The defibrination syndrome

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Abstract
Acquired hypofibrinogenemia occurs not infrequently in association with a variety of clinical disorders. It is only a complication of some underlying disease process which should be diagnosed and treated. Eight patients with this hemorrhagic catastrophy were encountered in a 2-year period. Only, 2 of these patients survived. In none of the 5 autopsied cases could intravascular thrombi be demonstrated at postmortem examination, a not uncommon finding, although the basic mechanism for defibrination seems to be intravascular coagulation with the rapid consumption of fibrinogen and/or increased fibrinolytic activity of the plasma. It is recognized that intravascular clotting causes multiple coagulation deficiencies and not just lowered fibrinogen levels or increased fibrinolytic activity. Therapy for the former consists in the administration of fibrinogen and fresh plasma whereas the latter should be treated with [epsilon]-aminocaproic acid or comparable antifibrinolytic drugs.