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Disseminated Intravascular Coagulation

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81. Dual inhibition of thrombin and activated factor X attenuates disseminated intravascular coagulation and protects organ function in a baboon model of severe Gram-negative sepsis Full Text available with Trip Pro

Dual inhibition of thrombin and activated factor X attenuates disseminated intravascular coagulation and protects organ function in a baboon model of severe Gram-negative sepsis Inhibition of procoagulant pathways may improve outcome in sepsis. We examined whether a dual short-acting thrombin (factor II) and factor X (FX)a inhibitor (SATI) ameliorates sepsis-induced disseminated intravascular coagulation (DIC) and is organ-protective.Escherichia coli were infused for 2 h in 22 anesthetized (...) interleukin-6 release at 12 h was prevented in the treatment groups. In both SATI groups, fewer catecholamines were necessary and no bleeding complications were observed.Dual inhibition of thrombin and FXa preserved activation of coagulation, protected organ function and ameliorated inflammation in severe Gram-negative sepsis in baboons. SATI could be a novel therapeutic agent against sepsis-induced DIC.

2017 Critical Care

82. TAFRO Syndrome with Disseminated Intravascular Coagulation Successfully Treated with Tocilizumab and Recombinant Thrombomodulin Full Text available with Trip Pro

TAFRO Syndrome with Disseminated Intravascular Coagulation Successfully Treated with Tocilizumab and Recombinant Thrombomodulin TAFRO syndrome is a systemic inflammatory disorder that is characterized by thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly. Although thrombocytopenia is one of the major features of TAFRO syndrome, complications of disseminated intravascular coagulation (DIC) are not common. The therapeutic strategy for TAFRO syndrome complicated by DIC

2017 Internal Medicine

83. Management of disseminated intravascular coagulation: current insights on antithrombin and thrombomodulin treatments Full Text available with Trip Pro

Management of disseminated intravascular coagulation: current insights on antithrombin and thrombomodulin treatments Sepsis and septic shock are frequently complicated by disseminated intravascular coagulation (DIC), which decreases the survival rate of patients with sepsis. In the past, large international randomized controlled trials (RCTs) using physiological anticoagulants for sepsis-induced DIC were not performed; however, RCTs have been conducted for sepsis and/or septic shock

2017 Open access emergency medicine : OAEM

84. Life‐threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia Full Text available with Trip Pro

Life‐threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia A 77-year-old man with severe septic disseminated intravascular coagulation following urinary infection was transported to our hospital. He had developed urinary retention induced by untreated prostatic hyperplasia. Immediate drainage with a Foley catheter was successfully (...) intravascular coagulation.This case report illustrates the risk of placement of Foley catheters in patients with severe septic disseminated intravascular coagulation.

2016 Acute medicine & surgery

85. Successful anticoagulant therapy for disseminated intravascular coagulation during conservative management of placenta percreta: a case report and literature review. Full Text available with Trip Pro

Successful anticoagulant therapy for disseminated intravascular coagulation during conservative management of placenta percreta: a case report and literature review. Placenta percreta is a rare obstetric condition associated with the risk of massive intraoperative hemorrhage. Recently, conservative management of placenta percreta has been performed to reduce maternal morbidity. However, various complications have been reported during such management. Only a few cases of asymptomatic (...) disseminated intravascular coagulation (DIC) or fever without infection have been reported. Here, we discuss such a case and review the related literature to understand this rare condition better. For this, we performed an electronic literature review.We present the clinical course, results of blood tests, and serial magnetic resonance images of a 35-year-old female (gravida 5, para 2) with placenta percreta complicated by placenta previa that was managed conservatively. The patient successfully delivered

2017 BMC Pregnancy and Childbirth

86. How I treat disseminated intravascular coagulation. Full Text available with Trip Pro

How I treat disseminated intravascular coagulation. Disseminated intravascular coagulation (DIC) is a condition characterized by systemic activation of coagulation, potentially leading to thrombotic obstruction of small and midsize vessels, thereby contributing to organ dysfunction. At the same time, ongoing consumption of platelets and coagulation proteins results in thrombocytopenia and low concentrations of clotting factors, which may cause profuse hemorrhagic complications. DIC is always (...) proven successful in improving clinically relevant outcomes so far. In patients with major bleeding or at risk for hemorrhagic complications, administration of platelet concentrates, plasma, or coagulation factor concentrates should be considered.© 2018 by The American Society of Hematology.

