Heparin-Induced Thrombocytopenia with Pulmonary Embolism and Disseminated Intravascular Coagulation Associated with Low-Molecular-Weight Heparin

2003 ◽  
Vol 325 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Alex P. Betrosian ◽  
George Lambroulis ◽  
Dimitrios Kostantonis ◽  
Margarita Balla ◽  
Metaxia Papanikolaou ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Disseminated Intravascular Coagulation ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Heparin Induced Thrombocytopenia ◽  
Intravascular Coagulation

Human Urinary Soluble Thrombomodulin (MR-33) Improves Disseminated Intravascular Coagulation without Affecting Bleeding Time in Rats: Comparison with Low Molecular Weight Heparin

1997 ◽  
Vol 77 (04) ◽  
pp. 789-795 ◽  
Author(s):  
Yasuo Takahashi ◽  
Yoshitaka Hosaka ◽  
Kazunori Imada ◽  
Takehiro Adachi ◽  
Hiromi Niina ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Disseminated Intravascular Coagulation ◽  
Low Molecular Weight Heparin ◽  
Bleeding Time ◽  
Low Molecular Weight ◽  
Soluble Thrombomodulin ◽  
Intravascular Coagulation ◽  
Significant Prolongation ◽  
Dose Dependent Fashion ◽  
Dose Dependent

SummaryWe compared the antithrombotic and hemorrhagic effects of naturally existing human urinary soluble thrombomodulin (MR-33) with those of low molecular weight heparin (LMW-heparin) in rats. In in vitro experiments, MR-33 prolonged APTT in a dose-dependent fashion; its effect in this respect was as potent as that of LMW-heparin, but it was less potent than unfractionated heparin (UF-heparin). MR-33 was effective on endotoxin- or thromboplastin-induced disseminated intravascular coagulation (DIC) in rats. In both DIC models, infusion of MR-33 improved hematological abnormalities compatible with DIC in a dose-dependent fashion without excessive prolongation effect on APTT. Although LMW-heparin and UF-heparin also improved both DIC models, excessive prolongation of APTT was observed at high doses. It is well-known that the excessive prolongation of APTT with antithrombotic drugs like heparins is an index for hemorrhage, which is a major side effect in the treatment of DIC. We therefore further compared the antithrombotic (Benefit: dose required for 50% inhibition of fibrinogen decrease: ED50) and hemorrhagic (Risk: minimum dose required for significant prolongation of bleeding time) effects of MR-33 and LMW-heparin in the thromboplastin-induced DIC model. As a result, Benefit-Risk ratio was 1:27 for MR-33 and 1:3 for LMW heparin. These results indicate that MR-33 may be a clinically useful antithrombotic agent with reduced risk for hemorrhage compared with LMW-heparin.

scholarly journals Coronavirus disease (COVID-19) and disseminated intravascular coagulation syndrome

2020 ◽  
Vol 14 (2) ◽  
pp. 123-131 ◽  
Author(s):  
A. D. Makatsariya ◽  
K. N. Grigoreva ◽  
M. A. Mingalimov ◽  
V. O. Bitsadze ◽  
J. Kh. Khizroeva ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Molecular Weight ◽  
Disseminated Intravascular Coagulation ◽  
Low Molecular Weight Heparin ◽  
Multiple Organ ◽  
Low Molecular Weight ◽  
Intravascular Coagulation ◽  
Critical Patients ◽  
Fibrinogen Content ◽  
D Dimer

COVID-19 is an infectious disease caused by the beta-coronavirus SARS-CoV-2 that in 2020 has spread worldwide. In most severe patients, the clinical picture begins with respiratory failure further deteriorating up to multiple organ failure. Development of coagulopathy is the most adverse prognostic. Analyzing currently available clinical data revealed that 71.4 % and 0.6 % of survivors and fatal cases, respectively, demonstrated signs of overt disseminated intravascular coagulation (DIC). Monitoring D-dimer level, prothrombin time, platelet count and fibrinogen content is important for determining indications for treatment and hospitalization in COVID-19 patients. In case such parameters deteriorate, a more pro-active “aggressive” intensive care should be applied. Low molecular weight heparin (LMWH) should be administered to all patients with diagnosed COVID-19 infection (including non-critical patients) requiring hospitalization, but having no contraindications to LMWH.

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