77788
document
Coagulation factor concentrate in the treatment of the haemorrhagic diathesis of fulminant hepatic failure . To assess the value of clotting factor concentrate infusions in fulminant hepatic failure , a controlled trial was performed in which nine patients were randomly allocated to treatment with either concentrate alone or concentrate plus heparin . The five patients receiving concentrate alone all died , with major bleeding as the direct cause of death in three , whereas in the four receiving heparin as well there was only one instance of bleeding and one patient survived . Clinical evidence of intravascular coagulation appeared in two patients treated with concentrate alone and the laboratory evidence of this progressed during the period of infusions in all patients in both treatment groups , although to a lesser extent in those receiving heparin . Additional evidence for intravascular coagulation came from the changes observed in factor VIII levels which , although initially high in all patients , fell subsequently , particularly in those given concentrate alone . There was some improvement in the prothrombin ratio in both groups of patients but not complete correction , and serial assays of clotting factors showed that although factor II rose to high levels during treatment , factors IX and X showed little response . Thus , the use of concentrate of factor IX in this trial , as well as potentiating intravascular coagulation , was inadequate as replacement for the clotting factor deficiencies .
77789
Intervention_Pharmacological
Coagulation factor concentrate
77790
Intervention_Pharmacological
clotting factor concentrate infusions
77791
Intervention_Pharmacological
concentrate alone or concentrate plus heparin
77792
Intervention_Pharmacological
concentrate
77793
Intervention_Pharmacological
heparin
77794
Intervention_Pharmacological
concentrate alone
77795
Intervention_Pharmacological
heparin
77796
Intervention_Pharmacological
concentrate
77797
Outcome_Physical
haemorrhagic diathesis
77798
Outcome_Physical
fulminant hepatic failure .
77799
Outcome_Physical
hepatic failure
77800
Outcome_Mortality
died
77801
Outcome_Physical
major bleeding
77802
Outcome_Physical
bleeding
77803
Outcome_Mortality
survived .
77804
Outcome_Physical
intravascular coagulation
77805
Outcome_Physical
factor VIII levels
77806
Outcome_Physical
prothrombin ratio
77807
Outcome_Physical
factor II
77808
Outcome_Physical
factors IX and X
77809
Outcome_Physical
factor IX
77810
Outcome_Physical
intravascular coagulation
77811
Participant_Condition
haemorrhagic diathesis of fulminant hepatic failure
77812
Participant_Condition
fulminant hepatic failure