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Consumption coagulopathy

  • M. L. Chierego
  • A. Gullo
Conference paper

Abstract

First described by McKay [1], disseminated intravascular coagulation (DIC) represents a diagnostic and therapeutic challenge for the clinician. DIC is not a disease or a symptom, but rather a poorly defined syndrome with a widely variable intensity, often complicating a diversity of severe disorders that are themselves related to extensive morbidity and mortality. Despite advances in knowledge, the mortality rate remains high (30% - 50%) [2]. Thrombin, the end product of activation, is the key enzyme responsible for this syndrome. Increased thrombin generation can occur systemically as in sepsis or in burned patients, or can be localized to one organ, becoming generalized only at the end, as in necrotic hemorrhagic pancreatitis and obstetric complications. The outcome of any activation depends on the rate and extent of the activation, ability of the physiological antithrombotic processes to control thrombosis, specific diseases that activate the haemostasis, conditions of other organs and host response to these noxius stimuli. A sudden onset of the activating stimulus, as in septic shock or in a placental abruption, leads to acute DIC, whereas a chronic process is evident secondary to a gradually developing stimulus, as in patients with cancer, large aortic aneurysm, or retained death foetus. The severity of the coagulopathy will vary from mild to severe, reflecting the imbalance of the haemostatic system.

Keywords

Septic Shock Severe Sepsis Tissue Factor Systemic Inflammatory Response Syndrome Disseminate Intravascular Coagulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • M. L. Chierego
  • A. Gullo

There are no affiliations available

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