[Recognition of the disseminated intravascular coagulation syndrome: methodology and expert assessment]

Basing on the results of follow-up of 700 patients suffering from various forms of this syndrome (DIC syndrome), the authors have developed an algorithm and criteria for the expert evaluation of the diagnostic evidence of this condition with specification of the confidence measures for E. Shortliffe's equation. The major classes of evidence have been distinguished, including the causes and clinical situations leading to the development of the DIC syndrome (class A); manifestations of the syndrome--microcirculation blocking, organ ischemias and dysfunctions, thrombohemorrhages, etc. (class B); laboratory findings (class C), the most informative and easily available being: various shifts of different coagulation tests, eventuating in deep hypocoagulation in acute cases, abnormal blood platelet and fibrinogen levels, detection of soluble fibrin-monomer complexes and noncoagulating fibrinogen in the blood serum in the test with Echis carinatus venom, positive staphylococcal clumping test and increased level of fibrinogen degradation products in the plasma, the red cell injury phenomenon, reduced levels of antithrŏmbin III and plasminogen, intensive elimination of platelet factor 4 and beta-thromboglobulin into the plasma. Complexes of laboratory tests (up to 4-5) have been singled out, that help diagnose the disease with an accuracy of 90-97.5%, particularly as regards classes A and B evidence.