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

This report describes the clinical course of a child who had excision of several symptomatic cavernous hemangiomas. Disseminated intravascular coagulation resulted in severe postoperative bleeding. DIC was treated successfully with heparin.
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PMID:Disseminated intravascular coagulation after surgical excision of cavernous hemangioma. 45 69

Twenty-seven patients requiring massive transfusions were studied prospectively to determine whether administration of stored, modified whole blood induced a primary disorder of hemostasis evidenced by generalized microvascular oozing. Platelet counts fell in proportion to the number of units of blood transfused. In contrast, the levels of factors V and VIII correlated poorly with the units of blood transfused, 85% of the total variation in the levels being due to influences other than transfused blood. Levels of all other clotting factors were unrelated to the number of units of blood given. Eight patients developed abnormal bleeding. The cause appeared to be dilutional thrombocytopenia in five patients, and DIC in three. In six of the eight, bleeding was controlled with platelet concentrates alone. Two patients were given cryoprecipitate also. The most useful laboratory test for predicting abnormal bleeding was the platelet count. Fibrinogen levels should be followed as an aid in the diagnosis of DIC. The BT, PT, and PTT were not helpful in assessing the cause of bleeding, unless they were greater than 1.5 times the control value. We recommend that any patient receiving massive transfusions who develops diffuse microvascular bleeding be given platelet concentrates. Platelet counts as high as 100,000 may be required to control bleeding from surgical wounds. It is not necessary to supplement transfusions of stored, modified whole blood with fresh blood or fresh frozen plasma.
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PMID:Hemostasis in massively transfused trauma patients. 46 85

3 cases of severe septic shock are described; a 5 month old girl with congenital hyposplenia, a 2 3/12 year old boy splenectomized because of microspherozytosis and a 11 6/12 year old boy splenectomized because of Hodgkin's disease. In 2 cases pneumococci were found in the blood cultures. In all 3 cases the coagulation analysis showed a consumption coagulopathy. Intravenous streptokinase treatment was applied in addition to general treatment for shock and antibiotic therapy. 2 patients survived and made a complete recovery, whereas the 2 year old boy died. The histological findings showed a severe DIC. In the Department of Surgery, Innsbruck, 44 children have been splenectomized during the last 6 years, 38 of whom we were able to follow up on for an average of 3.3 years. After an average of 1.2 years following splenectomy, 4 patients (including the 3 cases mentioned above) contracted acute septicaemia; a further patient also incurring a probable sepsis with DIC. 3 of these 5 children died, representing a morbidity rate of 13% and a mortality rate of 8%. The mortality rate is thus as high as that caused by the primary disease, indicating the urgency of prophylaxis for infections of this kind. 3 prophylactic forms of treatment are suggested: protection with penicillin, active immunization with polyvalent pneumococcal antigen and spleen preservation whenever possible.
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PMID:[Asplenia and DIC (author's transl)]. 47 21

Peripheral blood lymphocytes from 32 patients with malignant melanoma were tested for cell-mediated cytotoxicity (CMC) against cultured autologous melanoma cells. Effector cells were prepared from venous blood by defibrination, gel sedimentation, nylon column filtration, and lysis of remaining erythrocytes with NH4Cl. Melanoma cells prelabelled with [3H])proline were used as target cells in a 40-h assay and CMC was evaluated against standards obtained with blood lymphocytes from the least reactive normal donor. Reproducible autologous CMC was detected in 18 of 32 patients in a series of 367 total tests. CMC correlated with tumor volume (5-500 cm3) but not with tumor stage or DNCB reactivity. Preliminary results indicated that autologous CMC was not affected by treatment with DTIC, dexamethasone, intralesional BCG, radiation therapy, or partial surgical excision. Lack of consistent CMC in 14 patients could not be attributed to a measurable decrease in general immune capacity or to increased resistance of the patients' melanoma cells to CMC in general. Fibroblasts were more resistant to CMC than melanoma cells, and therefore of questionable value for defining specificity in direct tests.
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PMID:Cell-mediated cytotoxicity for cultured autologous melanoma cells. 47 90

