Title |
Assessment of Haemostasis in Disseminated Intravascular Coagulation by Use of Point-of-Care Assays and Routine Coagulation Tests, in Critically Ill Patients; A Prospective Observational Study
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Published in |
PLOS ONE, March 2016
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DOI | 10.1371/journal.pone.0151202 |
Pubmed ID | |
Authors |
Thomas Kander, Anna Larsson, Victor Taune, Ulf Schött, Nahreen Tynngård |
Abstract |
Disseminated intravascular coagulopathy (DIC) relates to the consumption of coagulation factors and platelets with bleeding and micro thrombosis events. The aim of this study was to compare haemostasis parameters in critically ill patients with DIC versus patients without DIC, and in survivors versus non-survivors over time. Correlations between the DIC-score, the degree of organ failure and the haemostasis were assessed. Patients admitted to the intensive care unit with a condition known to be associated with DIC and with an expected length of stay of >3 days were included. Routine laboratory tests, prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen concentration and D-dimer were measured. Coagulation and platelet function were assessed with two point-of-care devices; Multiplate and ROTEM. DIC scores were calculated according to the International Society on Thrombosis and Haemostasis and Japanese Association for Acute Medicine. Blood was sampled on days 0-1, 2-3 and 4-10 from 136 patients with mixed diagnoses during 290 sampling events. The point-of-care assays indicated a hypocoagulative response (decreased platelet aggregation and reduced clot strength) in patients with DIC and, over time, in non-survivors compared to survivors. Patients with DIC as well as non-survivors had decreased fibrinolysis as shown by ROTEM. DIC scores were higher in non-survivors than in survivors. Patients with DIC displayed signs of a hypocoagulative response and impaired fibrinolysis, which was also evident over time in non-survivors. Patients with DIC had a higher mortality rate than non-DIC patients, and DIC scores were higher in non-survivors than in survivors. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 46 | 100% |
Demographic breakdown
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Student > Doctoral Student | 6 | 13% |
Student > Postgraduate | 5 | 11% |
Other | 4 | 9% |
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Unknown | 9 | 20% |
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Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
Veterinary Science and Veterinary Medicine | 2 | 4% |
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Other | 3 | 7% |
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