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1.
Rev. colomb. cardiol ; 28(4): 374-377, jul.-ago. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1351935

ABSTRACT

Resumen La coagulación intravascular diseminada es un proceso sistémico caracterizado por la activación generalizada de la coagulación, que tiene el potencial de causar trombosis vascular, hemorragia y falla orgánica. En raras ocasiones, las anomalías vasculares, como el aneurisma aórtico abdominal, pueden desencadenar coagulación intravascular diseminada crónica. Los aneurismas aórticos grandes, su disección y su expansión son factores de riesgo. En estos casos predominan los síntomas subclínicos y la coagulopatía solo se identifica mediante pruebas de laboratorio. Existe evidencia limitada basada en la experiencia de series de casos de coagulación intravascular diseminada crónica como complicación en pacientes con aneurisma aórtico abdominal. Además, la duración y la respuesta terapéutica a la heparina no se conocen bien, principalmente en los pacientes con manejo conservador. Se considera un desafío diagnóstico y terapéutico debido a la baja frecuencia de presentación. A continuación, se describen las características clínicas y paraclínicas, así como el tratamiento, de un paciente con aneurisma aórtico abdominal asociado con coagulación intravascular diseminada crónica.


Abstract Disseminated intravascular coagulation is a systemic process characterized by the widespread activation of coagulation with the potential for causing vascular thrombosis, hemorrhage and organ failure. Rarely, vascular anomalies like abdominal aortic aneurysm can trigger chronic disseminated intravascular coagulation. Large aortic aneurysms, dissection and expansion are risk factors. In these cases, subclinical symptoms predominate and coagulopathy is only identified by laboratory tests. Nowadays there is limited evidence based on experience from case series of chronic disseminated intravascular coagulation as complication in patients with abdominal aortic aneurysm. Furthermore, duration and therapeutic response with heparin therapy are not well known, mainly in those patients with conservative management. It is considered a diagnostic and therapeutic challenge due to the low presentation frequency. The clinical characteristics, laboratory and treatment of a patient with abdominal aortic aneurysm associated with chronic disseminated intravascular coagulation are described below.


Subject(s)
Humans , Aortic Aneurysm, Abdominal , Disseminated Intravascular Coagulation , Blood Coagulation , Risk Factors , Conservative Treatment
2.
Article in English | WPRIM | ID: wpr-879675

ABSTRACT

Throughout the past 2020, the pandemic COVID-19 has caused a big global shock, meanwhile it brought a great impact on the public health network. Trauma emergency system faced a giant challenge and how to manage trauma under the pandemic of COVID-19 was widely discussed. However, the trauma treatment of special population (geriatric patients and patients taking anticoagulant drugs) has received inadequate attention. Due to the high mortality following severe traumatic hemorrhage, hemostasis and trauma-induced coagulopathy are the important concerns in trauma treatment. Sepsis is another topic should not be ignored when we talking about trauma. COVID-19 itself is a special kind of sepsis, and it may even be called as serious systemic infection syndrome. Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma, or in intensive care and infection, etc. This article reviewed the research progress in areas including trauma emergency care, trauma bleeding and coagulation, geriatric trauma and basic research of trauma within 2020.


Subject(s)
COVID-19 , Community Networks , Disseminated Intravascular Coagulation/therapy , Emergency Medical Services , Female , Health Services for the Aged , Hemorrhage/therapy , Hemostasis , Humans , Male , Pandemics , Public Health , Sepsis/therapy , Time Factors , Trauma Centers , Wounds and Injuries/therapy
3.
Article in Spanish | LILACS, BINACIS | ID: biblio-1223884

ABSTRACT

La pandemia COVID-19 provocada por el betacoronavirus SARS-CoV-2 exige rápidas respuestas desde el campo de la medicina. El riesgo de tromboembolismo venoso y arterial está aumentado durante la infección, especialmente en pacientes críticos. En ese contexto se destaca una coagulopatía caracterizada por niveles elevados de dímero D, con tendencia a la falla multiorgánica, y aumento de la mortalidad. Esas anormalidades de la hemostasia responden a varios mecanismos que deben tenerse en cuenta para la toma de decisiones terapéuticas. Analizamos la evidencia científica disponible en la que se fundamenta el enfoque terapéutico de la coagulopatía descripta y sus complicaciones, con el objetivo de diseñar recomendaciones terapéuticas realistas tendientes a disminuir la morbilidad y la mortalidad en pacientes con COVID-19


