[Stages of disseminated intravascular coagulation after resuscitation in patients with massive hemorrhage and severe multiple trauma].

Changes in blood coagulation and fibrinolysis were followed up in 255 patients of intensive care wards during 5 days after effective treatment of grave and terminal stages of traumatic hemorrhagic shock. Four stages in the development of disseminated intravascular coagulation (DIC) were distinguished. Special attention is paid to the time course of the third stage with repeated hypercoagulation, suppressed fibrinolysis, and microthrombolysis in organs and tissues leading to multiple organ failure. The fourth stage of DIC is described, when involvement of the organs and generalized inflammation or sepsis is associated with remote (on days 3-5 and later) hemorrhages. These hemorrhages are apparently caused by disorders in fibrin production but not by acute fibrinolysis and consumption coagulopathy, as during the second stage of DIC.