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DOI: 10.1055/s-2001-18869
Laboratory Testing in Disseminated Intravascular Coagulation
Publikationsverlauf
Publikationsdatum:
06. Dezember 2001 (online)
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ABSTRACT
The lack of improvement in the clinical prognosis of disseminated intravascular coagulation (DIC) poses searching questions on the value of current laboratory testing in this area. There is little immediate chance of advancement unless new tests or new modes of analyzing currently available tests place an emphasis on identifying the early phase of DIC. An equal emphasis is also required on practicality to ensure that recommendations are applicable to the routine clinical setting. These two priorities need to be fulfilled to facilitate earlier therapeutic intervention in the clinical trials required for formal assessment of promising and emerging new molecules from successful animal studies. This article therefore discusses the advantages and disadvantages of available assays in DIC with these perspectives in mind. It also proposes a format to bring together the necessary elements required to make an impact on ultimately delivering clinical improvement in this critical area.
KEYWORD
Disseminated intravascular coagulation - DIC - laboratory tests - prothrombin time - scoring system - standardization
REFERENCES
- 1 Spero J A, Lewis J H, Hasiba U. Disseminated intravascular coagulation: findings in 346 patients. Thromb Haemost . 1980; 43 28-33
- 2 Astiz M E, Rackow E C. Septic shock. Lancet . 1998; 351 1501-1505
- 3 Siegal T, Seligsohn U, Aghai E, Modan M. Clinical and laboratory aspects of disseminated intravascular coagulation: A study of 118 cases. Thromb Haemost . 1978; 39 122-134
- 4 Giles A R. Disseminated intravascular coagulation. In: Bloom A, Forbes C, Thomas D, Tuddenham E, eds. Haemostasis and Thrombosis New York: Churchill Livingstone 1994: 969-986
- 5 Olson J D, Kaufman H H, Moake J. The incidence and significance of hemostatic abnormalities in patients with head injuries. Neurosurgery . 1989; 24 825-831
- 6 Bick R L. Disseminated intravascular coagulation: Pathophysiological mechanisms and manifestations. Semin Thromb Hemost . 1998; 24 3-18
- 7 Colman R W, Robboy S J, Minna J D. Disseminated intravascular coagulation: An approach. Am J Med . 1972; 52 679-689
- 8 Raimondi P, Bongard O, de Moerloose P, Reber G, Waldvogel F. D-Dimer plasma concentration in various clinical conditions. Thromb Res . 1993; 69 125-130
- 9 Kobayashi N, Maekawa T, Takada M, Tanaka H, Gonmori H. Criteria for diagnosis of DIC based on analysis of clinical and laboratory findings in 345 DIC patients collected by the Research Committee on DIC in Japan. Bibl Haematol . 1983; 49 265-275
- 10 Wada H, Wakita Y, Nakase T. Outcome of disseminated intravascular coagulation in relation to the score when treatment was begun. Thromb Haemost . 1995; 74 848-852
- 11 Mesters R M, Mannucci P M, Coppola R. Factor VIIa and antithrombin III activity during severe sepsis and septic shock in neutropenic patients. Blood . 1996; 88 881-886
- 12 Fijnvandraat K, Derkx B, Peters M. Coagulation activation and tissue necrosis in meningococcal septic shock: Severely reduced protein C levels predict a high mortality. Thromb Haemost . 1995; 73 15-20
- 13 Gando S, Kameue T, Nanzaki S, Nakanishi Y. Disseminated intravascular coagulation is a frequent complication of systemic inflammatory response syndrome. Thromb Haemost . 1996; 75 224-228
- 14 Wada H, Minamikawa K, Wakita Y. Hemostatic study before onset of disseminated intravascular coagulation. Am J Hematol . 1993; 43 190-194
- 15 Dempfle C E. The use of soluble fibrin in evaluating the acute and chronic hypercoaguable state. Thromb Haemost . 1999; 82 673-683
- 16 Zuckerman L, Cohen E, Vager J P, Woodword E, Kaprini J A. Comparison of thromboelastography with common coagulation tests. Thromb Haemost . 1981; 46 752-756
- 17 Mongan P D, Hosking M P. The role of desmopressin acetate in patients undergoing coronary artery bypass surgery. A controlled clinical trial with thromboelastographic risk stratification. Anesthesiology . 1992; 77 38-46
- 18 Downey C, Kazmi R, Toh C H. Novel and diagnostically applicable information from optical waveform analysis of blood coagulation in disseminated intravascular coagulation. Br J Haematol . 1997; 98 68-73
- 19 Toh C H, Downey C, Dwyre L. Thromboplastin sensitivity in waveform analysis. Thromb Haemost . 2000; 84 517-518
- 20 Downey C, Kazmi R, Toh C H. Early identification and prognostic implications in disseminated intravascular coagulation through transmittance waveform analysis. Thromb Haemost . 1998; 80 65-69
- 21 de Jonge E, Dekkers P E, Creasey A A. Tissue factor pathway inhibitor dose-dependently inhibits coagulation activation without influencing the fibrinolytic and cytokine response during human endotoxaemia. Blood . 2000; 95 1124-1129
- 22 Minnema M C, Chang A CK, Jansen P M. Recombinant human antithrombin III improves survival and attenuates inflammatory responses in baboons lethally challenged with Escherichia coli Blood . 2000; 95 1117-1123
- 23 Wheeler A P, Bernard G R. Treating patients with severe sepsis. N Engl J Med . 1999; 340 207-214