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A Pathological Clarification of Sepsis-Associated Disseminated Intravascular Coagulation Based on Comprehensive Coagulation and Fibrinolysis Function
- 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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Plasmin
medicine.medical_treatment
030204 cardiovascular system & hematology
Sepsis
Young Adult
03 medical and health sciences
0302 clinical medicine
Thrombin
Internal medicine
Fibrinolysis
medicine
Humans
Child
Blood Coagulation
Aged
Aged, 80 and over
Disseminated intravascular coagulation
business.industry
Infant
Hematology
Disseminated Intravascular Coagulation
Middle Aged
medicine.disease
Pathophysiology
Coagulation
Child, Preschool
030220 oncology & carcinogenesis
Hemostasis
Cardiology
Female
Blood Coagulation Tests
business
circulatory and respiratory physiology
medicine.drug
Subjects
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