Experimental disseminated intravascular coagulation effect of heparin and e-aminocaproic acid on test of hemostatic function

Chronic Intravascular Coagulation and Fibrinolysis (ICF) Syndromes (DIC)

“…Their use, in conjunction with heparin, is indicated in lifethreatening hemorrhagic emergencies. EACA alone can lead to thrombosis in human DIC states [180] and in experimental animals [156,159]. Prevention of gingival bleeding with EACA in the hemophiliac undergoing dental extraction is not thought to be dangerous, however, because there is no evidence of intravascular clotting.…”

Disseminated Intravascular Coagulation: Evaluation of Therapeutic Approaches

“…In acute DIC the ethanol gelation test and the protamine sulfate test are suitable to determine the presence of thrombininduced fibrinogen derivatives. Positive tests provide a solid basis for the decision to initiate therapeutic measures counteracting imminent or ongoing DIC [76,112,121,123,144]. If considerable secondary fibrinolysis is present, these tests may be negative despite the presence of soluble fibrin.…”

“…When the indication for heparin therapy was evaluated on the basis of analytical criteria compatible with and characteristic of consumption coagulopathy and/or secondary fibrinolysis, the prognosis with regard to hemorrhagic episodes was not altered. Yet, according to comparative data, the survival rate of patients with DIC due to septicemia was higher, although not statistically significant, in the groups which received heparin [30,112,124]. In 108 patients suffering from shock of different etiology, complicated by acute DIC, those with hemorrhages mainly due to secondary fibrinolysis had a better prognosis than those cases, especially with septic shock, who had no manifestation of bleeding [65].…”