2017 Blood

87. A 66-Year-Old Woman With Sudden Onset of Disseminated Intravascular Coagulation, Lactic Acidosis, and Hypoglycemia. Full Text available with Trip Pro

A 66-Year-Old Woman With Sudden Onset of Disseminated Intravascular Coagulation, Lactic Acidosis, and Hypoglycemia. A 66-year-old woman presented to an urgent care clinic for 2 to 3 weeks of general malaise, nausea/vomiting, night sweats, and dyspnea. On examination, she was tachycardic, and her laboratory evaluation was normal except for a lactate level of 4.4 mmol/L and platelet count of 118 × 109/L. CT imaging was performed. Two days later in the follow-up clinic, the patient's international (...) normalized ratio (INR) was elevated, and she was hospitalized with initial findings of disseminated intravascular coagulation (DIC) (ie, INR > 10, platelets 97 × 109/L, fibrinogen < 60 mg/dL, positive D-dimer result). Bone marrow aspirate and peripheral blood smears were unrevealing. On day 4 of her hospitalization, the patient developed severe lactic acidosis (24 mmol/L) and hypoglycemia (11 mg/dL), and she was transferred to our institution. The patient had a history of a benign ovarian tumor

2017 Chest

88. Rifampicin-induced disseminated intravascular coagulation in pulmonary tuberculosis treatment: A case report and literature review. Full Text available with Trip Pro

Rifampicin-induced disseminated intravascular coagulation in pulmonary tuberculosis treatment: A case report and literature review. Disseminated intravascular coagulation (DIC) induced by daily rifampicin therapy is rare, especially the patient is absent of malignancy, severe infection, and prior exposure to rifampicin.We report a case of DIC induced by daily rifampicin treatment for pulmonary tuberculosis. A 22-year-old, previously healthy man received an anti-tuberculosis therapy consisting

2017 Medicine

89. Complement-mediated thrombotic microangiopathy secondary to sepsis-induced disseminated intravascular coagulation successfully treated with eculizumab: A case report. Full Text available with Trip Pro

Complement-mediated thrombotic microangiopathy secondary to sepsis-induced disseminated intravascular coagulation successfully treated with eculizumab: A case report. Secondary thrombotic microangiopathies (TMAs) are induced by several underlying conditions; most are resolved by treating background disease. Eculizumab is a human monoclonal antibody that blocks the final stage of the complement system and effectively treats atypical hemolytic uremic syndrome (aHUS). In this report, we present (...) a patient with TMA secondary to sepsis- induced coagulopathy, who was successfully treated with eculizumab.A 44-year-old woman, who had no special medical history or familial history of TMAs, was admitted on suspicion of septic shock. Physical examination revealed gangrene on her soles. Blood tests revealed a decreased platelet count, disseminated intravascular coagulation (DIC), renal dysfunction, hemolysis, and infection. Although the coagulation disorder improved with intensive care, the low platelet

2017 Medicine

90. Risk of disseminated intravascular coagulation in patients with type 2 diabetes mellitus: retrospective cohort study. Full Text available with Trip Pro

Risk of disseminated intravascular coagulation in patients with type 2 diabetes mellitus: retrospective cohort study. To determine quantitatively the association between type 2 diabetes mellitus (T2DM) and disseminated intravascular coagulation (DIC).Retrospective cohort study using a claims database.Medical care institutions representing 9% of all secondary hospitals (acute care hospitals) in Japan.In total, 797 324 admissions, comprising 435 354 patients aged 18-79 years at the time

