Eng / Emergency situation

ON M.S MACHABELI ALLOCATE 4 STAGES

Stage I - hypercoagulability

Stage II - consumption coagulopathy

Stage III - a sharp decrease in the blood of all procoagulants, up to the complete absence of fibrinogen.

Stage IV - recovery.

CLASSIFICATION ACCORDING TO FEDOROV Z. D. AND

DR. (1979), BARYSHEV B. A. (1981)

Stage I - hypercoagulation.

Stage II - hypocoagulation.

Stage III - hypocoagulation with generalized activation of fibrinolysis

Stage IV - complete non-coagulability of the blood.

Stage I - hypercoagulation

Damage:

vascular endothelium of the microvasculature

platelets

Other formed elements of blood

Generalized microcirculation disorders

Entry into the blood of tissue and platelet coagulation factors

Generalized intravascular thrombosis

Consumption of coagulation factors and physiological anticoagulants – consumption coagulopathy

Activation of fibrinolysis

complete loss of blood clotting

Hypocoagulation

in the phase of spasm of venules and arterioles, stratification of plasma and formed elements develops in the capillaries - the “sludge” phenomenon.

Aggregation of formed elements, enveloping them with fibrin are accompanied by the consumption of blood coagulation factors and activation of fibrinolysis

PHASE 3 DIC

consumption with activation of local fibrinolysis.

Afibrinogenemia in combination with a pronounced activation of fibrinolysis.

PHASE 4 DIC

Generalized fibrinolysis

Treatment

increased anticoagulant activity of the blood (heparin, ATS, fresh frozen plasma);

improvement of antiplatelet activity (antiplatelet agents, antispasmodics, antioxidants, vitamins);

suppression of proteolysis (gordox, contrykal, trasylol);

removing toxins from the body (detoxification agents)

plasmapheresis

Treatment

antiplatelet agents (trental, agapurine, chimes), vitamin B6, antispasmodics (no-shpa), reopoliglyukin, heparin, fresh frozen plasma (FFP).

restoration of systemic hemodynamics (hydroxyethylated starch 6% and 10% 500.0-1000.0 ml, rheopolyglucin, polyglucin, albumin 5%, gelatinol)

crystalloid solutions: 5-10% glucose solution, isotonic sodium chloride solution, Ringer-Locke solution, lactasol

Waterhouse-Friderichsen syndrome