The coronavirus disease 2019 (COVID-19) pandemic requires rapid medical responses. The risk of venous and arterial thromboembolism increases in critically ill patients with SARS-CoV-2 infection. There is a hypercoagulable state that includes elevated levels of D-dimer, with an increased risk of organ failure and increased mortality. The abnormalities described in hemostasis should be considered for therapeutic decision making. We analyzed the available scientific evidence for the therapeutic approach of coagulopathy in the course of the disease with the objective of designing realistic therapeutic recommendations aimed at reducing morbidity and mortality in patients with COVID-19


Subject(s)
Humans , Male , Female , Thromboembolism , Blood Coagulation Disorders , Cytokines , Coronavirus Infections , Coronavirus , Disseminated Intravascular Coagulation , Heparin
4.
Rev. cuba. hematol. inmunol. hemoter ; 36(4): e1214, oct.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289416

ABSTRACT

Introducción: La sepsis es un proceso patológico que se caracteriza por un estado inflamatorio desmesurado que puede generar coagulopatías graves como la coagulación intravascular diseminada. Esta coagulopatía se caracteriza principalmente por la exposición del factor tisular que activa la cascada de coagulación y genera un estado protrombótico que puede empeorar la falla orgánica. Objetivo: Analizar criterios diagnósticos e implicación terapéutica con el fin de mostrar una actualización en el abordaje de un paciente con coagulación intravascular diseminada y sepsis. Métodos: Se realizó una búsqueda de artículos en la base de datos PubMed, Science direct y Scielo, utilizando los siguientes descriptores: coagulopatía, sepsis, coagulación intravascular diseminada, criterios diagnósticos y tratamiento. Conclusión: Se ha encontrado una mejora en la mortalidad de los pacientes tratados con anticoagulantes como la proteína C, la antitrombina, entre otros, sin embargo, estos hallazgos no han logrado la trascendencia necesaria para ser recomendados en las guías de tratamiento de coagulación intravascular diseminada(AU)


Introduction: Sepsis is a pathological process characterized by inordinate inflammation which may cause severe coagulopathies, such as disseminated intravascular coagulation. This coagulopathy is mainly characterized by exposure of the tissue factor, activating the coagulation cascade and generating a prothrombotic state which may worsen organ failure. Objective: Analyze diagnostic criteria and therapeutic implications to present an update on the management of patients with disseminated intravascular coagulation and sepsis. Methods: A search was conducted for papers published in the databases PubMed, Science Direct and SciELO, using the search terms coagulopathy, sepsis, disseminated intravascular coagulation, diagnostic criteria and treatment. Conclusion: Improvement was observed in the mortality of patients treated with anticoagulants such as protein C and antithrombin, among others. However, these findings have not achieved the relevance required to be recommended for inclusion in the treatment guides for disseminated intravascular coagulation(AU)


Subject(s)
Humans , Disseminated Intravascular Coagulation/diagnosis , Disseminated Intravascular Coagulation/drug therapy , Sepsis/epidemiology
5.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 227-232, dic. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1145596

ABSTRACT

La enfermedad producida por el nuevo coronavirus SARS-CoV-2 se identificó por primera vez en diciembre de 2019 en la ciudad de Wuhan, en la República Popular China, y en pocos meses se convirtió en una pandemia. Desde el comienzo ha sido un desafío mundial, que amenazó la salud pública y obligó a tomar medidas estrictas de aislamiento social. Como consecuencia de la emergencia sanitaria se ha producido una reducción importante de la actividad asistencial, que puso en riesgo el acceso y la continuidad de los métodos anticonceptivos, exponiendo a mujeres a embarazos no intencionales. Los derechos sexuales y reproductivos resultan esenciales y deben garantizarse siempre. (AU)


The disease caused by the new coronavirus SARS-CoV-2 was identified for the first time in December 2019 in the city of Wuhan, in the People's Republic of China, and within a few months it became a pandemic. From the beginning, it has been a global challenge, threatening public health, having to take strict measures of social isolation. As a consequence of the health emergency, there has been a significant reduction in healthcare activity, putting access and continuity of contraceptive methods at risk, exposing women to unintended pregnancies. Sexual and reproductive rights are essential and must always be guaranteed. (AU)


