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

In nine patients with suspected disseminated intravascular coagulation (DIC) and five controls, the following analyses were performed on admission and 7-29 hours later: Routine coagulation studies (fibrinogen, platelet count, fibrin(ogen) degradation products, ethanol gelation, reptilase time, Factor V) providing a semiquantitative DIC score, prekallikrein (PK), Factor XII, antithrombin III (AT-III), C1(-)-inhibitor and alpha 2-macroglobulin. Significant correlations were found: PK or AT III with the DIC-score, PK with AT-III and Factor XII, AT-III with Factor XII. The changes (expressed as a percentage of normal plasma) of PK and AT-III from the first to the second evaluation were nearly identical. The two patients with rapidly fatal irreversible shock showed the highest DIC score and a pronounced decrease of PK and AT-III, whereas in reversible shock stable or increasing PK and AT-III values were found. The other variables showed an overlap between reversible and irreversible shock. DIC in these shock patients, accompanied by a decrease in PK, probably was mediated via Factor XII activation. PK and AT-III might be of prognostic value in patients with (septic) shock.
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PMID:Plasma prekallikrein, factor XII, antithrombin III, C1(-)-inhibitor and alpha 2-macroglobulin in critically ill patients with suspected disseminated intravascular coagulation (DIC). 620 13

The procedure of endoscopic hemostasis with topical injection of absolute ethanol has been developed and applied since 1975 for the control of postoperative hemorrhage associated with diathermic polypectomy. Since June 1979, upper gastrointestinal hemorrhages other than varices have also been subjected to this procedure. This method is based on the principle of dehydration and fixation of the tissue with absolute ethanol. In this procedure, the bleeding vasculatures are dehydrated and fixed with consequent vasoconstriction and necrosis of the vascular wall including its endothelial lining, thereby thrombogenesis and hemostasis are facilitated. The troubled blood vessels fixed in vivo are disintegrated and disappeared. Rebleeding from the ulcer has been extremely rare with this method since the necrotized tissue seldom defoliates but often constitutes a part of the white coating and protects the base of ulcer. Treatment by this method has been successful in all 23 cases of upper gastrointestinal hemorrhage associated with endoscopic diathermy, and none has developed rebleeding. The hemostasis has also been successful in 51 cases (72 hemorrhagic lesions) with fresh blood clots adhering to the lesion, exposed blood vessels in the lesion or an actively bleeding lesion out of 126 cases referred for emergency endoscopic examination because of upper gastrointestinal hemorrhage during the 3-year period from June 1979 to May 1982. After hemostasis, however, 3 patients received an elective operation and one patient was also operated due to perforation of the gastric wall. Rebleeding occurred in 3 cases more than a week after the hemostasis; one of these was the above-described operated case of perforation. The rebleeding occurred in stress ulcers following surgery for femoral fracture. The other two were at the terminal stage of malignancy and complicated with DIC respectively. Of the patients treated by this method, 8 died by causes other than gastrointestinal hemorrhage. All the rest of 39 cases attained cure of ulcer by the non-surgical treatment alone.
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PMID:Endoscopic hemostasis of gastrointestinal hemorrhage by local application of absolute ethanol: a clinical study. 636 42

Rapid methods for determination of fibrin-monomer complexes and fibrinogen/fibrin degradation products were studied and compared in 76 patients with different abnormalities in the hemostatic system (acute thromboses, thromboembolism of the pulmonary artery, disseminated intravascular coagulation, immune thrombovasculitis, etc). The control group consisted of 36 healthy donors. The fibrin-monomer complexes were determined by the paracoagulation tests, the ethanol test (ET) and protamin sulfate tests (PST), whereas fibrinogen/fibrin degradation products (FDP) by the staphylococcus adhesion test (SAT) in which use was made of the Newman D2S strain variety obtained by the authors. It is inferred that the ET, PST and SAT are the most suitable for use in clinical medicine, since they are accessible, simple and quick in performance. However, these tests cannot be regarded as similar or interchangeable, since they are used for studying different products of the coagulation and fibrinolytic transformation of fibrinogen.
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PMID:[Comparative study of various rapid methods of determining fibrinogen transformation products in the diagnosis of intravascular coagulation and fibrinolysis]. 647 66

