Usefulness of the APTT waveform for the diagnosis of DIC and prediction of the outcome or bleeding risk

Thrombosis Journal

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[1] 0000 0004 0372 555X, grid.260026.0, Central laboratory, Mie University Graduate School of Medicine, Tsu, Mie, Japan;0000 0004 0372 555X, grid.260026.0, Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Mie, Japan;0000 0004 0372 555X, grid.260026.0, Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, 514-8507, Tsu, Mie, Japan;0000 0004 0372 555X, grid.260026.0, Division of Blood Transfusion Medicine and Cell Therapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan;0000 0004 0372 555X, grid.260026.0, Emergency Critical Care Center, Mie University Graduate School of Medicine, Tsu, Mie, Japan;0000 0004 1762 2738, grid.258269.2, Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan;

关键词: APTT waveform;    Hypofibrinogenemia;    Bleeding;    Outcome;   

DOI  :  10.1186/s12959-019-0201-0

来源: publisher

【 摘 要 】

BackgroundThe usefulness of the activated partial thromboplastin time (APTT) waveform has been reported in hemophilia, acquired hemophilia and monitoring for anticoagulants.Material and methodsThe APTT waveform was examined in patients suspected of having disseminated intravascular coagulation (DIC) to analyze its usefulness for the diagnosis of DIC or the prediction of the outcome or bleeding risk.ResultsDIC with fibrinogen < 2 g/L was frequently associated with infectious diseases (43.3%). The heights of the first derivative peak (1stDP) and second DP (2ndDP) were extremely low in DIC, especially DIC with hypofibrinogenemia, but high in infectious patients without DIC. The peak time and width of the 1stDP and 2ndDP were prolonged in patients with DIC. The heights of the 1stDP and 2ndDP were markedly low in patients with a poor outcome or those with hemoglobin < 8.0 g/dl.Discussion and conclusionAs bleeding type DIC was observed in infectious DIC, DIC without hypofibrinogenemia might switch to DIC with hypofibrinogenemia by the progression of DIC. The height of the 1stDP and 2ndDP is useful for the diagnosis of DIC and prediction of the bleeding risk or outcome.

【 授权许可】

CC BY