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

The correlation between disseminated intravascular coagulation (DIC) and pulmonary insufficiency following trauma and shock was studied in patients. Serial coagulation tests were performed on nine patients suffering from adult respiratory distress syndrome (ARDS), and six of nine showed the evidence of consumption coagulopathy. Heparin infusion was effective in two patients with the improvement of platelet counts, other coagulation factors and the concomitant improvement of lung function.
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PMID:Disseminated intravascular coagulation in the pathogenesis of adult respiratory distress syndrome: 1. Clinical study. 60 92

The role of disseminated intravascular coagulation (DIC) in the pathogenesis of adult respiratory distress syndrome (ARDS) was studied in the experimental animals. ARDS was simulated in dogs by the administration of various doses of Escherichia coli endotoxin (Difco). The alveolar surface activity in the group which received lethal dose of endotoxin (3 mg/kg) exhibited no significant alterations with mild pulmonary insufficiency and little pathologic change five hours after the induction of shock. On the other hand, a significant decrease in alveolar surface activity was found to develop in the group which received sublethal dose of endotoxin (1 mg/kg) accompanying enlarged alveolar-arterial oxygen tension differences (A-aDO2) and elevated pulmonary vascular resistance after 24 hours. These changes occurred concomitantly with pathologic findings of DIC, interstitial edema and atelectasis. The disturbance in ventilatory function observed in prolonged shock appeared to be related to the impairment of pulmonary microcirculation caused by DIC and subsequent hypoxia of lung tissue which led to a loss of alveolar surfactant.
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PMID:Disseminated intravascular coagulation in the pathogenesis of adult respiratory distress syndrome: 2. Experimental study. 60 93

Recent improvements in total artificial heart (TAH) experiments have changed the pathological findings as well as the concept of the TAH. In the past 3 years, 67 experiments were performed in our laboratory. This study concerns the 11 calves operated upon most recently. Histopathological findings in the lungs, kidneys, livers and spleens of these animals were greatly improved over findings from previously studied animals. Disseminated intravascular coagulation (DIC) syndrome has been seen in only 1 calf. These improvements can be attributed to the following factors: (1) Improved management of the lumg during surgery has essentially eliminated pulmonary insufficiency;(2) liver damage has been successfully prevented by the discovery of the relationship between high right atrial pressure and anemia; (3) careful aseptic surgical procedures and optimal prophylactic use of antibiotics and anticoagulants have minimized the incidence of infection and clot formation.
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PMID:Refinement in application of total artificial heart, with improvement in survival and histopathological findings. 115 7

This review encompasses a description of the main pathophysiological events leading to disseminated intravascular coagulation (DIC). Emphasis has been put on microcirculatory disturbances and endothelial dysfunction. The normal hemostatic functions of the vascular endothelium are described. The close connection between endothelium and superimposed immuno-modulators is stressed as is the interrelation between the proteolytic cascade systems in the blood. The importance of differentiating local and systemic events is discussed. Organ dysfunction in multiple organ failure (MOF) is exemplified by pulmonary insufficiency in the adult respiratory distress syndrome (ARDS). Essential laboratory tests of DIC are described as are the cornerstones of treatment.
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PMID:Disseminated intravascular coagulation. 192 29

Abruptio placentae rarely produces severe maternal complications while the fetus is alive in utero. The advent of fetal death (grade III) indicates a severe form of abruptio placentae and a real risk that an overt coagulopathy might develop (grade IIIB). Overt coagulopathy associated with a live fetus is, however, uncommon. The advent of an overt coagulopathy should be viewed as ominous. Treatment of abruptio placentae with overt coagulopathy should be directed toward obtaining a rapid and atraumatic vaginal delivery. Once delivery has occurred, spontaneous reversal of the coagulopathy can be anticipated. In the opinion of one of the authors (G.S.), the advent of severe consumption coagulopathy and/or uterine inertia is an indication for intravenous therapy with aprotinin. It has been shown that such therapy will limit DIC, reverse fibrinolysis, reawaken uterine activity, and lead to rapid vaginal delivery within 6-8 hours. Aprotinin is not commercially available for clinical use in the United States. Prolongation of the abruption-delivery interval will worsen maternal prognosis. Accordingly, the advent of uterine inertia prior to complete cervical dilatation is an indication for immediate cesarean section in circumstances where aprotinin is not available. Following delivery, the physician should be on the lookout for postpartum hemorrhage, which may necessitate immediate transfusion, the administration of oxytocics, and/or uterine manipulation. Surgical intervention is rarely indicated in such cases. The patient should also be carefully observed over the ensuing days and weeks for the evolution and resolution of complications, such as renal failure, pulmonary insufficiency, and panhypopituitarism.
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PMID:Abruptio placentae with coagulopathy: a rational basis for management. 258 Jun 57

