Pathogenic peculiarities of disseminated intravascular coagulation of various ethiology

Abstract

DIC is a severe complication, often resulting in multi-organ failure and fatal outcome. As any syndrome, it is polyethiologic, while a big number of its causes logically leads to various mechanisms of its forming. Main manifestations of the disseminated intravascular blood coagulation syndrome are clottage and haemorrhage. A result of a massive clottage in microcirculatory bed of internal organs is development of dystrophic changes in them and organ failure. Haemorrhage in its turn, results in decreased volume of circulating blood, arterial hypotension and hemic hypoxia, in most severe cases leading to the fatal outcome. Although, development mechanisms and manifestation degree of the disorder mentioned above are not always the same. As the syndrome may result from a great number of causes (currently, over 150 diseases have been described with which it can develop), namely its initial stages are different to the greatest extent. Main triggering mechanisms of the DIC may be: blood formed element activation and increased process of their microvesiculation, activation of coagulative hemostasis in intrinsic and extrinsic pathways, lack of anticoagulants and excessive activity of fibrinolytic system. Various ethiologic factors (sepsis, obstetrical pathology, leucosis and other malignant tumours, traumas, etc) have different effect on function of hemostasis system components. Depending on the degree of the above mentioned disorders mechanisms manifestation, the DIC may develop with prevailing coagulation, with prevailing fibrinolysis or with their balanced activation. Clinical manifestations of these DIC forms, as well as duration and manifestation degree of its stages (hypercoagulation, coagulopathy of consumption with compensatory activation of fibrinolysis, defibrination of the blood and excessive activation of fibrinolysis) will be different as well. Consequently, knowing the prevailing disorder in hemostasis system during a disease that is potentially dangerous in terms of the DIC development offers to find optimal methods of its prevention, diagnosing and treatment.