Disseminated Intravascular Coagulopathy during Experimental Pneumococcal Sepsis: Studies in Normal and Asplenic Rhesus Monkeys

1977 ◽  
Vol 6 (4) ◽  
pp. 203-218 ◽  
Author(s):  
H. Bradford Hawley ◽  
Tadataka Yamada ◽  
Deane F. Mosher ◽  
Douglas P. Fine ◽  
Richard F. Berendt
Keyword(s):  
Rhesus Monkeys ◽  
Disseminated Intravascular Coagulopathy ◽  
Pneumococcal Sepsis ◽  
Intravascular Coagulopathy

scholarly journals Sepsis-induced digital ischaemia in a professional pianist, in the absence of vasopressors

2019 ◽  
Vol 12 (10) ◽  
pp. e229659
Author(s):  
Vishnu Kurup ◽  
R Scott Simpson
Keyword(s):  
Rapid Development ◽  
Treatment Options ◽  
Coagulation Factors ◽  
Sepsis Syndrome ◽  
Limb Ischaemia ◽  
Optimal Care ◽  
Disseminated Intravascular Coagulopathy ◽  
Pneumococcal Sepsis ◽  
Intravascular Coagulopathy ◽  
Digital Ischaemia

Peripheral limb ischaemia and gangrene are devastating complications of pneumococcal sepsis. We report a 43-year-old professional pianist who presented with early sepsis and rapid development of this syndrome. No vasopressor medication was ever administered. We urgently reviewed the medical literature on a range of therapies recommended by consulting teams, to ensure he received optimal care. Based on our review and on feedback from the patient himself, we gained valuable insights into this illness and the merits of selected treatment options. His fingers ultimately recovered their function, intact, although several toes were later amputated. More recently published reviews postulate that imbalances in coagulation factors and natural anticoagulants occur as a result of disseminated intravascular coagulopathy and ‘shock liver’ in the sepsis syndrome, leading to microcirculatory thromboses. We submit this report as we believe it supports this hypothesis and adds further valuable information. We hope our observations will assist other critical care clinicians confronting this serious condition.

scholarly journals Purpura Fulminans: a Rare but Fierce Presentation of Pneumococcal Sepsis

2019 ◽  
Author(s):  
Adeel Nasrullah ◽  
Anam Javed ◽  
Usman Tariq ◽  
Meilin Young ◽  
Zunera Moeen ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Purpura Fulminans ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Community Acquired Pneumonia ◽  
Rare Presentation ◽  
Disseminated Intravascular Coagulopathy ◽  
Intravascular Thrombosis ◽  
Pneumococcal Sepsis ◽  
Intravascular Coagulopathy

Infectious purpura fulminans (PF) is a rare presentation of disseminated intravascular coagulopathy (DIC) due to diffuse intravascular thrombosis and haemorrhagic infarction of the skin. PF can present in infancy/childhood or adulthood and usually presents as ecchymotic skin lesions, fever and hypotension. It is most commonly a consequence of sepsis related to Neisseria meningitidis, Streptococcus pneumoniae or Haemophilus influenzae. Despite aggressive management of sepsis with intravenous fluids, antibiotics, and conventional and nonconventional therapies, the condition still carries a mortality rate of 43%[1]. Streptococcus pneumoniae mostly presents with community-acquired pneumonia. We present a case of PF secondary to DIC related to Pneumococcal sepsis in an otherwise healthy and immunocompetent patient.

Disseminated Intravascular Coagulopathy in Critically Ill Patients in Amman, Jordan

2021 ◽  
pp. 109980042110172
Author(s):  
Eman Mahmoud Qasim Emleek ◽  
Amani Anwar Khalil
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Scoring System ◽  
Elevated Serum ◽  
Underlying Disease ◽  
Disseminated Intravascular Coagulopathy ◽  
Period Prevalence ◽  
Lower Baseline ◽  
Intravascular Coagulopathy

