GTC Biotherapeutics (fka GTCB)

[DewDiligence]

Coagulation Disorders After Severe Burn Injury

[Sepsis is not the only medical condition that induces DIC. Note: “SOFA” refers to Sequential Organ Failure Assessment, a standard ICU metric that evaluates a patient’s respiratory, cardiovascular, hepatic, coagulation, renal and neurological functions.]

http://tinyurl.com/35ykv7

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Intensive Care Med. 2008 Jan 12

Lavrentieva A, Kontakiotis T, Bitzani M, Papaioannou-Gaki G, Parlapani A, Thomareis O, Tsotsolis N, Giala MA.

Hatzipanagiotidi 2, 55236, Panorama, Thessaloniki, Greece.

OBJECTIVE: To evaluate the time course of coagulation markers in the early post-burn period and clarify the role of coagulation alterations in organ failure and in mortality prognosis.

DESIGN AND SETTING: This prospective study was conducted in the burn ICU of a tertiary hospital.

PATIENTS: 45 patients with severe thermal burn injury.

MEASUREMENTS AND RESULTS: Clinical data and coagulation and fibrinolysis parameters were measured during the first post-burn week. The ICU 28-day mortality rate was 33%. Significant differences in the time course of coagulation markers were observed between survivors and non-survivors.

SOFA score distinguished between patients with overt and non-overt disseminated intravascular coagulation (DIC) during the overall investigation period. Presence of overt DIC was related to mortality. Antithrombin, protein S, plasminogen activator inhibitor 1, and SOFA score on day 3, protein C on day 5, and thrombin/antithrombin complexes on day 7 revealed a good prognostic value for ICU mortality, according to the area under ROC curves.

CONCLUSIONS: Severe thermal injury is associated with the early activation of coagulation cascade, presence of DIC, organ failure, and increased mortality.
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