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DOI: 10.1055/s-0037-1619626
Coagulation parameters as predictors of DIC in patients with intact aortic aneurysm
Gerinnungsparameter als Prädiktoren einer DIC bei Patienten mit intaktem AortenaneurysmaPublication History
Publication Date:
22 December 2017 (online)
Summary
Clinically overt, preoperative, disseminated intravascular coagulation (DIC) is not common in patient with aortic aneurysm. However, cases with large and expanding aneurysm are especially prone for this coagulopathy. Contrary to the clinically overt form compensated DIC in patients with aortic aneurysm seems frequent and is probably underdiagnosed. The compensated DIC may be recognized, even without bleedings, by laboratory tests documenting the activated coagulation and fibrinolysis. We show that in about one third of patients with abdominal aorta aneurysm (AAA) compensated DIC can be identified. This enables the application of preoperative anticoagulation treatment to improve the intraoperative haemostasis.
Zusammenfassung
Eine klinisch manifeste, präoperative, disseminierte intravasale Gerinnung (DIC) tritt bei Patienten mit einem Aortenaneurysma nicht häufig auf. Patienten mit großem und wachsendem Aneurysma sind für diese Koagulopathie jedoch besonders anfällig. Im Gegensatz zur klinisch manifesten Verbrauchskoagulopathie ist eine kompensierte DIC bei Patienten mit Aortenaneurysma offenbar häufig und wird wahrscheinlich zu selten diagnostiziert. Die kompensierte DIC kann auch ohne Auftreten von Blutungen mit Hilfe von Labortests erkannt werden, die die aktivierte Gerinnung und Fibrinolyse belegen. Wir weisen nach, dass bei etwa einem Drittel der Patienten mit abdominellem Aortenaneurysma (AAA) eine kompensierte DIC erfasst werden kann. Dies ermöglicht die Anwendung einer präoperativen Therapie mit Antikoagulanzien, um die intraoperative Hämostase zu verbessern.
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