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[Clinical problems of microrheology in disseminated intravascular coagulation (author's transl)].

Among the earliest products of a potentially succeeding disseminated intravascular coagulation (DIC) are the soluble fibrin monomer complexes representing a state of hypercoagulability. They are passing microcirculation as long as there are no precipitation activities, which may involve only one single organ. A typical example is the endotoxin shock followed by fibrination of the kidneys. The clogging of microcirculation by fibrination specifically released in this organ or another may be prevented in case of a well-timed diagnosis, but scarcely can be removed therapeutically (possibly therapeutical fibrinolysis). The effects of localising fibrination yet independent of clotting mechanism may be tackled by treating the causal disease. Hypercoagulability always preceding DIC can be controlled mainly by heparin. Its well-timed application depends on diagnostics which are able to define the momentary situation in the mostly progredient process, comprising a mortality of about 50%. Finally, as a possible method to assess the clinical situation the resonance thrombography, a successor of thrombelastography, is put forward.