Coagulation Disorders

Question 1

What is the patho behind DIC

Answer 1

Characterized by widespread intravascular thrombin formation in response to excessive blood protease activity that overcomes the natural anticoagulation effects of the body
Most commonly caused by sepsis, cancer, trauma, and obstetrics
Systemic deposits of fibrin in vasculature can compromise blood flow to organs, especially lung, kidney, liver, and brain
Clotting factors and platelets are used up and subsequent systemic bleeding occurs

Question 2

Symptoms of DIC

Answer 2

• Oozing from vein puncture sites, petechiae, ecchymosis, hemorrhage, organ failure. Hemodynamic compromise

Question 3

Diagnostics for DIC

Answer 3

• Coag studies and Fibrin degradation product FDP, repeat. Q6-8 hours to reassess.

Question 4

Treatment for DIC

Answer 4

• Treat the underlying cause
• Can give FFP
• Cryo can be given if fibrinogen levels are <100
• Clotting factor not recommended as it can further aggravate bleeding
• No proven efficacy with the use of Anticoagulation