Temporal changes in factors associated with neutrophil elastase and coagulation in intensive care patients with a biphasic waveform and disseminated intravascular coagulation

Journal of Thrombosis and Haemostasis : JTH
John SamisMichael E Nesheim

Abstract

Summary. The biphasic waveform is an early marker of disseminated intravascular coagulation (DIC). Neutrophil elastase (NE) cleaves coagulation factors; thus, elevated elastase levels or its dysregulation by alpha-1-protease inhibitor (Alpha1PI) may be linked to DIC. Time courses over a period were determined for factors associated with NE and coagulation in 14 Intensive Care Unit patients with a biphasic waveform who developed DIC. The data were analyzed using a random coefficient linear regression model to predict the variables' mean values on day 0 and their mean rates of change over the period in which the biphasic waveform appeared. The biphasic waveform was normal on day 0, maximized on day 1, and approached normal again by day 4. Alpha1PI/NE complex levels were 2.5-fold greater than normal for the entire period. The A1PI activity, antigen, and specific activity levels were normal on day 0 and increased thereafter by 21.0, 10.5, and 8.9% of normal per day, respectively. Factor II, V, VII, IX, and X activity levels were, respectively, 57, 46, 46, 77, and 46% of normal on day 0, whereas factor VIII and fibrinogen levels were normal. All coagulation factor levels trended upward with time but not significantly. The prothrombi...Continue Reading

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Citations

Apr 12, 2006·Critical Care Medicine·Nicolas ChopinBernard Allaouchiche
Jun 30, 2011·Thrombosis Journal·Derek TilleyJohn A Samis
Sep 19, 2012·Journal of Visualized Experiments : JoVE·Derek TilleyJohn A Samis
Aug 31, 2004·Journal of Thrombosis and Haemostasis : JTH·H Ten Cate
Mar 8, 2005·Journal of Thrombosis and Haemostasis : JTH·C H Toh, C Downey
Jun 28, 2005·Journal of Thrombosis and Haemostasis : JTH·C H Toh, C Downey
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May 28, 2019·Journal of Clinical Medicine·Toshiaki IbaTheodore E Warkentin

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