Observation and Treatment of Pulmonary Microthrombosis in Childhood Pneumonia With Elevated D-dimer

Summary

Objective 1\. Master the clinical feathers, imaging features and laboratory diagnosis characteristics and economic costs of children pneumonia with higher D-dimer: 1. Compare the characteristics of different groups of children in the course of the disease，clinicalsymptoms and signs; 2. All the children in the study need to do enhanced CT, to observe if there were intrapulmonary vascular thrombosis and necrosis pneumonia signs; 3. compared changes of coagulation index beside D-dimer. 2\. Compared with low molecular weight heparin prevention Disseminated intravascular coagulation（DIC） dose and instructions to the recommended dose in safety and effectiveness,and proposed elevated anticoagulation D-Dimer specification of the clinical treatment of children with pneumonia. Background and rationale: Pneumonia is the main cause of lung function injury and death in children. The high blood coagulation state can lead to the formation of pulmonary vascular thrombosis, local pulmonary ischemia and necrosis, which may be an important mechanism for the occurrence of necrotizing pneumonia and pulmonary embolism in children with pneumonia. Elevated D-dimer is an important predictor of pulmonary thrombosis and necrotizing pneumonia. At present, D-Dimer in many children with severe pneumonia is found to increase, the symptom is severe, the late stage of the performance of necrotizing pneumonia, seriously affect the children's lung function and quality of life.

Timeline

Start

2014-12

Primary completion

2017-07

Completion

2018-02

Publications

• Background Esposito S, Cohen R, Domingo JD, Pecurariu OF, Greenberg D, Heininger U, Knuf M, Lutsar I, Principi N, Rodrigues F, Sharland M, Spoulou V, Syrogiannopoulos GA, Usonis V, Vergison A, Schaad UB. Antibiotic therapy for pediatric community-acquired pneumonia: do we know when, what and for how long to treat? Pediatr Infect Dis J. 2012 Jun;31(6):e78-85. doi: 10.1097/INF.0b013e318255dc5b.
• Background Schroeder JD, McKenzie AS, Zach JA, Wilson CG, Curran-Everett D, Stinson DS, Newell JD Jr, Lynch DA. Relationships between airflow obstruction and quantitative CT measurements of emphysema, air trapping, and airways in subjects with and without chronic obstructive pulmonary disease. AJR Am J Roentgenol. 2013 Sep;201(3):W460-70. doi: 10.2214/AJR.12.10102.
• Background Litmanovich DE, Hartwick K, Silva M, Bankier AA. Multidetector computed tomographic imaging in chronic obstructive pulmonary disease: emphysema and airways assessment. Radiol Clin North Am. 2014 Jan;52(1):137-54. doi: 10.1016/j.rcl.2013.09.002.
• Background Youn YS, Lee KY, Hwang JY, Rhim JW, Kang JH, Lee JS, Kim JC. Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia. BMC Pediatr. 2010 Jul 6;10:48. doi: 10.1186/1471-2431-10-48.
• Background Madzhuga AV, Somonova OV, Elizarova AL, Sviridova SP, Zubrikhin GN. [The clinical value of D-dimer in the diagnosis and treatment of thromboembolic complications and DIC syndrome in cancer patients]. Anesteziol Reanimatol. 2005 Sep-Oct;(5):55-7. Russian.
• Background Zhao D, Ding R, Mao Y, Wang L, Zhang Z, Ma X. Heparin rescues sepsis-associated acute lung injury and lethality through the suppression of inflammatory responses. Inflammation. 2012 Dec;35(6):1825-32. doi: 10.1007/s10753-012-9503-0.
• Background Lankisch P, Laws HJ, Wingen AM, Borkhardt A, Niehues T, Neubert J. Association of nephrotic syndrome with immune reconstitution inflammatory syndrome. Pediatr Nephrol. 2012 Apr;27(4):667-9. doi: 10.1007/s00467-011-2069-5. Epub 2011 Dec 29.
• Background van der Poll T, de Boer JD, Levi M. The effect of inflammation on coagulation and vice versa. Curr Opin Infect Dis. 2011 Jun;24(3):273-8. doi: 10.1097/QCO.0b013e328344c078.

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