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Related Experiment Video

Updated: Jan 23, 2026

Application of Hemostatic Devices in Laparoscopic Hepatectomy

Application of Hemostatic Devices in Laparoscopic Hepatectomy

Published on: April 19, 2022

Hemostatic function in hyperfibrinolytic disseminated intravascular coagulation.

Takashi Ishihara¹, Keiji Nogami¹, Tomoko Onishi¹

¹Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society

|June 23, 2019

Summary

Disseminated intravascular coagulation (DIC) involves complex global hemostatic changes. Thrombin and plasmin generation assays reveal sustained coagulation and fibrinolysis in acute myeloid leukemia-associated DIC, aiding diagnosis.

Keywords:

acute myeloid leukemia clot fibrinolysis waveform analysis disseminated intravascular coagulation rotational thromboelastometry thrombin and plasmin generation assay

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Area of Science:

Hematology
Oncology
Clinical Diagnostics

Background:

Disseminated intravascular coagulation (DIC) pathogenesis and diagnostic criteria remain incompletely understood.
Global hemostatic mechanisms in DIC require further elucidation.
Limited diagnostic tools exist for assessing overall hemostatic function in DIC.

Observation:

Dynamic global hemostatic changes were assessed using thrombin and plasmin generation assay (T/P-GA), clot fibrinolytic waveform analysis (CFWA), and non-activated rotational thromboelastometry (NATEM).
A patient with acute myeloid leukemia (AML)-associated DIC exhibited an elevated inverse plasmin lag time (P-LT) ratio and shortened fibrinolysis lag time (FLT), indicating enhanced fibrinolysis.
Coagulation activation was linked to intravascular tissue factor (TF) release, evidenced by normalized clotting time with anti-TF antibody treatment during severe epistaxis.

Findings:

The inverse P-LT ratio was significantly reduced after tranexamic acid (TXA) treatment.
Enhanced fibrinolysis was confirmed by a significantly shorter FLT compared to controls.
T/P-GA provided quantitative data superior to conventional assays for evaluating DIC hemostasis.

Implications:

Intravascular TF release drives sustained coagulation and fibrinolytic activity in AML-associated DIC.
T/P-GA offers a valuable tool for quantitative assessment of global hemostasis in complex DIC cases.
Improved understanding of DIC mechanisms can lead to refined diagnostic strategies and therapeutic interventions.