Shock in Patients with Disseminated Intravascular Coagulation (DIC) : SYMPOSIUM ON TREATMENT OF SHOCK

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概要

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• Relationship between shock and disseminated intravascular coagulation (DIC) was investigated in 699 consecutive autopsied cases. The diagnosis of DIC was made when consumption coagulopathy was observed. Among these patients, 106 cases had evidences of DIC and 30 ones had clinical and pathological findings highly suggestive of DIC although the coagulation findings were nonspecific. Shock was complicated in 38 of the former and in 10 of the latter. In 32 of these 48 cases with shock coagulation abnormalities were observed simultaneously with or after the development of the shock. The most common underlying disease in these patients was gram-negative septicaemia, while shock in gram-positive septicaemia, gastrointestinal hemorrhage and myocardial infarction caused DIC less frequently. In the other 16 cases, about 70% of which was patients with metastatic cancer of the gastrointestinal or biliary tracts, shock developed after the diagnosis of DIC was established, although marked exaggeration of the coagulation findings was observed following the shock. Levels of factor XII and C3 in plasma decreased in DIC. Especially, depletion of factor XII was remarkable in cases with septic shock. The most important clinical symptom in patients with DIC associated with shock was acute renal failure. Administration of low does of heparin to DIC improved coagulation abnormalities frequently, however no beneficial effects on symptoms other than bleeding, i.e. acute renal failure, were observed. Examination of autopsy material showed that fibrin thrombi were present in about 70% of these cases. It is concluded that shock is frequently accompanied with DIC and the patients with shock should be treated with heparin as soon as possible whenever DIC was suspected.

• 社団法人日本循環器学会の論文
• 1977-05-20

著者

• Shimada Kaoru

  Tokyo Metropolitan Yoikuin Geriatrics Hospital

• Matsuda Tamotsu

  Tokyo Metropolitan Institute Of Gerontology

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• Shock in Patients with Disseminated Intravascular Coagulation (DIC) : SYMPOSIUM ON TREATMENT OF SHOCK

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