Subject(s)
Humans , Female , Pneumonia, Viral/complications , Coronavirus Infections/complications , Hormonal Contraception/methods , Pneumonia, Viral/pathology , Pregnancy, Unwanted , Coronavirus Infections/pathology , Contraceptive Agents/administration & dosage , Contraceptive Agents/classification , Contraceptive Agents/supply & distribution , Reproductive Rights , Disseminated Intravascular Coagulation/etiology , Venous Thromboembolism/etiology , Pandemics , Betacoronavirus , Health Services Accessibility
7.
Medicina (B.Aires) ; 80(5): 505-511, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1287203

ABSTRACT

Resumen La pandemia COVID-19 provocada por el betacoronavirus SARS-CoV-2 exige rápidas respuestas desde el campo de la medicina. El riesgo de tromboembolismo venoso y arterial está aumentado durante la infección, especialmente en pacientes críticos. En ese contexto se destaca una coagulopatía caracterizada por niveles elevados de dímero D, con tendencia a la falla multiorgánica, y aumento de la mortalidad. Esas anormalidades de la hemostasia responden a varios mecanismos que deben tenerse en cuenta para la toma de decisiones terapéuticas. Analizamos la evidencia científica disponible en la que se fundamenta el enfoque terapéutico de la coagulopatía descripta y sus complicaciones, con el objetivo de diseñar recomendaciones terapéuticas realistas tendientes a disminuir la morbilidad y la mortalidad en pacientes con COVID-19.


Abstract The coronavirus disease 2019 (COVID-19) pandemic requires rapid medical responses. The risk of venous and arterial thromboembolism increases in critically ill patients with SARS-CoV-2 infection. There is a hypercoagulable state that includes elevated levels of D-dimer, with an increased risk of organ failure and increased mortality. The abnormalities described in hemostasis should be considered for therapeutic decision making. We analyzed the available scientific evidence for the therapeutic approach of coagulopathy in the course of the disease with the objective of designing realistic therapeutic recommendations aimed at reducing morbidity and mortality in patients with COVID-19.


Subject(s)
Humans , Pneumonia, Viral/blood , Thromboembolism/complications , Blood Coagulation Disorders/etiology , Coronavirus Infections/blood , Coronavirus , Pandemics , Argentina/epidemiology , Blood Coagulation Disorders/diagnosis , Blood Coagulation Disorders/prevention & control , Blood Coagulation Disorders/epidemiology , Cytokines , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Disseminated Intravascular Coagulation , Betacoronavirus , SARS-CoV-2 , COVID-19
8.
Rev. bras. anal. clin ; 52(2): 138-142, 20200630.
Article in Portuguese | LILACS | ID: biblio-1147024

ABSTRACT

A pandemia COVID-19 é uma emergência na sociedade atual, afetando países e suas populações em diversos níveis, bem como é uma ameaça a sistemas de saúde de todo o mundo. Compreender a relação entre os mecanismos fisiopatológicos da infecção pelo SARS-CoV-2 e o sistema de coagulação se tornou um importante instrumento para pesquisadores e trabalhadores das áreas da saúde no mundo inteiro, de modo que estratégias eficazes possam ser traçadas e seguidas para a recuperação de pacientes acometidos pela doença. O presente artigo caracteriza-se como uma revisão da literatura sobre a homeostasia na COVID-19 por meio da pesquisa e análise em bases de dados eletrônicas. Observou-se que a ocorrência de eventos trombóticos e alterações nos parâmetros da coagulação em pacientes com a COVID-19 é descrita em diversos estudos, e o uso de medicamentos anticoagulantes já é uma alternativa para a diminuição da letalidade do vírus em determinados casos. Além disso, o Dímero-D surge como um marcador do prognóstico da doença, sugerindo a ligação entre o estado hiper­coagulável da doença, decorrente da inflamação aguda, e sua taxa de letalidade.


COVID-19 pandemic is an emergency in current society, affecting the countries and their populations at different levels, as well as a threat to health systems around the world. Understanding the relationship between the pathophysiological mechanisms in SARS-CoV-2 infection and the coagulation system has become an important tool for researchers and healthcare workers worldwide so that effective strategies can be designed and followed for the recovery of patients affected by the disease. This article is characterized as a review on homeostasis in COVID-19 through research and analysis in electronic databases. It was observed that the occurrence of thrombotic events and changes in coagulation parameters in patients with COVID-19 has been described in several studies, and the use of anticoagulant drugs is already an alternative to reduce the lethality of the virus in certain cases. Also, D-Dimer appears as a marker of disease prognosis, suggesting the link between the hypercoagulable state of the disease, resulting from acute inflammation, and its lethality rate.


