Document Detail


Microvascular thrombosis and multiple organ dysfunction syndrome.
MedLine Citation:
PMID:  20083912     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This paper will review the involvement of disseminated intravascular coagulation-induced microvascular thrombosis in the pathogenesis of multiple organ dysfunction syndrome and the interaction between disseminated intravascular coagulation and systemic inflammatory response syndrome in critically ill patients. The published literature on clinical and experimental studies are the data sources of the study. Histologic evidence of microvascular thrombosis and tissue injury in disseminated intravascular coagulation has been reported in clinical, experimental, and autopsy findings. Proinflammatory cytokine-evoked neutrophil-endothelial activation and interplay between inflammation and coagulation through protease-activated receptors contribute to enhanced microvascular fibrin deposition in organs. In a clinical setting, systemic inflammatory response syndrome and disseminated intravascular coagulation synergistically play pivotal roles in the development of multiple organ dysfunction syndrome and in the poor prognosis of critical illness. Disseminated intravascular coagulation contributes to microvascular thrombosis and subsequent multiple organ dysfunction syndrome. Recent knowledge on the relationship between disseminated intravascular coagulation and systemic inflammatory response syndrome gives further insight into the pathogenic mechanisms of multiple organ dysfunction syndrome in critically ill patients.
Authors:
Satoshi Gando
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S35-42     Citation Subset:  AIM; IM    
Affiliation:
Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Japan. gando@med.hokudai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
ADAM Proteins / physiology
Acute Lung Injury / etiology
Animals
Cerebrovascular Disorders / etiology
Cytokines / physiology
Disseminated Intravascular Coagulation / complications
Endothelium, Vascular / physiology
HMGB1 Protein / physiology
Humans
Kidney Failure, Acute / etiology
Liver Diseases / etiology
Microvessels / physiopathology
Multiple Organ Failure / etiology*
Neutrophils / physiology
Receptors, Proteinase-Activated / physiology
Thrombosis / complications*
Thrombotic Microangiopathies / complications
Chemical
Reg. No./Substance:
0/Cytokines; 0/HMGB1 Protein; 0/Receptors, Proteinase-Activated; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/ADAMTS13 protein, human

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