Disseminated Intravascular Coagulation During Rewarming Following Hypothermia

DISSEMINATED intravascular coagulation (DIC) is a syndrome characterized by hemorrhage, thrombocytopenia, consumption of clotting factors, secondary fibrinolysis with elevated levels of fibrinogen-fibrin degradation products, microangiopathic hemolytic anemia, and fibrin thrombi in blood vessels.¹This syndrome occurs in a variety of clinical conditions and is initiated by the liberation of tissue thromboplastin into the circulation, by vascular endothelial damage, by abnormalities of blood flow, or by all three.¹Disseminated intravascular coagulation has been recognized as a complication of hypothermia in two series of neonatal infants²,³but has been reported in only one adult patient.⁴The present report describes a 13-year-old in whom DIC developed during the rewarming phase of accidental hypothermia. Methods The prothrombin time was determined using rabbit brain thromboplastin and the activated partial thromboplastin time was performed with a kaolin-activated reagent (Coag-A-Chek). Fibrinogen levels were measured using a standard thrombin reagent (Data-Fi) and fibrinogen determination