MÔ HÌNH DẠNG SÓNG HAI PHA VÀ KHẢ NĂNG DỰ BÁO TÌNH TRẠNG DIC Ở BỆNH NHÂN SUY GAN CẤP

Abstract

Objective: To describe of Biphasic Waveform Pattern (BWP) characteristics and ability to predict disseminated intravascular coagulation (DIC) status in patients with acute liver failure (ALF). Subjects and Methods: A study was carried on 40 patients with acute liver failure (ALF) treated at the Center for Critical care medicine of Bach Mai Hospital from July 2023 to July 2024. Blood samples were collected on admission before the use of anticoagulants and were analyzed using the CS 5100 machine and Dade Actin FSL reagent. The values of the clot waveform analysis (CWA), including min1, min2, max2 and  waveform characteristics, along with sepsis and non-sepsis status, and disseminated intravascular coagulation (DIC) status were recorded. CWA data was analyzed for correlation with infection and DIC status at the time of admission by using medical statistical software. Results: The male ratio was higher than female, accounting for 70%, with an average age of 55.2 ± 15.5 (23-82). The majority of the CWA waveform shape was normal (Sigmoid wave) at 42.5%, with biphasic waveform (BWP) at 27.5%, prolonged waveform at 22.5%, and combined waveform at 7.5%. The BWP waveform in patients with ALF and sepsis accounted for 78.6%, and those without sepsis was 11.5%. The presence of BWP waves in ALF patients with sepsis and DIC score ≥ 5 was higher than the group without sepsis and DIC < 5 with odds ratios were 27.8 times (CI95% 4.9-162.5) and 13.5 times (CI95% 2.43-74.9), respectively. Conclusions: The BWP waveform is able to predict DIC in patients with sepsis, therefore, clot waveform analysis should be included in test panel for these patients.