Disseminated intravascular coagulation in burned patients

W. F. McManus, K. Eurenius, Basil A Pruitt

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Abstract

Burned patients have supranormal in vitro clotting activity, and may develop the syndrome of disseminated intravascular coagulation (DIC) coincident with septicemia or hypotension. This syndrome was observed in five patients. In each, the diagnosis was clinically suspected because of sudden diffuse hemorrhage, and was confirmed by laboratory evidence of consumption of fibrinogen, platelets, and Factor VIII activity, intravascular hemolysis, secondary fibrinolysis, and biopsy evidence of microthrombi in unburned skin. In this population, hypofibrinogenemia was the most reliable indicator of DIC. Thrombocytopenia, although present, was not limited to patients with DIC, and also occurred in patients dying with infection. In each patient with DIC, treatment with intravenous heparin reversed consumptive changes, decreased fibrinolysis, and produced clinical hemostasis. One patient survived. In three of four patients who died, premature reduction in anticoagulant therapy resulted in renewed consumption. Effective anticoagulation in such patients is best indicated by an increase in fibrinogen concentration and a decrease in fibrin degradation product titers. Serial determinations of these changes provide a reliable index upon which modifications of anticoagulant therapy are based.

Original languageEnglish (US)
Pages (from-to)416-422
Number of pages7
JournalJournal of Trauma
Volume13
Issue number5
StatePublished - 1973

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Disseminated Intravascular Coagulation
Fibrinolysis
Anticoagulants
Fibrinogen
Fibrin Fibrinogen Degradation Products
Factor VIII
Hemolysis
Hemostasis
Thrombocytopenia
Hypotension
Heparin
Sepsis
Therapeutics
Blood Platelets
Hemorrhage
Biopsy
Skin
Infection

ASJC Scopus subject areas

  • Surgery

Cite this

McManus, W. F., Eurenius, K., & Pruitt, B. A. (1973). Disseminated intravascular coagulation in burned patients. Journal of Trauma, 13(5), 416-422.

Disseminated intravascular coagulation in burned patients. / McManus, W. F.; Eurenius, K.; Pruitt, Basil A.

In: Journal of Trauma, Vol. 13, No. 5, 1973, p. 416-422.

Research output: Contribution to journalArticle

McManus, WF, Eurenius, K & Pruitt, BA 1973, 'Disseminated intravascular coagulation in burned patients', Journal of Trauma, vol. 13, no. 5, pp. 416-422.
McManus WF, Eurenius K, Pruitt BA. Disseminated intravascular coagulation in burned patients. Journal of Trauma. 1973;13(5):416-422.
McManus, W. F. ; Eurenius, K. ; Pruitt, Basil A. / Disseminated intravascular coagulation in burned patients. In: Journal of Trauma. 1973 ; Vol. 13, No. 5. pp. 416-422.
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