J.Jpn. Surg. Soc.. 83(1): 1-15, 1982

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Original article

CHANGES IN BLOOD COAGULATION AND RESPIRATORY FUNCTIONS DURING AND AFTER SHOCK INDUCED BY A PROLONGED BILATERAL LIMB ISCHEMIA IN DOGS-A PROBABLE RELEVANCE OF THE DISSEMINATED INTRA VASCULAR COAGULATION (DIC) TO THE ADULT RESPIRATORY DISTRESS SYNDROME (ARDS)

The etiology of adult respiratory distress syndrome (ARDS) is still controversial and many factors have been claimed to be contributory to ARDS. The disseminated interavascular coagulation syndrome (DIC) counts among them.
In order to clarify a suggested relevance of DIC to ARDS, we designed an experimental model of DIC in dogs by inducing a prolonged bilateral limb ischemia followed by recirculation.
As soon as the blood circulation was reestablished, the animals fell into a severe shock with marked decreases in platelets, fibrinogen, antithrombin III and plasminogen and increase in fibrinogen/fibrin degradation products (FDP). The P_aO₂ decreased simultaneously and the alveolar-arterial oxygen tension difference (_A-a DO₂), pulmonary shunt (Qs/Qt) and the physiological V_D/V_T ratio increased progressively. Marked perivascular edemas and dilated lymphatic channels were principal histological findings in the lungs.These findings closely resemble those observed in the early stage of ARDS in man.
An administration of heparin or prostaglandin E₁ prior to the induction of shock minimized or even prevented these changes in the respiratory functions as well as in blood coagulation.
Thus we presume that DIC may trigger ARDS after severe trauma or extensive surgery.

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