Disseminated Intravascular Coagulation in Sepsis

Zeerleder, Sacha; Hack, C. E.; Wuillemin, Walter A.

doi:10.1378/chest.128.4.2864

Cited by 246 publications

(191 citation statements)

References 124 publications

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“…Severe sepsis alone may be associated with an increased risk of stroke through hemodynamic collapse, increased systemic inflammation, and coagulopathy. 36,37 New-onset AF may simply be a marker for greater severity of illness, and thus, greater stroke risk. However, within the limitations of claims data, adjustment for clinical and demographic factors associated with severity of illness did not eliminate the strong associations of new-onset AF claims with incident stroke claims.…”

Section: Discussionmentioning

confidence: 99%

Incident Stroke and Mortality Associated With New-Onset Atrial Fibrillation in Patients Hospitalized With Severe Sepsis

Walkey¹,

Wiener²,

Ghobrial³

et al. 2012

Survey of Anesthesiology

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Context-New-onset fibrillation (AF) has been reported in 6-20% of patients with severe sepsis. Whereas chronic AF is a known risk factor for stroke and death, the clinical significance of newonset AF in the setting of severe sepsis is uncertain.Objective-To determine the in-hospital stroke and in-hospital mortality risks associated with new-onset AF in patients with severe sepsis. Conclusion-Among patients with severe sepsis, patients with new-onset AF were at increased risk for in-hospital stroke and death compared with patients with no AF and patients with preexisting AF. Design-Retrospective

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Section: Discussionmentioning

confidence: 99%

Incident Stroke and Mortality Associated With New-Onset Atrial Fibrillation in Patients Hospitalized With Severe Sepsis

Walkey¹,

Wiener²,

Ghobrial³

et al. 2012

Survey of Anesthesiology

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“…De presentarse manifestaciones trombóticas graves se requiere anticoagulación con heparina no fraccionada continua. [6][7][8] Esta fue la conducta terapéutica asumida inicialmente con el paciente, a la que se añadió la administración de PFC (como fuente de AIII; proteínas C y S) y plaquetas (para disminuir el riesgo de sangrados espontáneos).…”

Section: Resultadounclassified

Déficit de proteína C en un paciente con coagulación intravascular diseminada asociada a sepsis y trombosis venosa profunda

Tassin¹

2013

Arch Argent Pediat

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Presentación de casos clínicos RESUMENLa coagulación intravascular diseminada es un síndrome clinicopatológico que complica a varias enfermedades graves; la sepsis es la causa más común en los pacientes pediátricos. Resulta de una anormal activación del sistema de coagulación, que conduce a la formación de trombos en la microcirculación, y al consumo de plaquetas y factores de la coagulación. Los hallazgos clínicos son variables; las hemorragias son la presentación más frecuente, seguidas de la púrpura y la gangrena de las extremidades (púrpura fulminante). Se presenta el caso de un paciente con coagulación intravascular diseminada asociada a sepsis, con trombosis venosa profunda concomitante. Los estudios permitieron diagnosticar una trombofilia hereditaria asociada a déficit hereditario de proteína C. Palabras clave: sepsis, coagulación intravascular diseminada, trombosis venosa profunda, déficit de proteína C. SUMMARYDisseminate intravascular coagulation (DIC) is a clinical pathological syndrome associated to several diseases. Sepsis is the most common cause in infants and children. DIC results from the anomalous activation of blood coagulation, widespread formation of thrombi in the microcirculation, and consumption of clotting factors and platelets. Clinical findings are variable; the most common is bleeding, followed by purpura and acral gangrene (purpura fulminans). We report a patient with sepsis associated-DIC and concurrent deep venous thrombosis. The diagnostic evaluation allowed to discover inherited thrombophilia associated to protein C deficiency.

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“…The serious reduction in anticoagulant capacity and the inhibition of fibrinolysis result in a massive activation of coagulation, finally leading to overwhelming fibrin formation and the consumption of clotting factors and inhibitors. Abundant intravascular fibrin formation leads to microvascular thrombosis, which contributes to the development of multiple organ failure [14] .…”

Section: Discussionmentioning

confidence: 99%

Tanshinone IIA protects rabbits against LPS-induced disseminated intravascular coagulation (DIC)

Lin

Sun

2012

Acta Pharmacol Sin

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Aim: To evaluate the effects of tanshinone IIA (Tan IIA), a lipophilic diterpene from the Chinese herb Salvia miltiorrhiza, on lipopolysaccharide (LPS)-induced disseminated intravascular coagulation (DIC) in rabbits. Methods: LPS-induced DIC model was made in adult male New Zealand rabbits by continuous intravenous infusion of LPS (0.5 mg/kg) via marginal ear vein for 6 h. The animals were simultaneously administered with Tan IIA (1, 3 and 10 mg/kg) or heparin (500 000 IU/kg) through continuous infusion via the contralateral marginal ear vein for 6 h. Before and 2 and 6 h after the start of LPS infusion, blood samples were taken for biochemical analyses. Results: Continuous infusion of LPS into the rabbits gradually impaired the hemostatic parameters, damaged renal and liver functions, increased the plasma TNF-α level, and led to a high mortality rate (80%). Treatment of the rabbits with Tan IIA dose-dependently attenuated the increase in activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrin-fibrinogen degradation products (FDP); ameliorated the decrease in plasma levels of fibrinogen and platelets; and reversed the decline in activity of protein C and antithrombin III. Meanwhile, the treatment significantly suppressed the increase in the plasma levels of aminotransferase, creatinine and TNF-α, and led to much lower mortality (46.7% and 26.7% for the medium-and high-dose groups). Treatment of the rabbits with the high dose of heparin also effectively improved the hemostatic parameters, ameliorated liver and renal injuries, and reduced the plasma level of TNF-α, and significantly reduced the mortality (33.3%). Conclusion: Tan IIA exerts a protective effect against DIC in rabbits.

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Disseminated Intravascular Coagulation in Sepsis

Cited by 246 publications

References 124 publications

Incident Stroke and Mortality Associated With New-Onset Atrial Fibrillation in Patients Hospitalized With Severe Sepsis

Incident Stroke and Mortality Associated With New-Onset Atrial Fibrillation in Patients Hospitalized With Severe Sepsis

Déficit de proteína C en un paciente con coagulación intravascular diseminada asociada a sepsis y trombosis venosa profunda

Tanshinone IIA protects rabbits against LPS-induced disseminated intravascular coagulation (DIC)

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