Asphyxia by Drowning Induces Massive Bleeding Due To Hyperfibrinolytic Disseminated Intravascular Coagulation

Critical Care Medicine
Michael SchwameisBernd Jilma

Abstract

To date, no study has systematically investigated the impact of drowning-induced asphyxia on hemostasis. Our objective was to test the hypothesis that asphyxia induces bleeding by hyperfibrinolytic disseminated intravascular coagulation. Observational study. A 2,100-bed tertiary care facility in Vienna, Austria, Europe. All cases of drowning-induced asphyxia (n=49) were compared with other patients with cardiopulmonary resuscitation (n=116) and to patients with acute promyelocytic leukemia (n=83). Six drowning victims were investigated prospectively. To study the mechanism, a forearm-ischemia model was used in 20 volunteers to investigate whether hypoxia releases tissue plasminogen activator. None. Eighty percent of patients with drowning-induced asphyxia developed overt disseminated intravascular coagulation within 24 hours. When compared with nondrowning cardiac arrest patients, drowning patients had a 13 times higher prevalence of overt disseminated intravascular coagulation at admission (55% vs 4%; p<0.001). Despite comparable disseminated intravascular coagulation scores, acute promyelocytic leukemia patients had higher fibrinogen but lower d-dimer levels and platelet counts than drowning patients (p<0.001). Drowning victi...Continue Reading

References

Jul 1, 1977·Annals of Internal Medicine·T A Ports, T F Deuel
Nov 1, 1975·Annals of Internal Medicine·R M Culpepper
Sep 1, 1992·The Journal of Trauma·R L ReedR P Fischer
Dec 24, 1997·British Journal of Haematology·B BennettR Herriot
Jan 1, 1997·Scandinavian Journal of Infectious Diseases·C T Carpenter, A B Kaiser
Jul 15, 1998·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·K MeijerJ van der Meer
Oct 21, 2005·Chest·Sacha ZeerlederWalter A Wuillemin
May 13, 2008·The Journal of Trauma·Karim BrohiJean-François Pittet
Jun 6, 2009·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Albert J D W R RamakerHerman G D Hendriks
Feb 24, 2012·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Jiri RuzickaAles Krouzecky
Jun 1, 2012·The New England Journal of Medicine·David SzpilmanJames P Orlowski
Jun 30, 2012·The Journal of Trauma and Acute Care Surgery·Sisse R Ostrowski, Pär I Johansson
Jul 7, 2012·Journal of the American College of Surgeons·Crystal IvesDemetrios Demetriades
Sep 15, 2012·Resuscitation·Joonghee KimKyeong Won Kang
Nov 28, 2012·Journal of Thrombosis and Haemostasis : JTH·I RazaK Brohi
Dec 3, 2014·Journal of the American College of Surgeons·Matthew J PommereningBryan A Cotton

❮ Previous
Next ❯

Citations

Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Nathan J WhiteAndrew P Cap
Mar 24, 2017·The Journal of Trauma and Acute Care Surgery·Michael A MeledeoAndrew P Cap
Jul 13, 2018·Expert Review of Hematology·Marcel Levi, Suthesh Sivapalaratnam
Aug 11, 2018·Critical Care Medicine·Nina BuchteleMichael Schwameis
May 19, 2019·Journal of Thrombosis and Haemostasis : JTH·Satoshi Gando, Takeshi Wada
Dec 26, 2015·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Michael SchwameisBernd Jilma
Feb 18, 2017·Clinical and Experimental Medicine·Christian SchoergenhoferPetra Jilma-Stohlawetz
Jul 28, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Eslam SamahaBernd Jilma
Jan 29, 2020·Research and Practice in Thrombosis and Haemostasis·Anton IlichNigel S Key
Oct 17, 2017·Frontiers in Medicine·Takeshi Wada
Dec 14, 2019·Wiener klinische Wochenschrift·Nina Buchtele
Apr 21, 2021·Seminars in Thrombosis and Hemostasis·Maria J ColominaAntoni Sabate
Jul 24, 2021·Wilderness & Environmental Medicine·Dong LaiChing-Feng Weng

❮ Previous
Next ❯

Methods Mentioned

BETA
enzyme-linked immunosorbent assay

Software Mentioned

DIC
ROTEM
SPSS

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.