[Study of 51 cases of disseminated intravascular coagulation with reference to the association with acute renal failure. Results in severely ill patients (author's transl)].

During the years 1977 to 1979 51 patients admitted to a general Intensive Care Unit were diagnosed of disseminated intravascular coagulation (DIC); their clinical histories were reviewed and they form the basis of this report. The diagnosis was made independently of the eventual clinical manifestations and it was based on the platelet count, serum fibrinogen levels, alteration of the prothrombin time and the cephalin-kaolin time, elevation of fibrin degradation products, and positivity of the ethanol test. An attempt was made to elucidate the precipitating cause of the coagulopathy, and to see if there was one or more of them. Particular emphasis is made on the association with Gram negative sepsis. Survival was evaluated in relation to heparin therapy, massive doses of corticosteroids, and association to acute renal failure. In conclusion, severe DIC with or without bleeding appears to be a manifestation of multiorgan failure seen in severely ill patients; the prognosis and mortality of this form of DIC is worse than the usual DIC and treatment with heparin or corticosteroids do not increase survival, while its association to acute renal failure implies a higher mortality (p less than 0.02).