Subject(s)
Coronavirus Infections , Disseminated Intravascular Coagulation , Anticoagulants
9.
Rev. bras. anal. clin ; 52(2): 131-137, 20200630.
Article in Portuguese | LILACS | ID: biblio-1146823

ABSTRACT

A COVID-19 se manifesta principalmente como uma infecção do trato respiratório. Entretanto, uma enorme quantidade de estudos mostra características de uma enfermidade sistêmica com repercussões nos sistemas cardiovascular, respiratório, gastro­intestinal, neurológico, hematopoiético e imunológico. Os estudos realizados em vários centros de pesquisa na China, Europa e nos Estados Unidos indicam que os resultados laboratoriais podem fornecer à equipe clínica muitos marcadores prognósticos de grande utilidade. O impacto no sistema hematopoiético e na hemostasia é evidenciado por alterações importantes na quantidade de linfócitos, granulócitos e plaquetas além de alterações no processo de coagulação. Estes parâmetros podem ser monitorados e têm efeito prognóstico na evolução da doença podendo ajudar a identificar pacientes que necessitem de cuidados intensivos. Em resumo, a COVID-19 apresenta alterações importantes do sistema hematopoiético estando frequentemente associada a um estado de hipercoagulabilidade. A avaliação cuidadosa dos índices laboratoriais no início da doença e durante a evolução podem ajudar o corpo clínico a formular uma abordagem de tratamento adaptada à situação além de permitir atenção especial àqueles pacientes que apresentam maior necessidade.


COVID-19 manifests itself mainly as an infection of the respiratory tract. However, a huge number of studies show characteristics of a systemic disease with repercussions on the cardiovascular, respiratory, gastrointestinal, neurological, hematopoietic and immunological systems. Studies carried out in various research centers in China, Europe and the United States indicate that laboratory results can provide the clinical team with many useful prognostic markers. The impact on the hematopoietic system and hemostasis is evidenced by important changes in the amount of lymphocytes, granulocytes and platelets, in addition to changes in the coagulation process. These parameters can be monitored and have a prognostic effect on the evolution of the disease and can help to identify patients who need intensive care. In summary, COVID-19 presents important changes in the hematopoietic system and is frequently associated with a state of hypercoagulability. Careful assessment of laboratory indexes at the onset of the disease and during evolution can help the clinical staff to formulate a treatment approach adapted to the situation, in addition to allowing special attention to those most severe patients.


Subject(s)
Thrombocytopenia , Blood Cell Count , Blood Coagulation , Coronavirus Infections , Coronavirus , Severe Acute Respiratory Syndrome , Disseminated Intravascular Coagulation , Betacoronavirus , Leukopenia , Neutrophils
10.
J. vasc. bras ; 19: e20200107, 2020.
Article in Portuguese | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1135079

ABSTRACT

Resumo A Covid-19 é uma doença respiratória potencialmente grave causada pelo RNA vírus SARS-CoV-2, que apresenta risco aumentado de tromboembolismo venoso (TEV). Sua fisiopatologia está relacionada a processo inflamatório exacerbado e a coagulopatia associada, verificada pelo aumento do D-dímero, do fibrinogênio e dos produtos da degradação da fibrina. Sua ocorrência deve ser monitorada, prevenida e tratada de acordo com as recomendações e diretrizes existentes. Devido a sua associação com as formas mais graves da doença e morte, alguns grupos vêm propondo uma conduta profilática e terapêutica mais agressiva. Entretanto, não existe uma definição quanto ao risco-benefício desse tipo de conduta, devendo ser avaliada individualmente e de forma multidisciplinar. Neste estudo, revisamos os principais estudos e evidências disponíveis até o momento sobre o diagnóstico, profilaxia e recomendações de tratamento do TEV em pacientes COVID-19.


