrocephalus due to intraventricular hemorrhage. Main anesthetics used were fentanyl and sevoflurane. Major problems encountered by anesthetists were: bleeding tendency, water and electrolyte management, body temperature control, and immaturity and fragility of premature infant. Coagulopathy in Kasabach-Merritt syndrome must be a risk factor for intraventricular hemorrhage, which is a characteristic complication of a very low birth weight infant.
 ...
PMID:[Anesthetic problems in a very low birth weight infant with Kasabach-Merritt syndrome]. 881 2

Pathomorphology in the preterm infant represents an interaction of morphological organ immaturity and neonatal management with their respective sequelae. PATHOMORPHOLOGICAL EXAMPLES: include the modification in the morphology of hyaline membrane disease and bronchopulmonary dysplasia as a consequence of modern neonatal therapy. Hemorrhagic and ischemic/ hypoxic lesions of the central nervous system may occur in age- and agent-related distributional patterns, with subependymal hemorrhage and periventricular leukomalacia representing the most important examples. The most common intestinal finding, namely, necrotizing enterocolitis, typically shows segmental alterations, the morphology of which largely depends on the dominating causative agent. Hepatic cholestasis and fatty change are mostly consequences of parenteral nutrition or hypoxic/ischemic stress. Hepatic necrosis can be associated with the latter, but may also indicate disseminated intravascular coagulation. Vascular pathomorphology is represented by thromboembolic lesions, in most instances corresponding to sequelae of neonatal management.
 ...
PMID:[Pathomorphological findings in preterm infants]. 1066 58


1 2 Next >>