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A Pathological Clarification of Sepsis-Associated Disseminated Intravascular Coagulation Based on Comprehensive Coagulation and Fibrinolysis Function

Authors :
Takashi Ishihara
Midori Shima
Kenji Nishio
Masato Kasahara
Keiji Nogami
Satoki Inoue
Masaharu Yamasaki
Hiroshi Kobayashi
Toshiya Nishikubo
Tomoko Onishi
Itsuto Amano
Hidetada Fukushima
Masahiko Kawaguchi
Source :
Thrombosis and Haemostasis. 120:1257-1269
Publication Year :
2020
Publisher :
Georg Thieme Verlag KG, 2020.

Abstract

Background The functional dynamics of coagulation and fibrinolysis in patients with disseminated intravascular coagulation (DIC) vary due to the pathology and severity of various underlying diseases. Conventional measurements of hemostasis such as thrombin–antithrombin complex, plasmin-α2-plasmin-inhibitor complex, and fibrinogen-fibrin degradation products may not always reflect critical pathophysiologic mechanisms in DIC. This article aims to clarify the pathology of sepsis-associated DIC using assessment of comprehensive coagulation and fibrinolysis. Methods Plasma samples were obtained from 57 patients with sepsis-associated DIC at the time of initial diagnosis. Hemostasis parameters were quantified by clot-fibrinolysis waveform analysis (CFWA) and thrombin/plasmin generation assays (T/P-GA). The results were expressed as ratios relative to normal plasma. Results CFWA demonstrated that the maximum coagulation velocity (|min1|) ratio modestly increased to median 1.40 (min − max: 0.10 − 2.60) but the maximum fibrinolytic velocity (|FL-min1|) ratio decreased to 0.61 (0 − 1.19). T/P-GA indicated that the peak thrombin (Th-Peak) ratio moderately decreased to 0.71 (0.22 − 1.20), whereas the peak plasmin (Plm-Peak) ratio substantially decreased to 0.35 (0.02 − 1.43). Statistical comparisons identified a correlation between |min1| and Th-Peak ratios (ρ = 0.55, p Conclusion A pathological clarification of sepsis-associated DIC based on the assessment of coagulation and fibrinolysis dynamics may be useful for the hemostatic monitoring and management of optimal treatment in these individuals.

Details

ISSN :
2567689X and 03406245
Volume :
120
Database :
OpenAIRE
Journal :
Thrombosis and Haemostasis
Accession number :
edsair.doi.dedup.....4b9cad992268523cbc8cd792fb3860d1
Full Text :
https://doi.org/10.1055/s-0040-1713890