Background: The disseminated intravascular coagulation (DIC) is under-recognized in critically ill patients. The International Society of Thrombosis and Haemostasis (ISTH; DIC) provides a useful scoring system for accurate DIC identification. The study investigated the period prevalence of ISTH DIC from 2015 to 2017 in critically ill patients. Methods: In this multi-center, retrospective observational study, we included all patients identified with a DIC code or medically diagnosed with DIC during all admissions. Based on ISTH DIC scores ≥ 5, patients were classified with overt DIC. Results: A total of 220 patients were included in this study. The period prevalence of DIC was 4.45%. The point prevalence of DIC has increased from 3.49% to 5.58% from 2015 to 2017 (27.7% female; median age 61.6 years). Based on the ISTH-Overt DIC criteria, 45.2% of the sample had sepsis. Overt DIC patients had significantly lower baseline hemoglobin (HB; t = 2.137, df = 193, p = 0.034), platelet count ( t = 3.591, df = 193, p < 0.001) and elevated serum creatinine level ( M = 2.1, SD = 1.5, t = 2.203, df = 193, p = 0.029) compared to non–Overt DIC. There was a statistically significant elevation in FDPs among Overt DIC compared to non–Overt DIC (χ2 = 30.381, df = 1, p < 0.001). Overt DIC patients had significantly prolonged PT ( U = 2,298, z = 5.7, p < 0.001), PTT ( U = 2,334, z = 2.0, p = 0.045) and INR ( U = 2,541, z = 5.1, p < 0.001) compared to those with non–Overt DIC. Conclusion: The ISTH overt-DIC score can be used in critically ill patients regardless of the underlying disease. Efforts are required to predict and identify overt DIC using a valid scoring system on admission and follow-up of adult patients admitted to ICU.

Evaluation of obstetrical patients with disseminated intravascular coagulopathy – tertiary center experience

2015 ◽  
Vol 29 (18) ◽  
pp. 2929-2933 ◽  
Author(s):  
Serdar Başaranoğlu ◽  
Mehmet Sıddık Evsen ◽  
Elif Ağaçayak ◽  
Senem Yaman Tunç ◽  
Zülfikar Yılmaz ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulopathy ◽  
Tertiary Center ◽  
Intravascular Coagulopathy

scholarly journals Emergency Cardiac Surgery in Patients on Oral Anticoagulants

2021 ◽  
Author(s):  
Rami Akhrass ◽  
A. Marc Gillinov ◽  
Faisal Bakaeen ◽  
Scott Cameron ◽  
Jay Bishop ◽  
...  
Keyword(s):  
Circulatory Arrest ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Difficult Patient ◽  
Disseminated Intravascular Coagulopathy ◽  
Reversal Agents ◽  
Coagulation Profile ◽  
Intravascular Coagulopathy ◽  
Time To Onset ◽  
Case Basis

Emergency surgery, blood transfusion, and reoperation for bleeding have been associated with increased morbidity and mortality. Every effort is made to optimize patients preoperatively including cessation of oral anticoagulants in an attempt to normalize the coagulation profile. The recent explosive use of direct oral anticoagulants (DOACs) and antiplatelet medications has made the above more difficult. Cardiopulmonary bypass (CPB), with its associated fibrinolysis and platelet consumption, may exacerbate a pre-existing coagulopathy. In addition, the underlying surgical pathology, such as endocarditis accompanied by sepsis and disseminated intravascular coagulopathy (DIC) or aortic dissection requiring hypothermia and circulatory arrest, can aggravate an already challenged hematological profile. Ensuring a dry operative field upon entry by correcting the coagulopathy is offset by the concern of potentially hindering efforts to anticoagulate the patient in preparation for CPB, in addition to possibly creating a hypercoagulable state that could increase the risk of thromboembolic events. Management is challenging and decisions are typically made on a case-by-case basis. Surgery is delayed when possible and less invasive percutaneous options should be considered if feasible. If surgery is unavoidable, attention is paid to exercising meticulous techniques, avoiding excessive hypothermia, treating coexisting issues such as sepsis and correcting the coagulopathy with antidotes, reversal agents and blood products, with the understanding that a normal coagulation profile does not necessarily translate into hemostasis or the absence of thrombosis. Proper knowledge of the mechanism of action of the oral anticoagulants, available antidotes and their time to onset are essential in properly treating this difficult patient population.

Disseminated intravascular coagulopathy following fatal brown spider bite (necrotic arachnidism)

1972 ◽  
Vol 80 (6) ◽  
pp. 1035-1037 ◽  
Author(s):  
Hal Vorse ◽  
Paul Seccareccio ◽  
Kay Woodruff ◽  
G. Bennett Humphrey
Keyword(s):  
Disseminated Intravascular Coagulopathy ◽  
Intravascular Coagulopathy ◽  
Brown Spider ◽  
Spider Bite
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