Dissemine intravasküler koagulasyon (DIC).

Dissemine intravasküler koagulasyon (DIC) aşırı trombin oluşumuyla sonuçlanan kompleks edinsel bir koagulopatidir. Anormal doku faktörü birçok bozuklukta DIC’i başlatan en önemli mekanizmadır. Predominant kanama, tromboembolik komplikasyonlar veya organ yetersizliği gibi klinik belirtiler, laboratuvar test sonuçları profili ile birlikte değerlendirilir. DIC’i teşhis etmek için birçok laboratuvar testi mevcuttur. Tedavide prensip, DIC’e neden olan primer hastalığı identifiye etmek, hemostatik defekti düzeltmek ve kan ürünleri, heparin, antitrombin III (AT III) ve antifibrinolitik ajanlarla pıhtılaştırıcı/fibrinolitik işlemleri bastırmaktır. Ayrıca, DIC’in özelliğine, etiyolojisine, hayvanın yaşına, hemoraji veya trombozisin yeri ve şiddetine, hemodinamik ve diğer klinik parametrelere bağlı olarak tedavi yönlendirilmelidir.

Anahtar Kelimeler:

prognoz, hayvan hastalıkları, yaygın damar içi pıhtılaşma, kan bozuklukları, klinik görünüm, tanı teknikleri, biyokimyasal parametreler, teşhis, klinik muayene, tedavi

Disseminated intravascular coagulation (DIC)

Disseminated intravascular coagulation (DIC) is a complex acquired coagulopathy resulting from excessive thrombin formation. Abnormal tissue factor is a major mechanism initiating DIC in many disorders. Clinical symptoms such as predominant bleeding, thromboembolic complications or organ failure should be evaluated together with the profile of laboratory test results. Numerous laboratory tests are available to monitor DIC. The guiding principle of therapy is to identify and vigorously treat the underlying cause of DIC without delay. Treatment options to correct the hemostatic defect and to dampen the intravascular clotting/fibrinolytic process include transfusion of blood product, heparin, antithrombin III (ATIII), and antifibrinolytic agents. Also, therapy must be directed depending on the nature of DIC, age, etiology of DIC, site and severity of hemorrhage or thrombosis, and hemodynamic and other clinical parameters.

Keywords:

prognosis, animal diseases, disseminated intravascular coagulation, blood disorders, clinical aspects, diagnostic techniques, biochemical parameters, diagnosis, clinical examination, therapy,

PDF

___

Gül Y, İssi M: Haemorrhagica Diathesis. Bültendif, 11, 15-20,1998.
Saville M, Brown V: Clinical aspects of coagulation. Anaesthesia and Intensive Care Medicine, 8 (6): 234- 238, 2007.
Franchini M, Lippi G, Manzato F: Recent acquisitions in the pathophysiology, diagnosis and treatment of DIC. Thromb J, 4, 4-10, 2006.
Gökçe E: Dissemine intravasküler koagulasyon (DIC). Kafkas Üniv Sağlık Bi. Ens.Doktora Semineri-II, 2004.
Bistner SI, Ford RB: Handbook of Veterinary Procedures: Emergency Treatment. 6th ed. W.B. Saunders Co., 53-54, 1995.
Green LA, Thomas JS: Hemostatic Disorders, Coagulopathies and Trombosis. In, Ettinger SJ, Feldman EC (Eds): Textbook of Veterinary Internal Medicine. W.B. Saunders Co. Philadelphia, 1946-1963, 1995.
Carlson GP: Disase of the Hematopoietic and Hemolymphatic systems. In, Smith BP (Ed): Large Animal Internal Medicine. The C.V. Morby Company. USA. 1068-1126, 1990.
Hohenhaus AE: Feline coagulopathies. World Congress, Asterdam, Scientific Proceeding. 25-29 April, 197-199, 2000.
Turgeon ML: Hemostasis and Thrombosis. Clinical Heamatology. Theory and Procedures. 2nd ed. Litle, Brown and Company Boston/Toronto/London. 290-292, 1993.
Radostits OM, Blood DC, Henderson JA: Diseases of the Blood and Blood-Forming Organs. Veterinary Medicine, 8th ed. Bailliere Tindall. London. 304-305, 1983.
Jain NC: Coagulation and its Disorders. Essentials of Veterinary Haematology. Lea & Febiger. Philadelphia, 82- 104, 1993.
Bick RL: Disseminated intravasculer coagulation: Objective clinical and laboratory diagnosis, treatment, and assesment of therapeutic response. Semin Thromb Haemostas,22 (1): 69-88, 1996.
Couto CG: Bleeding disorders: (Part 1,2). Vet Med, 94 (5): 449-459, 1999.
Dodds WJ: Hemostasis. In, Kaneko J, Harvey JW, Bruss ML (Eds): Clinical Biochemistry of Domestic Animals. 5th ed. USA, 241-279, 1997.
Tvedten H: Hemostataic abnormalities. In, Willard MD, Tvedten H, Turnwald GH (Eds): Small Animal Clinical Diagnosis by Laboratory Methods. 2nd ed. 80-95, W.B. Saunders Co. Philadelphia, 1994.
Turgut K: Veteriner Klinik Laboratuar Teşhis. Bahçıvanlar Basım Snayi A.Ş. Konya, 104-129, 1995.
Irmak K, Güzelbekteş H: Septisemi şüpheli buzağılarda koagulasyon profilinin değerlendirilmesi. Kafkas Univ Vet Fak Derg,9 (1): 85-87, 2003.
Maruyama H, Mıura T, Sakaı M, Koıe H, Yamaya Y, Shıbuya H, Sato T, Watarı T, Takeuchı A, Tokuriki M, Hasegawa A: The incidence of disseminated intravascular coagulation in dogs with malignant tumor. J Vet Med Sci,66 (5): 573-575, 2004.
Irmak K, Sen İ, Cöl R, Birdane FM, Güzelbektes H, Civelek T, Yılmaz A, Turgut K: The evaluation of coagulation profiles in calves with suspected septic shock. Vet Res Comm,30, 497-503, 2006.
Irmak K, Turgut K: Disseminated intravascular coagulation in cattle with abomasal displacement. Vet Res Comm,29, 61-68, 2005.
Sarıalıoğlu F, Yurdakök M, Kutluk MT, Çalıkoğlu AS: Çocuk Hastalıklarında Tanı ve Tedavi. 1. Cilt, 1. Baskı, Barış Kitapevi/Apleton & Lange., 644-647, 1993.
Çöl R: Tavşanlarda endotoksin ile oluşturulan dissemine intravasküler koagulasyon üzerine vitamin E ve prednisolon’un etkileri. Selçuk Üniv Sağlık Bil Enst. Fizyoloji (Vet) Anabilim Dalı Doktora Tezi. Konya, 2003.
Riewald M, Riess H: Treatment for clinically recognized disseminated intravascular coagulation. Semin Thromb Hemost,24 (1): 53-59, 1998.
Jonge E, Levi M, Stoutenbeek CP, Deventer SHJ: Current drug treatment strategies for disseminated intravascular coagulation. Drugs,55 (6): 767-777, 1998.
Hellstern P, Muntean W, Schramm W, Seifried EG, Solheim BG: Practical guidelines for the clinical use of plasma. Thromb Res,107, 53-57, 2002.
Mischke R, Fehr M, Nolte I: Efficacy of low molecular weight heparin in a canine model of thromboplastininduced acute disseminated intravascular coagulation. Research in Vet Sci,79, 69-76, 2005.
Arepally GM, Ortel TL: Heparin-induced thrombocytopenia. N Engl J Med,355, 809-817, 2006