Cytokine-mediated disease
Causes
- Tissue injury - burns, trauma, fat embolus
- Infections
- Vascular/perfusion disorders: vasculitis, PAN, ARDS
- Haematological disorders
- Neoplasms
- Systemic: pancreatitis, burns, embolism, hypothermia
Recognition intraoperatively / clinically
- Understand risk factors
- Bleeding / oozing which is difficult to control
- Hypotension
- Tachycardia
- Low oxygen saturations
- Bleeding from ususual areas - venepuncture, cannulation sites, epistaxis, haematuria from uncomplicated bladder catheterisation
Diagnosis
- Low platelets
- Low plasma fibrinogen (used up in coagulating)
- Increased PT and APTT (clotting factors used up)
- Increased FDPs / D-dimers (more degradation products)
- Haemolysed fragmented red cells