Organ damage in shock, disseminated intravascular coagulation, and stroke.
Disseminated intravascular coagulation (DIC) may cause multiple organ failure. Although DIC may cause capillary occlusion in any and all organs, the lungs, liver, kidneys, gut, heart and brain are particularly affected. Focal brain necrosis can also be caused by DIC. Fibrinolytic therapy will often restore significant blood flow to the capillaries of the lungs. This results in significant increase in lung function because the lung is more resistant to actual necrosis and will resume function once circulation is restored. Administration of fibrinolytic therapy will also prevent liver and kidney failure if started within four hours after trauma. This therapy, when given in low doses intravenously over a twenty-four hour period, has little effect on the coagulation mechanism, and abnormal bleeding, therefore, has not been a concern. It is speculated that if plasminogen activators are effective and safe for treating the intravascular clots of DIC, then perhaps they would be effective in treating other types of intravascular coagulation in the brain, such as various types and degrees of stroke.
Hardaway
R M
RM
Dept. of Surgery, Texas Tech University, School of Medicine, El Paso 79906.
D000368:Aged; D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D009102:Multiple Organ Failure / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012769:Shock / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D015912:Thrombolytic Therapy