Abstract COVID-19 is a potentially serious respiratory disease caused by the SARS-CoV-2 virus that involves an increased risk of venous thromboembolism (VTE). Its pathophysiology is apparently related to an exacerbated inflammatory process and coagulopathy, verified by an increase in D-dimer, fibrinogen, and fibrin degradation products. Occurrence must be monitored, prevented, and treated according to existing recommendations and guidelines. The increased risk of thrombosis, and the association between this phenomenon and the most severe forms of the disease and death have prompted some groups to propose a more aggressive prophylactic and therapeutic approach. However, the risk-benefit profile of this type of conduct has not been defined and cases must be assessed individually, with a multidisciplinary approach. In this study, we review the main studies and evidence available to date on diagnosis, prophylaxis, and treatment of venous thromboembolism in COVID-19 patients.


Subject(s)
Thrombosis , Disseminated Intravascular Coagulation/prevention & control , Betacoronavirus , Anticoagulants , Coronavirus Infections
12.
Rev. chil. reumatol ; 36(4): 120-124, 2020. tab
Article in Spanish | LILACS | ID: biblio-1282555

ABSTRACT

La vida del mundo cambió como la conocíamos, desde diciembre de 2019, por una nueva pandemia viral, el "Coronavirus 2". Virus de alta contagiosidad y gravedad por el Síndrome Respiratorio Agudo Severo (SARS CoV-2) provocando alta morbimortalidad, desbordado las Unidades de Cuidados Intensivos del mundo, para atender a estos pacientes cuyo cuadro es primariamente respiratorio. Actualmente, además se enfrenta a una segunda amenaza, el aumento sustancial en comparación a otros pacientes hospitalizados (no COVID-19) de las complicaciones tromboembólicas.Esta publicación pretende realizar una revisión de la información actualizada disponible respecto a la epidemiología, fisiopatología y manejo de la enfermedad tromboembólica en pacientes con COVID-19 hospitalizados.


The life of the world changed as we knew it, since december 2019, due to a new viral pandemic, the "Coronavirus 2". Virus of high contagiousness and severity due to Severe Acute Respiratory Syndrome (SARS CoV-2) causing high morbidity and mortality, overwhelmed the Intensive Care Units of the world, to care for these patients whose primarily respiratory symptoms. Currently, it also faces a second threat, the substantial increase compared to other hospitalized patients (not COVID-19) of thromboembolic complications.This publication aims to review the updated information available regarding the epidemiology, pathophysiology, and management of thromboembolic disease in hospitalized COVID-19 patients.


Subject(s)
Humans , Thrombosis/drug therapy , COVID-19/drug therapy , Anticoagulants/therapeutic use , Thrombosis/physiopathology , Thrombosis/blood , Blood Coagulation/drug effects , Disseminated Intravascular Coagulation , COVID-19/complications , COVID-19/blood
14.
Article in Korean | WPRIM | ID: wpr-811440

ABSTRACT

A 64-year-old man was treated with sunitinib as a first-line therapy for metastatic renal cell carcinoma. He was given oral sunitinib in cycles of 50 mg once daily for 2 weeks followed by a week off. During the 5th week of treatment right upper quadrant pain developed, but this resolved spontaneously during the 6th week (off treatment). However, on the 8th week of treatment, he was admitted to hospital because the acute right upper quadrant pain recurred with nausea, vomiting, and fever. Acute acalculous cholecystitis was then diagnosed by ultrasonography and CT. In addition, his laboratory findings indicated disseminated intravascular coagulation. Accordingly, sunitinib therapy was discontinued and broad-spectrum antibiotics initiated. He subsequently recovered after emergent percutaneous cholecystostomy. His Naranjo Adverse Drug Reaction Probability Scale score was 7, indicaing a probable association of the event with sunitinib. Suspicion of sunitinib-related acute cholecystitis is required, because, although uncommon, it can be life-threatening.


Subject(s)
Acalculous Cholecystitis , Anti-Bacterial Agents , Carcinoma, Renal Cell , Cholecystitis, Acute , Cholecystostomy , Disseminated Intravascular Coagulation , Drug-Related Side Effects and Adverse Reactions , Fever , Humans , Middle Aged , Nausea , Ultrasonography , Vomiting
16.
Article in English | WPRIM | ID: wpr-827417

ABSTRACT

In the clinical settings, disseminated intravascular coagulation (DIC) and complications such as hemorrhage are commonly seen in acute promyelocytic leukemia patients, whereas thrombosis is rarely reported. We reported a case here that the patient presented with cerebral infarction as the first manifestation. During the admission, the patient encountered differentiation syndrome, pulmonary embolism, pulmonary hemorrhage, and myocardial ischemia, as well as bleeding and thrombosis complications. Hence the patient was diagnosed as DIC. After the treatment of blood transfusion instead of anticoagulation, his condition was stable and the remission was completely achieved. The treatment experience provides guides for other patients with similar complications of simultaneous bleeding and thrombosis.


