Clotting: Disseminated Intravascular Coagulation Flashcards
What is Disseminated Intravascular Coagulation?
A disruption of hemostasis characterized by widespread intravascular clotting and bleedin
What is the pathophysiology of DIC?
Proteins that control clotting become overactive and causes small clots to form in blood vessels. These clots restrict blood flow to the brain, liver, or other organs
How can DIC be triggered?
It can be triggered by damage of endothelial tissues, the release of tissue factors into circulation, or inappropriate activation of the clotting cascade by endotoxin or products of microorganisms.
What conditions can make DIC occur in regard to tissue damage?
- Trauma: burns, gunshot wounds, frostbite, head injury
- Obstetric complications: Septic abortions, abruptio placenta, amniotic fluid embolus, retained dead fetus
- Neoplasms: acute leukemia, adenocarcinomas
- Hemolysis
- Fat embolisms
What conditions can make DIC occur in regard to vessel damage?
- aortic aneurysm
- Acute glomerulonephritis
- Hemolytic uremic syndrome
What conditions can make DIC occur in regard to infections?
- Bacterial infection or sepsis
- Viral or mycotic infections
- Malaria
What are the risk factors for DIC?
- hemolytic reactions to blood transfusions, blood infections by bacteria or fungi, and improperly formed blood vessels
- Leukemia, pancreatitis, and liver diseases
- recent surgery or anesthesia and severe tissue damage such as burns or head injuries also increase the risk of developing DIC
- pregnancy complications
What is the difference between acute and chronic DIC?
Acute DIC develops rapicly over hours or days and requires immediate treatment.
Chronic DIC develops slowly, over weeks or months. It causes excessive blood clotting but usually does not lead to bleeding. Pts with cancerous tumors and aortic aneurysms are commonly affected by chronic DIC.
What are the clinical manifestations of the cardiovascular system with DIC?
- Decreased perfusion
- Shock
- Inappropriate clotting
- Tissue necrosis and gangrene
- Oozing from wounds, IV sites, and mucous membranes
What are the clinical therapies for cardiovascular manifestations for DIC?
- administer fluids as ordered
- monitor intake and output
- monitor vital signs
- maintain bed rest
What are the respiratory clinical manifestations of DIC?
impaired gas exchange resulting from micro clots in the pulmonary vasculature
What are the clinical therapies for respiratory clinical manifestations of DIC?
- monitor respiratory status
2. Maintain ventilatory support if required
What are the CNS clinical manifestations of DIC?
Impaired cerebral perfusion
What are the clinical therapies for CNS manifestations for DIC?
Conduct neurologic assessment every 2 hours during the critical period, then every 4 hours until stabilized.
What are the urinary clinical manifestations of DIC?
1 impaired renal perfusion
2. Impaired clotting mechanism leading to bleeding