scholarly journals The anticoagulant treatment for sepsis induced disseminated intravascular coagulation; network meta-analysis

2018 ◽  
Vol 171 ◽  
pp. 136-142 ◽  
Author(s):  
Tomoaki Yatabe ◽  
Shigeaki Inoue ◽  
So Sakamoto ◽  
Yuka Sumi ◽  
Osamu Nishida ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Meta Analysis ◽  
Anticoagulant Treatment ◽  
Intravascular Coagulation

scholarly journals Prognostic accuracy of different disseminated intravascular coagulation criteria in critically ill adult patients: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024878
Author(s):  
Jumpei Yoshimura ◽  
Kazuma Yamakawa ◽  
Akira Kodate ◽  
Mari Kodate ◽  
Satoshi Fujimi
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Critically Ill ◽  
Disseminated Intravascular Coagulation ◽  
Scoring System ◽  
Meta Analysis ◽  
Adult Patients ◽  
Intravascular Coagulation ◽  
Operating Points ◽  
Receiver Operating

IntroductionDisseminated intravascular coagulation (DIC) is a common and serious condition that can lead to poor outcomes in critically ill patients. To make a correct diagnosis and improve the outcome of patients with DIC, several organisations have put forward DIC scoring systems. However, which criteria is the best to use for diagnosing DIC remains a continuing controversy even though many studies have been conducted to validate the diagnostic accuracy of each DIC scoring system.Methods and analysisWe will conduct a systematic review and meta-analysis of the diagnostic accuracy of DIC criteria for the prediction of mortality in critically ill adult patients. The primary objective is to assess the predictive values of the DIC criteria of Japanese Association for Acute Medicine, International Society on Thrombosis and Haemostasis, Japanese Ministry of Health and Welfare, Korean Society on Thrombosis and Hemostasis and Chinese Diagnostic Scoring System for 28-day mortality. We will search electronic bibliographic databases such as MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials. Two reviewers will independently screen titles and abstracts, perform full article reviews and extract study data. We will report study characteristics and assess methodological quality using the Quality of Diagnostic Accuracy Studies-II tool. If pooling is appropriate, we will compute parameter estimates using bivariate random-effects and hierarchical summary receiver operating characteristic models to produce summary receiver operating curves, summary operating points (pooled sensitivity and specificity) and 95% confidence regions around the summary operating points. Clinical and methodological subgroup and sensitivity analyses will be performed to explore heterogeneity.Ethics and disseminationThis systematic review will help physicians diagnose DIC accurately and improve their clinical practice in critically ill settings. Approval from an ethics committee is not required. The findings will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42017079350.

Thrombin Does Not Alter Vascular Hyporeactivity in Models of Endotoxin-Induced Septic Shock in Rats

1995 ◽  
Vol 88 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Viviane Martin ◽  
Marie-Louise Wiesel ◽  
Anne Albert ◽  
Alain Beretz
Keyword(s):  
Nitric Oxide ◽  
Disseminated Intravascular Coagulation ◽  
Vascular Tone ◽  
Endotoxic Shock ◽  
Vascular Wall ◽  
Anticoagulant Treatment ◽  
Intravascular Coagulation ◽  
Vascular Hyporeactivity

1. Hypotension and vascular hyporesponsiveness to vasoconstrictors are observed during endotoxic shock, and are associated with increased production of nitric oxide in the vascular wall. Disseminated intravascular coagulation is another feature of septicaemia. We hypothesized that thrombin generated during disseminated intravascular coagulation might modulate the changes in vascular tone induced by endotoxin. 2. Incubation of rat aortic rings for 4 h with α-thrombin (0.003–3.0 NIH units/ml) did not change their reactivity to noradrenaline. Incubation for 4 h with lipopolysaccharide increased the EC50 for noradrenaline, whereas co-incubation of thrombin (0.5 NIH units/ml) with lipopolysaccharide did not alter this hyporeactivity to noradrenaline. 3. In vivo in rats, lipopolysaccharide caused early (1 h) and late (4–6 h) hyporeactivity to noradrenaline. In rats infused with lipopolysaccharide and heparin (1 U min−1 kg−1, 0.4 ml/h) or hirudin (2.2 mg ml−1 kg−1, 0.8 ml/h), vasopressor responses to noradrenaline were not different from those after infusion of lipopolysaccharide alone. Aortic rings taken from rats receiving both anticoagulant treatment and lipopolysaccharide had the same sensitivity to noradrenaline as those obtained from rats receiving lipopolysaccharide alone. 4. Our results suggest that, in vivo, disseminated intravascular coagulation does not modify the early and late effects of lipopolysaccharide on arterial pressure and that, in vitro, thrombin neither induces hyporeactivity to noradrenaline nor modifies lipopolysaccharide-induced hyporeactivity. We propose that thrombin generated during disseminated intravascular coagulation in rats does not play a major role in the alterations of vascular tone observed during endotoxic shock.

