Blood Coagulation and Shock

Saldeen, Tom

doi:10.1016/s0344-0338(79)80073-4

Cited by 24 publications

(4 citation statements)

References 52 publications

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“…Animal studies support the hypothesis that minimal release of material from the medullary cavity into the blood system leads to intravascular coagulation and to a clear increase in perioperative pulmonary embolisms [26]. This effect is caused by the release of thromboplastin from the bone marrow into the venous blood system.…”

Section: Shock and Clottingmentioning

confidence: 60%

Pathophysiology of Fat Embolism after Intramedullary Reaming

Schult¹,

Frerichmann²,

Schiedel³

et al. 2003

European Journal of Trauma

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Primary operative stabilization by an intramedullary procedure is the treatment of first choice for fractures of long tubular bones for reasons of biomechanics, the minimally invasive approach, and the early loadability of the injured limb. Additionally, in the case of multiple injuries, the pulmonary situation can be improved so that both the duration of ventilation and the period spent in intensive care are reduced. However, a postoperative increase in the incidence of posttraumatic lung failure has been found following early intramedullary nailing and seen as being linked to the procedure. The increase in intramedullary pressure occurring on intramedullary nailing or reaming can result in release of bone marrow and fat into the venous blood system. The potentially lethal consequences may be adult respiratory distress syndrome (ARDS) and multiple organ failure.For these reasons, a method was sought to bring about a reduction in intramedullary pressure at primary nailing. These efforts led to further developments in implant and reamer design as well as in nailing techniques. However, a clear release of fat was still apparent under these conditions. This review gives an overview of pathophysiologic aspects of reamed intramedullary nailing and suggestions for the optimal reaming system. A new-designed rinsing-suction reamer is briefly presented.

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Section: Shock and Clottingmentioning

confidence: 60%

Pathophysiology of Fat Embolism after Intramedullary Reaming

Schult¹,

Frerichmann²,

Schiedel³

et al. 2003

European Journal of Trauma

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“…The significance of other therapeutic measures is difficult to evaluate. Any positive effect of dextrans could be due to inhibiting either platelet action or normal fibrin polymerization leaving the latter more susceptible to fibrinolysis (31). Various case reports mention the efficiency of exchange transfusion and plasmapheresis.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Intravascular Coagulation, Antithrombin III, and Complement in Meningococcal Infections

Laursen

Faber

Brock

et al. 1981

Journal of Internal Medicine

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ABSTRACT. Serial assessments of some blood coagulation factors, antithrombin HI (AT III), and complement were made in 18 patients with meningococcal (mgc) infection. All patients displayed laboratory evidence of activation of the blood clotting system. Two patients showed clinical signs of disseminated intravascular coagulation. Only AT III differed significantly between patients with and without complications. There was no correlation between changes in blood clotting, activation of the complement system and the course or duration of the disease. These results do not enable one to identify patients who need specific prophylactic therapy. Controlled clinical trials, including administration of heparin, dextran, aprotinin, and others, are still required to ensure optimal treatment in fulminant mgc infections.

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“…Mikrothrombose und Mikroembolismus sind Vorgänge, die wahrscheinlich häufiger als bekannt auftreten. Sie können unbemerkt und ohne Krankheitserscheinungen einhergehen, sie können sich auch systemisch bis zu dem Mikroemboliesyndrom (SALDEEN 1979) steigern. Unter zahlreichen möglichen Ursachen der Mikrothrombose-bzw.…”

Section: Mikrothrombose Mikroembolismusunclassified

Perfusionsstörungen

Mittermayer¹

1983

Spezielle Pathologische Anatomie

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Die morphologische Unterscheidung zwischen Thrombose und Thromboembolie ist oft schwer, mitunter unmöglich. So wird auch in der Literatur nicht immer exakt unterschieden zwischen dem in situ entstandenen Thrombus der Pulmonalarterien und dem embolisch in die Pulmonalarterien verschleppten Thrombus, was eine exakte Angabe der Häufigkeitsrelation beider Ereignisse erschwert. Generell läßt sich aber sagen, daß der Verschluß der Pulmonalarterien durch autochthone Thromben häufig vorkommt (KEATING et al. 1953), allerdings seltener als die Thromboembolie der Pulmonalarterien (BALL et al. 1956). Die Thrombose der Pulmonalarterien soll hier nur in soweit besprochen werden, als sie sich von der Thromboembolie, die im folgenden Kapitel ausführlich behandelt wird, unterscheidet. BALL et al. (1956) führen in ihrer Untersuchung über Thrombose und Thromboembolie der großen Pulmonalarterien folgende Unterscheidungskriterien an:1. Das Vorliegen lokaler Erkrankungen der Pulmonalarterien, beispielsweise von Atherosklerose, spricht für die in situ-Thrombose.2. Der autochthone Thrombus paßt im Gegensatz zu dem gewunden vorliegenden Embolus genau in das Gefäß.3. Der in si tu-Thrombus läßt eine schichtweise Ablagerung erkennen, wobei die einzelnen Lagen annähernd parallel zur Arterienwand verlaufen.

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Blood Coagulation and Shock

Cited by 24 publications

References 52 publications

Pathophysiology of Fat Embolism after Intramedullary Reaming

Pathophysiology of Fat Embolism after Intramedullary Reaming

Disseminated Intravascular Coagulation, Antithrombin III, and Complement in Meningococcal Infections

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