INTRAVASCULAR COAGULATION ASSOCIATED WITH ADULT RESPIRATORY-DISTRESS SYNDROME

In 7 of 30 consecutive patients with the adult respiratory distress syndrome, disseminated intravascular coagulation (DIC) developed. Increasing respiratory dysfunction characterized by decreased effective static compliance and increased hypoxemia coincided with the development of DIC. Patients in whom DIC developed were characterized by a high incidence of bleeding, gangrene of the extremities, renal dysfunction, mortality and autopsy evidence of fibrin microthrombi in the lungs, kidney and skin. In 12 of 23 patients who did not meet the criteria for DIC, the platelet count decreased by at least 50% of the initial values at some time during their illness. Fibrin microthrombi were found in the lungs in the majority of the patients subjected to autopsy. Deposition of platelets on damaged pulmonary capillary endothelium apparently may be more common in the adult respiratory distress syndrome than the DIC syndrome.