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13:08
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Disseminated intravascular coagulation and coagulation disorders
1Department of Medicine, University Hospital of Mannheim, Mannheim, Germany. carl-erik.dempfle@med.ma.uni-heidelberg.de
Current Opinion in Anaesthesiology
|October 6, 2006
Summary
Disseminated intravascular coagulation (DIC) involves massive coagulation activation. Drotrecogin alpha (activated) improves survival in severe sepsis patients with or without DIC, unlike other treatments.
Area of Science:
- Hematology
- Critical Care Medicine
- Pathophysiology
Background:
- Disseminated intravascular coagulation (DIC) is a complex syndrome characterized by widespread coagulation activation and consumption of clotting factors.
- Clinical presentations include consumption coagulopathy, sepsis-induced purpura fulminans, and viral hemorrhagic fevers.
- Current diagnostic scoring systems lack specificity for differentiating asymptomatic DIC, consumption coagulopathy, and thrombotic syndromes.
Purpose of the Study:
- To provide an update on recent advancements in the diagnosis and treatment of disseminated intravascular coagulation (DIC).
- To review current understanding of DIC pathophysiology and clinical manifestations.
- To evaluate the efficacy of novel therapeutic agents in managing DIC and associated conditions.
Main Methods:
- Review of recent literature on disseminated intravascular coagulation (DIC) diagnosis and treatment.
- Analysis of clinical trial data for agents like drotrecogin alpha (activated), tifacogin, and antithrombin.
- Examination of laboratory findings and clinical syndromes associated with DIC, including sepsis-induced purpura fulminans and viral hemorrhagic fevers.
Main Results:
- Disseminated intravascular coagulation (DIC) is marked by laboratory evidence of intense coagulation activation and depleted procoagulant factors.
- Drotrecogin alpha (activated) demonstrated a mortality benefit in severe sepsis patients, irrespective of DIC status, and is indicated for sepsis-induced purpura fulminans.
- Factor V Leiden mutation may confer a survival advantage in severe sepsis, suggesting a potential benefit from enhanced coagulation activation in this context.
Conclusions:
- Drotrecogin alpha (activated) offers improved survival chances for severe sepsis patients, with or without disseminated intravascular coagulation (DIC).
- Antithrombin and tifacogin have not shown significant benefits in improving clinical outcomes for severe sepsis.
- Further research is needed to refine diagnostic criteria and therapeutic strategies for various DIC presentations.
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