A report is given of a fatal pneumococcal septicaemia in a young man, who had been splenectomized after a traffic accident, but who was not otherwise immunodeficient. Adequate treatment could not prevent the progress of a very severe DIC-syndrome. The use of a polyvalent pneumococcal vaccine after splenectomy is recommended.
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PMID:Fatal pneumococcal septicaemia in a young asplenic man. 49 76

Sepsis of the newborn induced by gram negative bacteria, especially E. coli is often accompanied by a severe coagulation disorder. It can be treated by blood exchange transfusion (ET) with heparinized blood. In this study the hematological effect obtained by the exchange transfusion was investigated in rabbits after induction of a generalized Shwartzman reaction by two spaced injections of endotoxin (75 microgram/kg) 24 hrs. apart. Three groups of 6 animals each were investigated: group I: without endotoxin but with ET (controls); group II: endotoxin without ET; group III: endotoxin with ET. Fibrinogen, soluble fibrin monomer complexes (SFMC), fibrin(ogen) degradation products (FDP), platelet- and leukocyte counts and urine volume (ml/hr) were estimated. In group II a decline in the fibrinogen level, and in platelet and leukocyte count, as well as an increase in SFMC and FDP could be observed from 6 hrs. on after the second endotoxin injection. In group III 6 hrs. after the second endotoxin injection, exchange transfusion with heparinized blood was performed. Variance analysis showed significant differences in all parameters, except in the urine volumes after exchange transfusion between group III and group II. By exchange transfusion an approach of the values towards the values of the controls could be recognized. The findings indicate, that by blood exchange transfusion the hematological consequences of the endotoxin induced DIC can be corrected, while the dysfunction of the kidneys can be improved only slightly.
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PMID:The effect of heparinized blood exchange transfusion on endotoxin induced disseminated intravascular coagulation (DIC). 50 9

Clinical studies in the treatment of 54 children suffering from DHF with a combination of dipyridamole and ASA as an adjuvant of our standard therapy consisted of fluid, electrolytes, blood, plasma and plasma expanders were evaluated. Heparin was administered in cases of DIC. It appeared that dipyridamole and ASA did not change the mortality significantly, but it prevented the progress of the severity of the disease from grade I and II to grade III and IV.
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PMID:Dipyridamole in the treatment of dengue haemorrhagic fever. 51 1

FPA immunoreactivity was elevated in 14 out of 15 patients with disseminated neoplasia. Two of the patients showed signs of DIC, two had clinically evident thrombosis and one a positive 125I-fibrinogen uptake test suggesting thrombosis. Infusion of heparin produced a prompt fall in FPA levels. FPA immunoreactivity correlated well with the turnover of intravasal 125I-fibrinogen. The results confirm that the RIA of FPA provides a specific and quantitative index of the conversion of fibrinogen into fibrin and indirectly of the thrombin action in vivo.
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PMID:[Fibrinogen metabolism and plasma fibrinopeptide A in disseminated neoplasms]. 53 71

In 18 cases of perinatal intraventricular haemorrhage, continuous ventricular drainage was applied. As a result, ICP hypertension was inhibited and thus brain damage prevented. The early intervention prevented the formation of hydrocephalus (evoidence of shunt dependence) and aspiration of the bleeding prevented DIC and maintained coagulation factors.
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PMID:Successful treatment of perinatal intraventricular haemorrhage. 54 18

Liver function tests involving the use of Bromsulphalein can lead to hemolysis and consequent DIC. Latent forms can be detected by means of fibrinolytic degradation products and reduction in the number of leukocytes containing acid mucopolysaccharides of the heparin type, together with an increase in the total leukocyte count as a sign of stress. In comparisons between the bromsulphalein and indocyanine green tests, these parameters have sho4n that liver function tests using indocyanine green are harmless.
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PMID:Consumptive coagulopathy during the Bromsulphalein test--indocyanine green as an alternative. 54 27


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