Among 113 consecutive patients with disseminated intravascular coagulation (DIC), twenty cases who developed this condition under surgical intervention are the subject of this study. At the onset of DIC, fourteen cases were suffered from severe infection. Coagulation study in these patients revealed decreased platelet counts and prolonged prothrombin time. There was marked increase in fibrinogen degradation products and positive ethanol gelation test was frequently observed. These findings were analogous to those found in the more chronic presentations of DIC in the patients with neoplastic diseases, however, plasma concentration of fibrinogen was normal. Antithrombin III level was extremely low in the patients with surgical DIC. The patients with DIC in surgery took acute or subacute courses with very high incidence of major organ failure. The patients with dysfunction of more than three organs were seen in eight of 20 cases. The lungs, kidneys, liver and gastrointestinal tracts were involved in the descending order of frequency. Fourteen patients died and six of these were autopsied. All had multiple fibrin thrombi in more than two organs. The numbers and sites of microthrombi in the major organs were well matched with the clinical manifestations. These results suggested that DIC might be one of the precipitating factors of multiple organ failure.
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PMID:[A clinical study on surgical patients with disseminated intravascular coagulation: with special reference to the occurrence of major organ failures]. 667 56

An immunoenzyme histochemical study was conducted to localize fibrin degradation products (FDPs) in rat tissues during disseminated intravascular coagulation (DIC). Serial measurements of FDP levels in serum after thrombin-induced DIC showed peak levels to be found at 30 minutes; the FDPs were rapidly cleared from the circulation (half-life about one hour). Rat tissues obtained from 10 minutes to 3 hours after the induction of DIC were studied by means of immunohistochemistry. A method was developed to differentiate FDPs from fibrin in tissue sections. This method is based on the observation that, in paraplast-embedded tissues, FDPs can be demonstrated following ethanol fixation only, and that fibrin is demonstrable after both paraformaldehyde fixation and ethanol fixation. Moreover, FDPs will react to some of the antiserums employed only, while fibrin will react to all antiserum used (antiserums against fibrin monomer, against the constituent chains of fibrinogen, and against FDP-D and -E). At 10-20 minutes after the induction of DIC, FDPs were found in kidney proximal tubule epithelial cells. These FDPs could be demonstrated using antiserum against the constituent chains of fibrinogen, but not by antiserums against FDP-D or -E. At 30-90 minutes, FDPs were found inside liver macrophages. The FDPs in liver did not react to anti-chain antiserums, though they did react to antiserums against FDP-D and -E. Since no FDPs were found in other tissues, rat FDPs are apparently cleared by kidney (earlier phase) and liver (later phase) only. In human cases of DIC, FDPs, could be demonstrated in kidney proximal tubules cells and in liver macrophages as well.
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PMID:Immunoenzyme histochemical localization of fibrin degradation products in tissues. 701 71

Coagulation profiles were performed in 30 consecutive alcoholic cirrhotic patients without known infection, malignancy, recent surgery, transfusion, or alcoholic intake. Hemorrhagic phenomena were present in 70% and included gastrointestinal bleeding, oozing from venipuncture sites, bruising, and epistaxis. All 30 patients had multiple liver function and coagulation abnormalities, the most frequent of which were increases in F VIII components and decreases in F XI and F VII. Also decreased in half or more of the 30 patients were Fletcher F, F II, F X, prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT), reptilase time (RT), anti-thrombin III, and plasminogen. When comparing cirrhotic bleeders with nonbleeders, four parameters were significantly different in those with a bleeding tendency: F VII, anti-thrombin III, plasminogen, and albumin. The prolonged APTT was associated in four cases with a blocking inhibitor of unknown etiology. The prolonged TT and RT, in the absence of fibrin split products, fibrin monomers, DIC, or shortened euglobulin lysis time in any patient were suggestive of an abnormal fibrinogen, a dysfibrinogen. In three other patients, there was an inhibitor of the TT. Further investigation of the suspected dysfibrinogen in 21 patients by SDS-polyacrylamide gel electrophoresis revealed that the molecular weights of the Aalpha, Bbeta, and gamma polypeptide chains of fibrinogen were not different from normal. Two-dimensional immunoelectrophoresis of the suspected dysfibrinogen was similar to normal in 18 of 21 patients, with loss of the initial shoulder in three.
Alcohol Clin Exp Res 1982
PMID:Bleeding and coagulation abnormalities in alcoholic cirrhotic liver disease. 704 81

