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This book contains four sections of 35 chapters devoted to a comprehensive review of the author's research and experience since 1950. Original investigation was stimulated by four clinical cases with a common triad of shock, bleeding tendency, and acute renal failure. This was identified as the syndrome of acute disseminated intravascular coagulation (DIC).
Diagnosis is based on histologic evidence of capillary thrombi and clinical observation of sudden hypotensive shock and a bleeding tendency. The coagulopathy involves fibrinogen (plus any or all of the 12 coagulation factors), platelets, and activated endogenous heparin and fibrinolysins. The inciting clinical conditions are many; they include trauma, burns, transfusion reaction, acute organ failure, hemolytic disorders, complications of late pregnancy, extracorporeal circulation, and others.
Etiologic studies are based on observations in dogs and are accompanied by excellent photomicrographs in chapters 2 and 3. The coagulopathy is postulated to be a three-stage mechanism involving formation of a