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Studies on the effects of primary therapy for DIC following circulatory arrest
Insights
Early treatment for disseminated intravascular coagulation (DIC) in dogs showed better results with FOY (gabexate mesilate) and FUT-175 (nafamostat mesilate) compared to heparin. These anticoagulants helped maintain platelet and antithrombin-III levels, crucial for managing DIC.
Area of Science:
- Cardiovascular Research
- Hematology
- Pharmacology
Background:
- Disseminated intravascular coagulation (DIC) is a severe complication following circulatory arrest.
- Early intervention is critical for managing DIC and improving patient outcomes.
- Heparin has been a traditional treatment, but newer agents are being explored.
Purpose of the Study:
- To compare the efficacy of early treatment for DIC induced by circulatory arrest in dogs.
- To evaluate heparin, FOY (gabexate mesilate), and FUT-175 (nafamostat mesilate) in managing DIC parameters.
Main Methods:
- Three groups of dogs were studied following induced circulatory arrest.
- Treatments administered included heparin, FOY (gabexate mesilate), and FUT-175 (nafamostat mesilate).
- Key parameters monitored: platelet count, prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen, antithrombin-III (AT-III), and fibrin/fibrinogen degradation products (FDP).
Main Results:
- Heparin group showed less drop in platelets and AT-III but similar FDP levels compared to controls.
- FOY group maintained normal PT, APTT, platelet, and AT-III levels, with normal FDP.
- FUT-175 group demonstrated prolonged APTT, preserved platelet and AT-III levels, and normal FDP.
Conclusions:
- Early treatment for DIC is crucial for effective management.
- FOY (gabexate mesilate) and FUT-175 (nafamostat mesilate) demonstrated superior efficacy over heparin in preserving key coagulation parameters.
- These findings support the use of gabexate mesilate and nafamostat mesilate as potentially more effective treatments for DIC.
Abstract:
Comparative studies in early treatment for DIC caused by circulatory arrest were carried out on three groups of dogs during 300 min from the recovery of circulatory arrest: a heparin group, a FOY (gabexate mesilate) group, and a FUT-175 (nafamostat mesilate) group. The parameters employed were platelet count, prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen, antithrombin-III (AT-III), and fibrin or fibrinogen degradation products (FDP). In the heparin group, there was less of a drop in the platelet count and the level of AT-III than in the control group, but the FDP levels were the same as in the control group. The PT and APTT remained within normal limits in the FOY group and no decrease was observed in either platelet count or AT-III levels. In addition, FDP levels were kept within normal limits. In the FUT-175 group, prolongation of APTT, no decline in the platelet count and AT-III levels, and normal levels of FDP were observed. The results of these experiments indicate the importance of early treatment for DIC. Judging from the parameters, better results were obtained in the FOY and FUT-175 group than in the heparin group.