Subject(s)
Blood Coagulation , Cerebral Infarction , Disseminated Intravascular Coagulation , Humans , Leukemia, Promyelocytic, Acute , Thrombosis
17.
Gac. méd. boliv ; 42(2): 172-175, dic. 2019. ilus., tab.
Article in Spanish | LILACS | ID: biblio-1293198

ABSTRACT

El feto papiráceo es un feto aplanado y momificado, sin cambios externos, se presenta en embarazo gemelar o múltiple, es de causa desconocida. Las causas de muerte ipueden ser fetales, ovulares y materna. Complicaciones: en la madre es coagulación intravascular diseminada y en el feto sobreviviente puede presentar Aplasia Cutánea Csongénita, disgenesia renal y atresia intestinal. Paciente de 42 años, con embarazo de 38 semanas, cesárea iterativa, diabetes gestacional no controlada, se realiza un manejo conservador con ecografías seriadas y control de laboratorio. Para la culminación del embarazo: cesárea bajo anestesia raquídea, recién nacido de sexo masculino, alumbramiento de placenta más feto papiráceo. En conclusión, manejo individual con control ecográfico seriado del feto sobreviviente, realizar ecografía Doppler, medir el volumen del líquido amniótico, perfil biofísico y control de los factores de riesgo modificables materno, para tomar una conducta optima y adecuada para la culminación del embarazo


The papyraceus fetus is a flat and mummified fetus, without external changes, it occurs in twin or multiple pregnancy, of unknown cause. Intrauterine death both fetal, ovular and maternal. Complications: in the mother it is disseminated intravascular coagulation and in the surviving fetus may present Congenital Cutaneous Aplasia, renal dysgenesis and intestinal atresia. A 42-year-old patient, with a 38-week pregnancy, iterative cesarean section, uncontrolled gestational diabetes, conservative management with serial ultrasound and laboratory control. For the culmination of pregnancy: caesarean section under spinal anesthesia, male newborn, delivery of placenta plus papiraceous fetus. In conclusion, individual management with serial ultrasound control of the surviving fetus, perform Doppler ultrasound, measure the volume of amniotic fluid, biophysical profile and control of maternal modifiable risk factors, to take an optimal and adequate behavior for the culmination of pregnancy


Subject(s)
Humans , Pregnancy , Adult , Fetal Death , Pregnancy, Twin , Disseminated Intravascular Coagulation
18.
Rev. cuba. obstet. ginecol ; 45(1): 25-36, ene.-mar. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093620

ABSTRACT

Introducción: La hemorragia obstétrica es una de las complicaciones más temidas y una de las principales causas de mortalidad materna. Objetivo: Caracterizar la hemorragia obstétrica en el servicio de Anestesiología y Reanimación del Hospital Dr. Agostinho Neto de Guantánamo. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo en el mencionado servicio de salud desde 2015 - hasta 2017. De un universo de 388 pacientes que tuvieron diagnóstico de morbilidad materna extremadamente grave, la muestra quedó constituida por las diagnosticadas con hemorragia obstétrica (n= 71). Para el procesamiento estadístico se utilizó el porcentaje, la media y la desviación estándar. Resultados: La hemorragia obstétrica se precisó en 18,2 por ciento de las pacientes; de ellas, 0,7 por ciento fallecieron. La edad media de las pacientes fue de 24,2 ± 6,2 años. La edad gestacional fue de 34,2 ± 6,2 años y la estadía en días fue de 5,9 ± 4,2 [IC 95 por ciento 5,3 - 6,5]. La atonía uterina (50,8 por ciento) fue la causa más común de la hemorragia. El 91,5 por ciento de las pacientes presentó inestabilidad hemodinámica, lo que condicionó el uso de altos volúmenes de fluidos y hemoderivados para su reanimación. La coagulación intravascular diseminada fue la causa de muerte fundamental. Conclusiones: La hemorragia obstétrica continúa una causa importante de morbilidad y mortalidad en el mencionado servicio de salud(AU)


