[Significance of tissue perfusion disorders and disseminated intravascular blood coagulation in the pathogenesis of post-resuscitation disease in patients with massive hemorrhage and severe multiple trauma].

A total of 198 patients with massive blood loss and grave combined injury treated at the intensive care ward were monitored for 5 days. This paper presents data on the blood content of peripheral tissues assessed by rheovasography and the time course of coagulating characteristics of the blood and fibrinolysis. Despite the stabilization of arterial pressure in the first hours of treatment, disorders of tissue perfusion persisted for 5 days. Signs of disseminated intravascular coagulation were detected as soon as after 6 h in the presence of expressed progressing thrombinemia, decelerated fibrinolysis in the blood plasma, thrombocytopenia, and consumption of some blood clotting factors. According to our data, disseminated intravascular blood coagulation in the microvessels is possible after 12 h and reaches its maximum on day 2 of treatment; it persisted over the entire follow-up (5 days) period and was associated with clinically manifest involvement of the functions of parenchymatous organs and systems starting from the end of the first or beginning of the second day of treatment.