2017 BMJ open

91. Pharmacokinetics of recombinant human soluble thrombomodulin in disseminated intravascular coagulation patients with acute renal dysfunction. Full Text available with Trip Pro

Pharmacokinetics of recombinant human soluble thrombomodulin in disseminated intravascular coagulation patients with acute renal dysfunction. Recombinant human soluble thrombomodulin (ART-123) is a novel anticoagulant for patients with disseminated intravascular coagulation (DIC). It is widely used in clinical settings throughout Japan. Furthermore, a global Phase 3 study is currently being conducted. In healthy subjects, ART-123 is excreted mainly via the kidneys. Therefore, ART-123 dose

2017 Thrombosis and haemostasis

92. Disseminated intravascular coagulation is associated with the neurologic outcome of cardiac arrest survivors. (Abstract)

Disseminated intravascular coagulation is associated with the neurologic outcome of cardiac arrest survivors. We aimed to examine the serial changes in coagulofibrinolytic markers that occurred after the restoration of spontaneous circulation (ROSC) in cardiac arrest patients, who were treated with targeted temperature management (TTM). We also evaluated the association between the disseminated intravascular coagulation (DIC) score and clinical outcomes.This was a single-centre, retrospective (...) -2.405).The activity of coagulation and fibrinolysis decreased over time. An increased DIC score was an independent prognostic factor for poor neurologic outcome and 6-month mortality.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 American Journal of Emergency Medicine

93. Low plasma FVII:C and activated FVII as predictive markers for overt disseminated intravascular coagulation. (Abstract)

Low plasma FVII:C and activated FVII as predictive markers for overt disseminated intravascular coagulation. In sepsis, binding of factor VII (FVII:C) and activated factor VII (FVIIa) with tissue factor is the key step of coagulation resulting in disseminated intravascular coagulation (DIC). We conducted a prospective cohort study among 47 septic patients, aged 8 months to 18.8 years. They were initially divided into three groups of no DIC (n=27), non-overt DIC (n=14) and overt DIC (n=6). Blood

2017 Thrombosis and haemostasis

94. Haematological interventions for treating disseminated intravascular coagulation during pregnancy and postpartum. (Abstract)

Haematological interventions for treating disseminated intravascular coagulation during pregnancy and postpartum. Disseminated intravascular coagulation (DIC) is an acquired syndrome characterised by systemic intravascular activation of coagulation. There are several obstetric causes of DIC during pregnancy and postpartum.To assess the clinical effectiveness and safety of haematological interventions such as heparins (low molecular weight heparin (LMWH) and unfractionated heparin (UFH

2011 Cochrane

95. Treatment for disseminated intravascular coagulation in patients with acute and chronic leukemia. (Abstract)

Treatment for disseminated intravascular coagulation in patients with acute and chronic leukemia. Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by systemic intravascular activation of coagulation, leading to deposition of fibrin in the bloodstream, that may occur in patients with acute and chronic leukemia.To assess the clinical effectiveness and safety of any pharmacological intervention for treating DIC in acute or chronic leukemia.The search strategy (...) the effectiveness of interventions for treating disseminated intravascular coagulation (DIC) in patients with acute and chronic leukemia.Two review authors independently performed study selection, risk of bias assessment and data extraction.Four RCTs (126 participants) met the inclusion criteria. These trials evaluated the human activated protein C, recombinant human soluble thrombomodulin, tranexamic acid and dermatan sulphate. Included RCTs reported data on mortality and bleeding. The included RCTs were

2011 Cochrane

96. Disseminated Intravascular Coagulation

Disseminated Intravascular Coagulation Disseminated Intravascular Coagulation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Disseminated Intravascular Coagulation Disseminated Intravascular Coagulation Aka: Disseminated Intravascular Coagulation , Disseminated Intravascular Coagulopathy , DIC From Related Chapters II. Pathophysiology Intravascular fibrin deposition occludes small vessels Microemboli or thrombi form in vasculature Consumptive Widespread coagulation activation breaks down formed clot and depletes factors Results in both bleeding and clotting Factors depleted Platelets Protein C Tissue factor pathway inhibitor III

