The diagnosis and management of disseminated intravascular coagulation.
نویسندگان
چکیده
This review describes disseminated intravascular coagulation (DIC) as a syndrome in which hemostatic factors are activated. The syndrome ranges in severity from a decompensated coagulopathy (overt-DIC) to the subclinical compensated activation of hemostatic factors (nonovert DIC). The first part of this review emphasizes two points. First, activation of the hemostatic system is controlled by a vast network of capillaries and venules through anticoagulant and anti-inflammatory regulatory factors that operate from the endothelium (e.g., protein C and thrombomodulin, tissue factor pathway inhibitor). These hemostatic regulators can be overridden by procoagulant disorders such as amniotic fluid embolism or degraded by proinflammatory disorders such as sepsis. Second, because this link between the microvascular endothelium and circulating hemostatic factors is so close, even a relatively mild disturbance of the microvasculature targeted by the inflammatory process may be reflected systemically by changes in molecular biomarkers of hemostatic activity. Therefore, application of criteria for the diagnosis of nonovert DIC should be of value in detecting a compensated response to inflammatory stress of the microvasculature in patients who are at risk before they develop an uncompensated over DIC response and organ failure. The second part of this review covers the recent experience investigators have had in diagnosing and following the response of patients to treatment with biomarkers.
منابع مشابه
Disseminated Intravascular Coagulation in a Case of Brucellosis Misdiagnosed as Thrombotic Thrombocytopenia Purpura
متن کامل
Plasma Fibrinogen and D-dimer in Children With Sepsis: A Single-center Experience
Background & Objectives: In sepsis, enhanced fibrin formation, impaired fibrin degradation, and intravascular fibrin deposition lead to a prothrombotic state. The current study aimed at measuring various coagulation parameters to predict an early marker for disseminated intravascular coagulation (DIC). Methods: The current prospective s...
متن کاملThe Mechanism of the Emergence of Defibrillation Syndrome: Methods of Immediate Diagnosis and Treatment
Different mechanisms leading to disseminated intravascular coagulation (DIC) are briefly discussed and the hemorrhagic diathesis which is brought about by this consumption coagulopathy is visualized. Since there is an emergency need for correct management of the disorder. The problem is simplified in order, any physician, to be able to understand the syndrome and to be catious in treating t...
متن کاملDiagnosis and treatment of disseminated intravascular coagulation: a case report.
Disseminated intravascular coagulation is a pathologic syndrome with different medical disorders. Diagnosis and treatment of this syndrome is one of the difficult managements in medical science. Thromboelastogram is the only guide for early diagnosis and precise management of this syndrome. We describe a patient who developed disseminated intravascular coagulation due to endocarditis and spleen...
متن کاملSupportive management strategies for disseminated intravascular coagulation
Disseminated intravascular coagulation (DIC) is a syndrome characterised by the systemic activation of blood coagulation, which generates intravascular fibrin leading to thrombosis of smalland medium-sized vessels and eventually contributes to organ dysfunction (1). In addition, the consumption of platelets and coagulation factors may predispose patients with DIC to haemorrhagic complications. ...
متن کاملDisseminated intravascular coagulation in obstetrics, pregnancy, and gynecology: Criteria for diagnosis and management
Disseminated intravascular coagulation is a confusing syndrome, regarding diagnostic and therapeutic modalities. Confusion and controversy stem from (1) the fact that many unrelated clinical scenario may induce DIC (2) a lack of uniformity in clinical manifestations (3) confusion regarding appropriate laboratory diagnosis and (4) unclear guidelines for management with respect to specific therap...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Current hematology reports
دوره 1 1 شماره
صفحات -
تاریخ انتشار 2002