To provide more information on the pathways of fibrinogen catabolism in generalized cancer, the effect of heparin on fibrinopeptide A (fpA) and on 125I-fibrinogen kinetics was studied in 15 patients with disseminated neoplasia. Three patients had evidence of venous thrombosis and in 2 additional patients a low fibrinogen level together with increased amounts of FDP/fdp and a positive ethanol test indicated disseminated intravascular coagulation (DIC). The plasma levels of fpA were grossly elevated (4.6--20, mean 11.4 ng/ml, normal values 1.01 +/- 0.45 ng/ml) in patients with thrombosis or DIC, and normal to grossly elevated (0.4--10.4, mean 6.1 ng/ml) in the other patients. Intravenous heparin bolus lowered the fpA level in 11/11 patients, and continuous heparin treatment led to an impressive suppression or complete normalization of the plasma fpA in 5/6 patients. This finding is thought to reflect heparin suppression of thrombin activity on fibrinogen. In some cases, the fpA fall after heparin bolus was slow and/or incomplete, suggesting fpA generation at sites not easily accessible to heparin or insufficient heparin dosage. The 125I-fibrinogen kinetics were characterized by a significantly shorter half-life (t1/2: 2.5 days), increased catabolic rate constant (j: 0.44 days-1), and increased absolute turnover (68.9 mg fibrinogen/kg/day) as compared to 4 normal subjects (t1/2: 4.2 days; j: 0.26 days-1; turnover 21.7 mg fibrinogen/kg/day). As estimated from the fpA generation rates, intravascular thrombin action on fibrinogen contributed only in minor part to increase the turnover of 125I-fibrinogen. In particular, the turnover was greatly accelerated in heparin-treated patients despite impressive suppression or normalization of the fpA levels in 5/6 cases.
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PMID:Comparison of 125I-fibrinogen kinetics and fibrinopeptide A in patients with disseminated neoplasias. 709 24

During the years 1977 to 1979 51 patients admitted to a general Intensive Care Unit were diagnosed of disseminated intravascular coagulation (DIC); their clinical histories were reviewed and they form the basis of this report. The diagnosis was made independently of the eventual clinical manifestations and it was based on the platelet count, serum fibrinogen levels, alteration of the prothrombin time and the cephalin-kaolin time, elevation of fibrin degradation products, and positivity of the ethanol test. An attempt was made to elucidate the precipitating cause of the coagulopathy, and to see if there was one or more of them. Particular emphasis is made on the association with Gram negative sepsis. Survival was evaluated in relation to heparin therapy, massive doses of corticosteroids, and association to acute renal failure. In conclusion, severe DIC with or without bleeding appears to be a manifestation of multiorgan failure seen in severely ill patients; the prognosis and mortality of this form of DIC is worse than the usual DIC and treatment with heparin or corticosteroids do not increase survival, while its association to acute renal failure implies a higher mortality (p less than 0.02).
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PMID:[Study of 51 cases of disseminated intravascular coagulation with reference to the association with acute renal failure. Results in severely ill patients (author's transl)]. 725 33

The influence of haemoperfusion on blood-coagulation and cellular constituents of the blood was studied in three groups of patients. In four patients haemoperfusion was performed using a column containing acrylic-hydrogel coated activated charcoal (Haemocol), in five patients with a column containing uncoated XAD-4 nonionic polystyrene resin (Amberlite) and in five patients with a column containing cellulose coated activated charcoal (Gambro Adsorba 300 C). Perfusion was performed during 4 h with a flow of 300 ml/min. Before the start, 2 h after the start, at the end and 2 h after the end of the perfusion the haemoglobin concentration, haematocrit, leucocyte number, differential white cell count, thrombocyte number and heparin concentration were measured. Before the start and 2 h after the end prothrombin time, thrombin time, partial thromboplastin time, reptilase time, fibrinogen, prothrombin, factors V, VII, X, antithrombin III, bleeding time (Ivy), ethanol gelation test, fibrin split products and plasminogen were measured. The following conclusions can be drawn: haemoperfusion per se causes haemodilution; polystyrene resin causes in some patients a temporary reduction of the leucocyte number during haemoperfusion; polystyrene resin causes a significant reduction of thrombocyte number compared to coated activated charcoal; polystyrene resin and to a lesser extent acrylic-hydrogel-coated activated charcoal causes in some patients a prolongation of bleeding time probably by inducing alteration of thrombocyte function caused by release; polystyrene resin and probably also acrylic-hydrogel-coated activated charcoal causes an increased fibrinolytic activity without signs of disseminated intravascular coagulation.
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PMID:The influence of haemoperfusion on haemostasis and cellular constituents of the blood in the treatment of intoxications: a comparative study of three types of columns (Haemocol, Amberlite XAD-4, Gambro Adsorba 300 C). 727 53

Fresh frozen plasma is prepared within 6 hrs after collection in a double bag system. A second centrifugation at 4600 x g is necessary to obtain a platelet poor plasma. A special bag freezing system fitted to a conventional cryostat and cooled with ethanol to -50 degrees C was developed to reach the required cooling rate. It is possible to freeze 25 plasma bags simultaneously within 30 min in this new apparatus. Fresh frozen plasma prepared in this manner contains all coagulation factors and inhibitors with almost normal activities. Freezing at -40 degrees C in the air, prolonged storage of the starting material, or insufficient cooling of the frozen product deteriorate its quality. The influence of these variables with the discussed in detail. Indications of fresh frozen plasma, especially for dilution- and posttraumatic consumption coagulopathy as well as liver disease, are presented.
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PMID:[Deep frozen fresh plasma in blood component therapy: preparation--quality control--indications]. 730 26


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