scholarly journals The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis

Critical Care ◽  
2022 ◽  
Vol 26 (1) ◽  
Author(s):  
Vanessa Catenacci ◽  
Fatima Sheikh ◽  
Kush Patel ◽  
Alison E. Fox-Robichaud
Keyword(s):  
Sensitivity And Specificity ◽  
Disseminated Intravascular Coagulation ◽  
Protein C ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Host Responses ◽  
Cochrane Library ◽  
Intravascular Coagulation ◽  
Prognostic Utility ◽  
Sepsis Survivors

Abstract Background Sepsis, the dysregulated host response to infection, triggers abnormal pro-coagulant and pro-inflammatory host responses. Limitations in early disease intervention highlight the need for effective diagnostic and prognostic biomarkers. Protein C’s role as an anticoagulant and anti-inflammatory molecule makes it an appealing target for sepsis biomarker studies. This meta-analysis aims to assess the diagnostic and prognostic value of protein C (PC) as a biomarker for adult sepsis. Methods We searched MEDLINE, PubMed, EMBASE, CINAHL and Cochrane Library from database inception to September 12, 2021. We included prospective observational studies of (1) adult patients (> 17) with sepsis or suspicion of sepsis that; (2) measured PC levels with 24 h of study admission with; and (3) the goal of examining PC as a diagnostic or prognostic biomarker. Two authors screened articles and conducted risk of bias (RoB) assessment, using the Quality in Prognosis Studies (QUIPS) and the Quality Assessment in Diagnostic Studies-2 (QUADAS-2) tools. If sufficient data were available, meta-analysis was conducted to estimate the standardized mean difference (SMD) between patient populations. Results Twelve studies were included, and 8 were synthesized for meta-analysis. Pooled analysis demonstrated moderate certainty of evidence that PC levels were less reduced in sepsis survivors compared to non-survivors (6 studies, 741 patients, SMD = 0.52, 95% CI 0.24–0.81, p = 0.0003, I2 = 55%), and low certainty of evidence that PC levels were less reduced in septic patients without disseminated intravascular coagulation (DIC) compared to those with DIC (3 studies, 644 patients, SMD = 0.97, 95% CI 0.62–1.32, p < 0.00001, I2 = 67%). PC could not be evaluated as a diagnostic tool due to heterogeneous control populations between studies. Conclusion and relevance Our review demonstrates that PC levels were significantly higher in sepsis survivors compared to non-survivors and patients with sepsis but not disseminated intravascular coagulation (DIC). Our evaluation is limited by high RoB in included studies and poor reporting of the sensitivity and specificity of PC as a sepsis biomarker. Future studies are needed to determine the sensitivity and specificity of PC to identify its clinical significance as a biomarker for early sepsis recognition. Trial Registration PROSPERO registration number: CRD42021229786. The study protocol was published in BMJ Open.

scholarly journals Incidence and impact of disseminated intravascular coagulation in COVID-19 a systematic review and meta-analysis

2021 ◽  
Vol 201 ◽  
pp. 23-29 ◽  
Author(s):  
Xianghui Zhou ◽  
Zhipeng Cheng ◽  
Lili Luo ◽  
Ying Zhu ◽  
Wenyi Lin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disseminated Intravascular Coagulation ◽  
Meta Analysis ◽  
Intravascular Coagulation

scholarly journals Incidence and Impact of Disseminated Intravascular Coagulation in COVID-19

2020 ◽  
Author(s):  
Xianghui Zhou ◽  
Zhipeng Cheng ◽  
Lili Luo ◽  
Ying Zhu ◽  
Wenyi Lin ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Poor Prognosis ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Pooled Analysis ◽  
China National Knowledge Infrastructure ◽  
Intravascular Coagulation ◽  
Knowledge Infrastructure ◽  
Coagulation Dysfunction ◽  
Death Group

Abstract Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease, with significant morbidity and mortality. This meta-analysis is to evaluate the prevalence of disseminated intravascular coagulation (DIC) in COVID-19 patients and to determine the association of DIC with the severity and prognosis of COVID-19.Methods: We searched the PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) database until August 12, 2020. The meta-analysis was performed using Stata 16.0 software.Results: 15 studies were included in our meta-analysis. The pooled analysis revealed that the incidence of COVID-19 patients developing DIC was 4% (95%: 2%-5%, P<0.001). In addition, DIC was more likely to occur in the death group (Log OR = 2.4, 95% CI: 1.58-3.21, P<0.001) with statistical significance.Conclusions: DIC is associated with the severity and poor prognosis of COVID-19 patients. Therefore, attention should be paid to coagulation dysfunction in COVID-19 patients. Monitoring of coagulation indicators may improve the prognosis of COVID-19 inpatients.

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