The significance of immediate coagulation monitoring during the treatment for DIC / 解放军医学杂志

ABSTRACT

Objective To explore the value of application of immediate coagulation monitor, with the use of Sonoclot analyzer in the treatment of disseminated intravascular coagulation (DIC). Methods Two hundred and thirty-seven DIC patients were randomly divided into Sonoclot group (n=116, guided by Sonoclot analyzer) and control group (n=121, guided by traditional coagulation indexes) according to the principle of random number. The type, dose and duration of replacement treatment, and the outcomes such as complication rate, ICU stay and 30-day survival rate were recorded and compared. Results There were no difference in the demographic data between two groups (P>0.05). In Sonoclot group, the ratio of heparin used was much higher, though with shorter duration and lower dose than those in control group (P<0.05). The regional bleeding rate was significantly lower in Sonoclot group than that of control group (P<0.05). The replacement doses of the fresh frozen plasma, PLT, and cryoprecipitate were also much lower in the Sonoclot treatment group (P<0.05). A shorter ICU stay was found in the Sonoclot group (P<0.05). In sonoclot group the prognosis was significantly improved as shown by Kaplan-Meier analysis curve (P<0.05). Conclusions Sonoclot analysis is helpful in choosing rational blood products and necessary dosage. It is also useful for effectively guiding anticoagulant therapy in order to reduce the bleeding risk and mortality rate in DIC patients.