A Histological Study on Microthrombi in Autopsy Cases of DIC

Kojima, Mizu; Shimamura, Kayako; Mori, Naoyoshi; Oka, Kuniyuki; Nakazawa, Masaki

doi:10.1159/000408450

Cited by 15 publications

(15 citation statements)

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“…It, therefore, is indicated to evaluate coagulation parameters in horses treated surgically for LCV. Coagulation dysfunction can be as difficult to diagnose as it is to treat, and post‐mortem confirmation can also be challenging due to lysis of thrombi prior to pathological evaluation 27 . Coagulation testing ante mortem is, therefore, necessary both to characterize the severity of the ongoing inflammatory process further and to direct any additional clinical intervention that might improve outcome.…”

Section: Discussionmentioning

confidence: 99%

Coagulation profiles in 27 horses with large colon volvulus

Dallap

Dolente

Boston

2003

J Vet Emergen Crit Care

126

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Objective: The objective of this study was to evaluate coagulation profiles in horses with surgical treatment of large colon volvulus (LCV), and determine if an association exists between hemostatic dysfunction and outcome. Design: Prospective clinical investigation from February to December 2000. Setting: Large animal intensive care unit in a veterinary teaching hospital. Interventions: Blood was collected from horses intra-operatively, 24, and 48 hours following surgical treatment for LCV. Measurements: Coagulation profiles, thrombin-antithrombin (TAT) levels, and D-dimer concentrations were determined for each time point. The number of tests abnormal in the standard coagulation profile, defined as the degree of hemostatic dysfunction, was determined for each horse for the duration of the study period. The association between each test and outcome, as well as the degree of hemostatic dysfunction for each horse and outcome, was determined using univariate analysis and logistic regression. TAT levels and D-dimer concentrations were compared to the results of the standard coagulation profile and to patient outcome using univariate analysis and logistic regression. Main results: Seventy percent of horses evaluated with surgical treatment of LCV had evidence of hemostatic dysfunction (3/6 tests abnormal). Only 18% of those patients had clinical signs recognized by the attending clinician as a coagulopathy. There was an association between the development of a coagulopathy and outcome, with horses with 4/6 tests abnormal being more likely to be euthanized, and those with 3/6 tests abnormal having a prolonged hospital stay. Platelet count, prothrombin time, and TAT levels may be helpful in predicting outcome in horses with LCV. Conclusions: Hemostatic function should be evaluated in horses with surgical treatment of LCV to detect subclinical coagulopathies and direct subsequent intervention. (J Vet Emerg Crit Care 2003; 13(4): 215-225)

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Section: Discussionmentioning

confidence: 99%

Coagulation profiles in 27 horses with large colon volvulus

Dallap

Dolente

Boston

2003

J Vet Emergen Crit Care

126

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“…Histologic studies 19,20,40,41 in patients with sepsis demonstrated microvascular thrombosis associated with significant ischemic organ injury. Angiographic studies 42,43 in patients with the ARDS demonstrated extensive microvascular obstruction, which improved following the administration of thrombolytics.…”

Section: Discussionmentioning

confidence: 99%

Coagulation Activation and Organ Dysfunction Following Cardiac Surgery

Dixon

Santamaria

Campbell

2005

Chest

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“…The extent of necrotic tissue injury was shown to be dependent on the quantity and duration of thrombosis, and a clear correlation was also demonstrated between thrombi and ischemic tissue damage (11,12). Shimamura et al (13) studied the distribution pattern of microthrombi in 37 autopsy cases of DIC.…”

Section: Microvascular Thrombosismentioning

confidence: 99%

“…The liver can be injured and its function altered by the activation of coagulation and inflammatory processes in sepsis (63). In patients with DIC associated with sepsis, hepatocellular necrosis and formation of fibrin thrombi in the sinusoids around the necrotic area are frequently demonstrated at autopsy (12,13,16). Using experimental models, Shibayama (64) confirmed that LPS administration induces fibrin deposition and infiltration of neutrophils in the hepatic sinusoid, leading to coagulative hepatocellular necrosis and liver injury.…”

Section: Microvascular Thrombosis and Organ Dysfunctionmentioning

confidence: 99%

Microvascular thrombosis and multiple organ dysfunction syndrome

Gando¹

2010

Critical Care Medicine

275

147

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This paper will review the involvement of disseminated intravascular coagulation-induced microvascular thrombosis in the pathogenesis of multiple organ dysfunction syndrome and the interaction between disseminated intravascular coagulation and systemic inflammatory response syndrome in critically ill patients. The published literature on clinical and experimental studies are the data sources of the study. Histologic evidence of microvascular thrombosis and tissue injury in disseminated intravascular coagulation has been reported in clinical, experimental, and autopsy findings. Proinflammatory cytokine-evoked neutrophil-endothelial activation and interplay between inflammation and coagulation through protease-activated receptors contribute to enhanced microvascular fibrin deposition in organs. In a clinical setting, systemic inflammatory response syndrome and disseminated intravascular coagulation synergistically play pivotal roles in the development of multiple organ dysfunction syndrome and in the poor prognosis of critical illness. Disseminated intravascular coagulation contributes to microvascular thrombosis and subsequent multiple organ dysfunction syndrome. Recent knowledge on the relationship between disseminated intravascular coagulation and systemic inflammatory response syndrome gives further insight into the pathogenic mechanisms of multiple organ dysfunction syndrome in critically ill patients.

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A Histological Study on Microthrombi in Autopsy Cases of DIC

Cited by 15 publications

References 0 publications

Coagulation profiles in 27 horses with large colon volvulus

Coagulation profiles in 27 horses with large colon volvulus

Coagulation Activation and Organ Dysfunction Following Cardiac Surgery

Microvascular thrombosis and multiple organ dysfunction syndrome

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