[Diagnosis of disseminated intravascular coagulation: the value of soluble fibrin, D-dimers and fibrin(ogen) split products]

Klin Wochenschr. 1989 Aug 1;67(15):764-73. doi: 10.1007/BF01745348.
[Article in German]

Abstract

The validity of the fibrin(ogen) derivatives 'soluble fibrin, D-dimers and fibrin(ogen) degradation products' was compared with other parameters in early and sensitive diagnosing of disseminated intravascular coagulation (DIC). In a clinical study 900 patients' samples from separate, defined groups were examined, including course observations of intensive care patients (n = 38) and patients with acute pancreatitis. The fibrin(ogen) derivatives correlated very well with the degree of blood coagulation disturbances: in particular, D-dimers and soluble fibrin proved to be more sensitive in early diagnosis of DIC than other parameters. The SF-PS-turbidimetry demonstrated a good validity and practicality in the quantitative determination of soluble fibrin, but a suitable analyzer is essential. Determination of D-dimers is preferable to that of fibrin(ogen) degradation products (both in the latex-agglutination test) because of the better sensitivity and practicality; even more sensitive results were provided by the D-dimer-ELISA, which is, however, not practical in acute diagnostics. The decrease in protein C was at least equally sensitive as the antithrombin III-levels in indicating the consumption of the hemostatic potential. The decrease of thrombocyte counts and fibrinogen levels could first be detected in a later stage of DIC. In conclusion, D-dimers and soluble fibrin can improve the DIC diagnostics, making them more reliable; additionally, antithrombin III and possibly protein C deserve further consideration, although the fibrin(ogen) derivatives are apparently of greater importance.

Publication types

  • English Abstract

MeSH terms

  • Acute Disease
  • Antithrombin III / blood
  • Blood Coagulation Tests
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / diagnosis*
  • Fibrin / analysis*
  • Fibrin Fibrinogen Degradation Products / blood*
  • Humans
  • Pancreatitis / complications
  • Platelet Count
  • Protein C / blood

Substances

  • Fibrin Fibrinogen Degradation Products
  • Protein C
  • fibrin fragment D
  • Antithrombin III
  • Fibrin