A 56-year-old female, who was diagnosed as CML in 1983 and had been well controlled with busulfan, was admitted to our hospital because of fever and iliac bone pain. Peripheral blood showed leukocytosis (WBC 70,000/microliters and bone marrow was normocellular with 53% leukemic cells, suggesting that she was in the blastic crisis. Chromosomal analysis of bone marrow cells at that time revealed t (9; 22; 12) and some additional abnormalities. The number of chromosomes ranged from 44 to 131 and the mode of chromosome number was 65. She was treated with combination regimen consisting of vincristine, 6-mercaptopurine and prednisolone and right iliac tumor was irradiated. Three months after admission, she died of DIC and pulmonary insufficiency due to leukemic infiltration.
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PMID:[Triploid clone observed at blastic crisis in chronic myelogenous leukemia with complex Ph1 translocation (9; 22; 12)]. 276 78

We describe a case of fatal falciparum malaria, with severe pulmonary insufficiency in the absence of fluid overload or cardiac failure. At autopsy the most striking change was a marked pulmonary interstitial edema. The endothelial cell was the most altered structure, showing marked cytoplasmic swelling which narrowed the capillary lumen. Monocytes were also found occupying the capillary lumen. The edematous interstitium also showed macrophages with endocytes and malarial pigment. There was no disseminated intravascular coagulation or other terminal complications. The patient's respiratory insufficiency seems not to have derived from the complications usually associated with the fatal malaria but from malaria-induced alveolar septal changes.
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PMID:Ultrastructure of the lung in falciparum malaria. 388 10

Nine cases of severe complicated falciparum malaria treated by exchange transfusion were studied. Eight patients survived and one patient died. Multisystemic complications were found in all cases. The CNS complications, acute renal failure, pulmonary insufficiency, jaundice, bleeding, sepsis, and DIC were found in 9, 7, 5, 7, 2, 4 and 1 cases, respectively. The fatal case presented with severe multisystemic complications together with 40% parasitemia. In eight survivors, whose parasitemia ranged from 0.3%, to 90%, had milder degrees of systemic complications. With the use of blood exchange 10-15 units, the parasitemia was decreased to less than 5% within 24 hours in all expect one who had parasitemia 90%. In comparison with the other 10 matched non-exchanged patients, there was no significant difference in survival rate between these two group (89% vs 80%). However, in the patients with ARDS the survival rate in the group who received the exchange transfusion therapy was superior (75% vs 0%). The exchange transfusion therapy is therefore strongly recommended in the treatment of malarial patients who present with parasitemia > 30% and severe systemic complications, particularly those who have severe acute renal failure or have lung complications. The amount of blood used for exchange transfusion should at least 1.2 times the blood volume for rapid removal of parasites and toxic metabolites from the circulation.
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PMID:Exchange transfusion therapy in severe complicated malaria. 788 48

Molar pregnancy is a gestation in which the ovum is transformed into a fleshy tumor mass or mole. Of all gynecologic tumors, it is one of the most feared. It is characterized by first trimester bleeding, hyperemesis, and toxemia and can be diagnosed using pelvic ultrasound. Suction currettage is the treatment of choice for molar pregnancy when a patient desires to have more children; however, hysterectomy may be necessary. Abdominal hysterectomy reduces the risk of malignant sequelae. Complications associated with molar pregnancy usually are a result of suction curettage and include pulmonary insufficiency syndrome, choriocarcinoma, hyperthyroidism, theca lutein cysts, and disseminated intravascular coagulation. The perioperative nurse can be instrumental in assessing, planning, organizing, and directing intervention for potential complications associated with the management of a molar pregnancy crisis. The perioperative nurse is encouraged to review all aspects of molar pregnancy to understand the ramifications of the surgical procedures.
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PMID:Intraoperative molar pregnancy crisis. 794 18