2018 FP Notebook

97. Comparison of Two Diagnostic Scores of Disseminated Intravascular Coagulation in Pregnant Women Admitted to the ICU. Full Text available with Trip Pro

Comparison of Two Diagnostic Scores of Disseminated Intravascular Coagulation in Pregnant Women Admitted to the ICU. To compare the validity of two previously published diagnostic scores of disseminated intravascular coagulation (DIC) in pregnant women admitted to ICU for an acute thrombotic or hemorrhagic complication of delivery and postpartum.This was a population based retrospective study of 154 patients admitted to ICU for severe delivery and postpartum complications in a University (...) ). The Kappa coefficient of correlation between both scores was 0.35. The lower sensitivity of the ISTH score was mainly explained by the lack of fibrinogen and fibrin-related peptides thresholds adapted to the physiological changes of coagulation induced by pregnancy.The new DIC score seem highly discriminant in the subset of patients admitted to the ICU after delivery for an acute specific complication. The ISTH score is not recommended in pregnant women because of its poor sensitivity.

2016 PLoS ONE

98. Pathogenic factors associated with development of disseminated intravascular coagulopathy (DIC) in a tertiary academic hospital in South Africa. Full Text available with Trip Pro

Pathogenic factors associated with development of disseminated intravascular coagulopathy (DIC) in a tertiary academic hospital in South Africa. Disseminated intravascular coagulopathy (DIC) is a thrombotic microangiopathy arising from consumption of both coagulation factors and platelets. DIC is triggered by a number of clinical conditions including severe infection, trauma and obstetric complications. Early diagnosis and treatment of the underlying condition is paramount. A high clinical (...) with DIC in this study. HIV showed the highest relative risk ratio of all pathogens although previous studies have not suggested that HIV was strongly associated with DIC. In almost half of the HIV infected patients, there was no other pathogen isolated despite extensive investigation. This suggests that HIV has a strong association with the development of DIC, warranting further research into the relationship between HIV and disseminated microvascular thrombosis.

2018 PLoS ONE

99. Assessment of Haemostasis in Disseminated Intravascular Coagulation by Use of Point-of-Care Assays and Routine Coagulation Tests, in Critically Ill Patients; A Prospective Observational Study Full Text available with Trip Pro

Assessment of Haemostasis in Disseminated Intravascular Coagulation by Use of Point-of-Care Assays and Routine Coagulation Tests, in Critically Ill Patients; A Prospective Observational Study Disseminated intravascular coagulopathy (DIC) relates to the consumption of coagulation factors and platelets with bleeding and micro thrombosis events.The aim of this study was to compare haemostasis parameters in critically ill patients with DIC versus patients without DIC, and in survivors versus non (...) -survivors over time. Correlations between the DIC-score, the degree of organ failure and the haemostasis were assessed.Patients admitted to the intensive care unit with a condition known to be associated with DIC and with an expected length of stay of >3 days were included. Routine laboratory tests, prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen concentration and D-dimer were measured. Coagulation and platelet function were assessed with two point-of-care devices

2016 PloS one

100. Current Pathological and Laboratory Considerations in the Diagnosis of Disseminated Intravascular Coagulation Full Text available with Trip Pro

Current Pathological and Laboratory Considerations in the Diagnosis of Disseminated Intravascular Coagulation Systemically sustained thrombin generation in vivo is the hallmark of disseminated intravascular coagulation (DIC). Typically, this is in response to a progressing disease state that is associated with significant cellular injury. The etiology could be infectious or noninfectious, with the main pathophysiological mechanisms involving cross-activation among coagulation, innate immunity (...) diagnostic tool for acute DIC, a composite scoring system using rapidly available coagulation tests is recommended by the International Society on Thrombosis and Haemostasis. Its usefulness and limitations are discussed alongside the advances and unanswered questions in DIC pathogenesis.

2016 Annals of laboratory medicine

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