Biomarkers of disseminated intravascular coagulation in pediatric intensive care unit in Thailand.

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  • Additional Information
    • Source:
      Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 101300213 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1751-553X (Electronic) Linking ISSN: 17515521 NLM ISO Abbreviation: Int J Lab Hematol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Blackwell Scientific Publications, c2007-
    • Subject Terms:
      Intensive Care Units, Pediatric*; Disseminated Intravascular Coagulation/*diagnosis; Adolescent ; Antithrombin III/analysis ; Biomarkers/analysis ; Child ; Child, Preschool ; Disseminated Intravascular Coagulation/complications ; Disseminated Intravascular Coagulation/mortality ; Hemorrhage/etiology ; Humans ; Infant ; Male ; Protein C/analysis ; Thailand ; Thrombomodulin/analysis ; Thrombosis/etiology
    • Abstract:
      Introduction: Disseminated intravascular coagulation (DIC) is a systemic activation of hemostatic system caused by several causes. Biomarkers including antithrombin (AT), protein C (PC), and thrombomodulin (TM) were reported as the additional markers for DIC in adults. This study aimed to determine the association between biomarkers among patients with overt DIC (ODIC) and nonovert DIC (NDIC) in children in PICU.
      Methods: We enrolled 103 subjects, aged 1 month-18 years, who were admitted to PICU at Chiang Mai University (CMU) Hospital >24 hours with underlying conditions predisposing to DIC were enrolled. Biomarkers were tested after 24 hours of admission. Subject who had NDIC on the 1 st investigations would have other tests on days 3-5 of admission.
      Results: The incidence of ODIC by the International Society on Thrombosis and Hemostasis (ISTH) DIC score was found 24%. The bleeding, thrombosis, and death were significantly higher in ODIC group (P < 0.05). Mean levels of AT and PC in ODIC group were significantly different from NDIC one (66.9% vs 79.9%, P < 0.001 and 46.1% vs 59.2%, P = 0.004, respectively) while mean level of TM was not different between two groups. Adding AT to DIC score was better than the original score for predict mortality [area under curve (AUC) = 0.662 vs AUC = 0.65] and bleeding (AUC = 0.751 vs AUC = 0.732).
      Conclusions: ODIC is prevalent among critically ill children. Adverse outcomes were more commonly found in children with ODIC. AT and PC levels after 24 hours of PICU admission seem to be the useful biomarkers for ODIC in PICU.
      (© 2018 John Wiley & Sons Ltd.)
    • Grant Information:
      117/2559 Faculty of Medicine, Chiang Mai University
    • Contributed Indexing:
      Keywords: antithrombin; disseminated intravascular coagulation; intensive care unit; pediatrics; protein C; thrombomodulin
    • Accession Number:
      0 (Biomarkers)
      0 (Protein C)
      0 (Thrombomodulin)
      9000-94-6 (Antithrombin III)
    • Publication Date:
      Date Created: 20180913 Date Completed: 20190219 Latest Revision: 20190320
    • Publication Date:
      20240104
    • Accession Number:
      10.1111/ijlh.12917
    • Accession Number:
      30208259