الفهرس 
Pathophysiology of septic induced coagulopathyOnly 14 pages are availabe for public view
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Abstract
Sepsis is a serious and relatively common disorder and represents the leading cause of mortality in non-coronary intensive care units worldwide. Sepsis, defined as infection-induced SIRS, almost invariably leads to haemostatic abnormalities ranging from insignificant coagulopathy to severe DIC. DIC results in the widespread formation of fibrin thrombosis, microvascular occlusion and reduced oxygen delivery to cells and tissues, leading to multiple organ dysfunction syndrome (MODS). Studies showed that clinical progression from SIRS to severe sepsis and septic shock increases the prevalence of DIC, organ dysfunction and the risk of death. DIC associated with sepsis is therefore a syndrome that should be diagnosed and treated early.
General illness severity scores are widely used in the ICU to predict outcome, characterize disease severity and degree of organ dysfunction, and assess resource use. The diagnosis of DIC in routine clinical practice was hampered by the limited availability of reliable and simple tools with sufficient diagnostic accuracy. Indeed, no single clinical or laboratory test has an adequate sensitivity and specificity to confirm or reject a diagnosis of DIC. However, combinations of several readily available coagulation tests may be helpful to establish this diagnosis. Three DIC scoring systems were developed. They provide helpful tools in clinical practice, also in the design and execution of trials aimed at improving the clinical management of patients with DIC and associated conditions.
Treatment of disseminated intravascular coagulation is controversial, but treatment guidelines have been published. Treatment should primarily focus on addressing the underlying disorder. Recent knowledge on important pathogenetic mechanisms that play a role in DIC has resulted in novel therapeutic approaches to patients with DIC. Strategies aimed at the inhibition of coagulation activation may theoretically be justified and have been beneficial in experimental and initial clinical studies. These strategies comprise inhibition of tissue factor mediated activation of coagulation and restoration of physiological anticoagulant pathways.
Viral haemorrhagic fevers are considered to be a serious threat to public health worldwide with up to 100 million cases annually. They are serious viral infections causing DIC. Ebola virus disease is one of the major health problems causing outbreaks with a case fatality rate of up to 90%. It is one of the world’s most virulent diseases. Severely ill patients require intensive supportive care. During an outbreak, those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients. Ebola virus disease outbreaks can devastate families and communities, but the infection can be controlled through the use of recommended protective measures in clinics and hospitals, at community gatherings, or at home. At present, no specific anti-Ebolavirus agents or vaccines are available. But many agents have been studied for the treatment or prevention of Ebola virus disease.