Transmittance waveform of routine coagulation tests is a sensitive and specific method for diagnosing non-overt disseminated intravascular coagulation.
The transmittance waveform profile on the routine coagulation test of the activated partial thromboplastin time can be characteristically biphasic in patients with disseminated intravascular coagulation (DIC). We have previously shown that there is increasing positive predictive value for DIC with increasing abnormality in this profile, and that waveform changes often preceded those in the more conventional parameters used for diagnosing DIC. We now show that a single analysis of the activated partial thromboplastin time waveform within the first hour of intensive care admission can assign risk of DIC development, and that this is superior to that of D-dimer measurements. Additionally, the analysis can also rapidly monitor progression from non-overt to overt DIC. This offers the potential of improved diagnostic means for targeting therapeutic intervention early in the DIC progress, as can be particularly useful in sepsis.
Toh
Cheng Hock
CH
Department of Haematology, Roald Dahl Haemostasis & Thrombosis Centre, Royal Liverpool University Hospital, Liverpool, UK. toh@liv.ac.uk
D001780:Blood Coagulation Tests / Q000379:methods*; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis*; D006801:Humans; D012680:Sensitivity and Specificity