Distribution Patterns of Microthrombi in Disseminated Intravascular Coagulation (Dic)

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

doi:10.1515/9783110850123-007

Cited by 31 publications

(39 citation statements)

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“…First, many organs show fibrin deposition at pathologic examination, and the presence of intravascular thrombi seems to be clearly related to the clinical dysfunction of the organs (19). Autopsy findings in patients with overt DIC include diffuse bleeding, hemorrhagic necrosis, microthrombi in small blood vessels, and thrombi in midsize and larger arteries and veins (20,21). Fibrin deposition in small and midsize vessels in patients with DIC in these studies was invariably associated with ischemia and necrosis and with clinical dysfunction of organs.…”

Section: Clinical Setting and Relevancementioning

confidence: 66%

Disseminated intravascular coagulation

Levi¹

2007

Critical Care Medicine

296

176

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Section: Clinical Setting and Relevancementioning

confidence: 66%

Disseminated intravascular coagulation

Levi¹

2007

Critical Care Medicine

296

176

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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. They reported that the incidence of microthrombi differed between organs: lung (100%), liver (94.6%), kidney (75.5%), heart (56.8%), pancreas (48.7%), adrenal gland (32.4%), and gastrointestinal tracts (18.9%).…”

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%

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Microvascular thrombosis and multiple organ dysfunction syndrome

Gando¹

2010

Critical Care Medicine

278

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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“…El incremento de la expresión de citoquinas y de procoagulantes contribuyen al desarrollo de la CID con un fenotipo trombótico 20 demostrándose en autopsias la existencia de microtrombosis diseminada 21 . Las endotoxinas bacterianas, como el lipopolisacárido, se unen a receptores endoteliales desencadenando una respuesta inflamatoria con incremento de la expresión de citoquinas (TNF-a, IL-1b, y IL-6) 22 , expresión de moléculas de adhesión (selectinas E y P), activación del complemento, expresión de factor tisular en la superficie endotelial, en monocitos y macrófagos y generación de micropartículas portadoras de factor tisular, que lleva a la activación de la coagulación 23 .…”

Section: Sepsis Coagulación Intravascular Diseminadaunclassified

Trombosis microvascular

Penella¹

2014

Angiología

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Trombosis microvascular;Coagulación intravascular diseminada; Púrpura trombótica trombocitopénica; Anticuerpos antifosfolípido; Trombocitopenia inducida por heparina Resumen El árbol microvascular está formado por una extensa red de arteriolas, capilares y vénulas que presentan un alto grado de heterogeneidad tanto en la morfología como en la función. El endotelio tiene un importante papel en la hemostasia, manteniendo el balance entre los factores protrombóticos y antitrombóticos. Las manifestaciones clínicas de las trombosis microvasculares suelen ser en forma de disfunción de órganos, en contraste con la sintomatología aguda característica de las trombosis arteriales y venosas. Sin embargo, algunas alteraciones microvasculares trombóticas se manifiestan de forma aguda, comprometiendo en ocasiones la vida del paciente. Los mecanismos responsables de las diferencias en la respuesta trombótica entre vénulas y arteriolas no se conocen plenamente. El objetivo de la presente revisión es recoger las principales entidades en las que la trombosis microvascular es la causa patogé-nica principal, remarcando las características diferenciales que pueden estar en la base de la heterogeneidad de las manifestaciones clínicas.Abstract The microvasculature is composed of a vast network of arterioles, venules, and capillaries with a high degree of heterogeneity both in structure and function. The endothelium has an important role in haemostasis, maintaining the balance between prothrombotic and antithrombotic factors. Microvascular thrombosis usually presents with insidious organ dysfunction, in contrast with the acute clinical presentation of venous or arterial macrovascular thrombosis. However, some microvascular thromboses cause acute symptoms and severe clinical manifestations. The mechanisms underlying the different thrombotic response between venules and arterioles are not completely understood. The present review focuses on microvascular thrombosis as the main cause of several diseases, and the differential characteristics that may explain, in part, the heterogeneity of the clinical manifestations.

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Distribution Patterns of Microthrombi in Disseminated Intravascular Coagulation (Dic)

Cited by 31 publications

References 0 publications

Disseminated intravascular coagulation

Disseminated intravascular coagulation

Microvascular thrombosis and multiple organ dysfunction syndrome

Trombosis microvascular

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