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Sonoclot coagulation analysis and plasma exchange in a case of meningococcal septicaemia.

Schött, Ulf LU and Björsell-Ostling, E (1995) In Canadian Journal of Anesthesia 42(1). p.64-68
Abstract
On the basis of a patient with fulminant meningococcaemia and severe disseminated intravascular coagulation (DIC) syndrome, the diagnostic potential of a clot impedance test - Sonoclot coagulation analysis - was used to evaluate plasma exchange. A 17-yr-old girl was treated for a fulminant infection with Neisseria meningitidis in our intensive care unit. She developed severe DIC. Whereas platelet administration caused immediate arterial oxygen desaturation necessitating ventilatory support, plasma exchange improved pulmonary and mental function. Three separate exchanges all improved haemostasis. Sonoclot analysis was used together with routine coagulation analyses to evaluate this DIC treatment. Sonoclot signs, such as lack of the shoulder... (More)
On the basis of a patient with fulminant meningococcaemia and severe disseminated intravascular coagulation (DIC) syndrome, the diagnostic potential of a clot impedance test - Sonoclot coagulation analysis - was used to evaluate plasma exchange. A 17-yr-old girl was treated for a fulminant infection with Neisseria meningitidis in our intensive care unit. She developed severe DIC. Whereas platelet administration caused immediate arterial oxygen desaturation necessitating ventilatory support, plasma exchange improved pulmonary and mental function. Three separate exchanges all improved haemostasis. Sonoclot analysis was used together with routine coagulation analyses to evaluate this DIC treatment. Sonoclot signs, such as lack of the shoulder and peak, prolonged shoulder-peak interval and peak time predicted clinical bleeding manifestations (haematuria, haemoptysis, epistaxis) and were improved by platelet transfusion and plasma exchange. Plasma exchange was successful even at a very low platelet count of < 23 x 10(9).L-1. Sonoclot coagulation analyses were normalised several days before routine coagulation analyses. The Sonoclot gave additional information to routine coagulation studies, correctly indicated insufficient haemostasis and predicted a positive outcome. Also, plasma exchanges and platelet transfusions could be controlled in the management of DIC. (Less)
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keywords
Bacteremia: blood, Bacteremia: therapy, Blood Coagulation Tests: methods, Disseminated Intravascular Coagulation: blood, Disseminated Intravascular Coagulation: therapy, Epistaxis: etiology, Hematuria: etiology, Hemoptysis: etiology, Meningococcal Infections: blood, Meningococcal Infections: therapy, Waterhouse-Friderichsen Syndrome: blood, Waterhouse-Friderichsen Syndrome: therapy
in
Canadian Journal of Anesthesia
volume
42
issue
1
pages
64 - 68
publisher
Springer New York
external identifiers
  • pmid:7889586
  • scopus:0028797205
ISSN
0832-610X
DOI
10.1007/BF03010573
language
English
LU publication?
yes
id
f1b04531-a8bb-4e92-a3f4-271e14f184d4 (old id 3634390)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/7889586?dopt=Abstract
date added to LUP
2013-07-02 13:08:59
date last changed
2017-08-06 04:51:36
@article{f1b04531-a8bb-4e92-a3f4-271e14f184d4,
  abstract     = {On the basis of a patient with fulminant meningococcaemia and severe disseminated intravascular coagulation (DIC) syndrome, the diagnostic potential of a clot impedance test - Sonoclot coagulation analysis - was used to evaluate plasma exchange. A 17-yr-old girl was treated for a fulminant infection with Neisseria meningitidis in our intensive care unit. She developed severe DIC. Whereas platelet administration caused immediate arterial oxygen desaturation necessitating ventilatory support, plasma exchange improved pulmonary and mental function. Three separate exchanges all improved haemostasis. Sonoclot analysis was used together with routine coagulation analyses to evaluate this DIC treatment. Sonoclot signs, such as lack of the shoulder and peak, prolonged shoulder-peak interval and peak time predicted clinical bleeding manifestations (haematuria, haemoptysis, epistaxis) and were improved by platelet transfusion and plasma exchange. Plasma exchange was successful even at a very low platelet count of &lt; 23 x 10(9).L-1. Sonoclot coagulation analyses were normalised several days before routine coagulation analyses. The Sonoclot gave additional information to routine coagulation studies, correctly indicated insufficient haemostasis and predicted a positive outcome. Also, plasma exchanges and platelet transfusions could be controlled in the management of DIC.},
  author       = {Schött, Ulf and Björsell-Ostling, E},
  issn         = {0832-610X},
  keyword      = {Bacteremia: blood,Bacteremia: therapy,Blood Coagulation Tests: methods,Disseminated Intravascular Coagulation: blood,Disseminated Intravascular Coagulation: therapy,Epistaxis: etiology,Hematuria: etiology,Hemoptysis: etiology,Meningococcal Infections: blood,Meningococcal Infections: therapy,Waterhouse-Friderichsen Syndrome: blood,Waterhouse-Friderichsen Syndrome: therapy},
  language     = {eng},
  number       = {1},
  pages        = {64--68},
  publisher    = {Springer New York},
  series       = {Canadian Journal of Anesthesia},
  title        = {Sonoclot coagulation analysis and plasma exchange in a case of meningococcal septicaemia.},
  url          = {http://dx.doi.org/10.1007/BF03010573},
  volume       = {42},
  year         = {1995},
}