Introduction: Obstetric hemorrhage is one of the feared complications and it is one of the main causes of maternal mortality. Objective: To characterize obstetric hemorrhage in the service of Anesthesiology and Reanimation at Dr. Agostinho Neto Hospital in Guantanamo, Cuba from 2015 to 2017. Methods: A descriptive, longitudinal and prospective study was carried out in the aforementioned health service from 2015 to 2017. Three hundred eighty eight (388) patients that had diagnostic of extremely serious maternal morbidity were the universe of this study. The sample was constituted by those diagnosed with obstetric hemorrhage (n = 71). Percentage, mean and standard deviation were used for the statistical analysis. Results: Obstetric hemorrhage occurred in 18.2 percent of the patients. 0.7 percent died. The mean age was of 24.2 ± 6.2 years; the pregnancies age was of 34.2 ± 6.2 years and hospital stay was of 5.9 ± 4.2 [IC 95 percentage 5.3 - 6.5]. Uterine atony (50.8 percent) was the most common cause of the hemorrhage. 91.5 percent of the patients had hemodynamic unsteadiness that conditioned the use of high volumes of fluids and hemoderivates for reanimation. Clotting intravascular was the main cause of death. Conclusions: Obstetric hemorrhage constitutes an important cause of morbidity and mortality in the mentioned health service(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications, Cardiovascular/blood , Shock/complications , Disseminated Intravascular Coagulation/drug therapy , Hysterectomy/methods , Epidemiology, Descriptive , Prospective Studies , Longitudinal Studies , Anesthesiology/methods
19.
Article in Chinese | WPRIM | ID: wpr-771903

ABSTRACT

OBJECTIVE@#To analyze the 5 experimental indexes of CDSS in the patients with acute leukemia (AL) so as to provide the laboratorial basis for the early diagnosis and treatment of the secondary DIC in AL.@*METHODS@#Three hundred and thirty three patients with AL were divided into 7 groups, such as AML-M1-M5, other AML and ALL. The experimental indexes and CDSS scores of all AL groups were compared and analyzed in pairs, meanwhile 100 healthy persons were taken in the control group. Clinical events such as early death in all cases were also analyzed.@*RESULTS@#The highest positive rate of Platelet was 59.76%, among the 5 experimental indexes, followed by D-D (30.93%), and the lowest APTT with only 2.70%. Compared with the control group, the differences of remaining indexes were statistically significant (P<0.01), except APTT in group AML-M3 and FIB in the other AML groups. The score of laboratory index was (1.50±1.51) in all AL patients, and the positive rate of overt DIC ( score≥4) was 14.11% ( 47 cases). The highest score of CDSS was (3.34 ±1.71) in group AML-M3. The difference in the incidence of early death and cerebral (pulmonary) hemorrhage in DIC patients were statistically significant (P<0.05 and P<0.01).@*CONCLUSION@#The application of quantitative integral method of experimental indexes in CDSS is objective and feasible, which is of great significance for early diagnosis and early treatment of acute leukemia complicated with DIC.


Subject(s)
Acute Disease , Disseminated Intravascular Coagulation , Hemorrhage , Humans , Leukemia, Myeloid, Acute , Leukemia, Promyelocytic, Acute
20.
Article in English | WPRIM | ID: wpr-760666

ABSTRACT

Placental abruption is a condition that should be carefully considered in perinatal management because it is associated with serious events in both the mother and neonate, such as intrauterine fetal death, cerebral palsy, obstetric critical bleeding, and uncontrollable bleeding. The concomitant presence of disseminated intravascular coagulation (DIC) more easily causes critical bleeding that may necessitate hysterectomy or multi-organ failure resulting in maternal death. Therefore, early management should be provided to prevent progression to serious conditions by performing both hemostatic procedures and DIC treatment. To take measures to improve the outcomes in both the mother and neonate, health guidance for pregnant women, early diagnosis, early treatment, development of the emergency care system, and provision of a system for transport to higher-level medical institutions should be implemented.


Subject(s)
Abruptio Placentae , Cerebral Palsy , Dacarbazine , Disseminated Intravascular Coagulation , Early Diagnosis , Emergency Medical Services , Female , Fetal Death , Fibrinogen , Hemorrhage , Humans , Hysterectomy , Infant, Newborn , Maternal Death , Mothers , Obstetric Surgical Procedures , Pregnancy , Pregnant Women
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