Related Experiment Videos
D-dimer as marker for microcirculatory failure: correlation with LOD and APACHE II scores
Matthias W A Angstwurm1, Armin J Reininger, Michael Spannagl
1Medizinische Klinik, Universitat Munchen, Ziemssenstr.1, 80336 Munich, Germany. angstwurm@medinn.med.uni-munchen.de
Thrombosis Research
|July 1, 2004
Summary
Plasma d-dimer levels indicate disease severity and organ dysfunction in critically ill patients, particularly those with circulatory issues or infections. Elevated levels may reflect microcirculatory failure, aiding treatment monitoring.
Area of Science:
- Critical Care Medicine
- Hematology
- Biomarker Discovery
Background:
- The prognostic value of plasma d-dimer levels in critically ill patients remains unclear.
- D-dimer is a fibrin degradation product, often elevated in thrombotic conditions.
Purpose of the Study:
- To investigate the association between plasma d-dimer levels and morbidity/organ dysfunction in severely ill patients.
- To explore d-dimer as a potential marker for microcirculatory failure.
Main Methods:
- Prospective study of 800 unselected intensive care unit patients.
- Measurement of plasma d-dimer levels at admission.
- Correlation analysis with APACHE II and Logistic Organ Dysfunction (LOD) scores.
Main Results:
- 91% of patients had elevated d-dimer levels, with some significantly higher than normal.
- Highest d-dimer levels were observed in patients with thromboembolic diseases, especially non-survivors of pulmonary embolism.
- Significant correlations found between d-dimer and APACHE II scores in patients with circulatory impairment (r=0.794) and infections (r=0.487).
- D-dimer correlated with LOD score in patients with circulatory impairment (r=0.474) but not in others.
- No correlation between d-dimer and single organ failure or infection indicators when all patients were considered.
Conclusions:
- Plasma d-dimer levels correlate strongly with disease severity and organ dysfunction in patients with circulatory impairment or infections.
- Elevated d-dimer may indicate the extent of microcirculatory failure.
- D-dimer levels could potentially monitor therapeutic strategies aimed at improving microcirculation.