title: Plasma prekallikrein, factor XII, antithrombin III, C1(-)-inhibitor and alpha 2-macroglobulin in critically ill patients with suspected disseminated intravascular coagulation (DIC).
abstract: In nine patients with suspected disseminated intravascular coagulation (DIC) and five controls, the following analyses were performed on admission and 7-29 hours later: Routine coagulation studies (fibrinogen, platelet count, fibrin(ogen) degradation products, ethanol gelation, reptilase time, Factor V) providing a semiquantitative DIC score, prekallikrein (PK), Factor XII, antithrombin III (AT-III), C1(-)-inhibitor and alpha 2-macroglobulin. Significant correlations were found: PK or AT III with the DIC-score, PK with AT-III and Factor XII, AT-III with Factor XII. The changes (expressed as a percentage of normal plasma) of PK and AT-III from the first to the second evaluation were nearly identical. The two patients with rapidly fatal irreversible shock showed the highest DIC score and a pronounced decrease of PK and AT-III, whereas in reversible shock stable or increasing PK and AT-III values were found. The other variables showed an overlap between reversible and irreversible shock. DIC in these shock patients, accompanied by a decrease in PK, probably was mediated via Factor XII activation. PK and AT-III might be of prognostic value in patients with (septic) shock.
mesh_terms: D000368:Aged; D000990:Antithrombin III / Q000032:analysis*; D003174:Complement C1 Inactivator Proteins / Q000032:analysis*; D003422:Critical Care; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D005174:Factor XII / Q000032:analysis*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007610:Kallikreins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011288:Prekallikrein / Q000032:analysis*; D011379:Prognosis; D000511:alpha-Macroglobulins / Q000032:analysis*
chemical_list: D003174:Complement C1 Inactivator Proteins; D000511:alpha-Macroglobulins; D000990:Antithrombin III; D005174:Factor XII; D005340:Fibrinogen; D011288:Prekallikrein; D007610:Kallikreins