الفهرس | Only 14 pages are availabe for public view |
Abstract Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by the intravascular activation of coagulation with loss of localization arising from different causes. It can originate from and cause damage to the microvasculature, which if sufficiently severe, can produce organ dysfunction. In sepsis, burn injury, trauma, malignancy and major surgery, blood and vascular endothelial cells are activated by various stimuli and chemical mediators such as inflammatory cytokines produced by activated leukocytes. It has become apparent that thrombin generation in DIC is exclusively mediated by the extrinsic (factor VIIa) pathway. In DIC, thrombin formation is excessive, uncontrolled, and overcomes the factors which normally inhibit thrombin generation. As DIC continues, fibrinogen, prothrombin, platelets, and other clotting factors are consumed beyond the capacity of the body to compensate, and bleeding ensues |