DIC Flashcards
What is disseminated intravascular coagulation?
• DIC is in response to an illness or disease which results in dysregulated blood clotting
• There is both bleeding and thrombosis simultaneously
What causes bleeding in DIC?
widespread activation of coagulation leads to a reduction in conc of circulating coagulation factors
Known as consumptive coagulopathy
What are some causes of DIC? (7)
Shock
Sepsis/severe infection
Major trauma/burns
Malignancies
Obstetric emergencies
Severe immune mediated reactions
Severe organ dysfunction
What are the complications of DIC? (6)
• Multi-organ failure
• Life-threatening haemorrhage
• Cardiac tamponade
• Haemothorax
• Intracranial haemorrhage
• Gangrene and loss of digits
What is needed for there to be a diagnosis of DIC?
Some evidence of a precipitating factor
What are some symptoms of DIC? (3)
Bleeding from unusual sites
Widespread or unexpected bruising
New confusion or disorientation
What are some clinical signs of DIC? (6)
• Signs of haemorrhage: bleeding from cannula sites/venepuncture sites, melaena, haematemesis, rectal bleeding, epistaxis, haemoptysis, haematuria
• Petechiae or purpura
• Livedo reticularis: a mottled lace-like patterning of the skin
• Purpura fulminans: widespread skin necrosis
• Localised infarction and gangrene for instance of the digits
• Confusion
What is seen on an fbc in DIC?
Thrombocytopenia
Which pathways is prothrombin time a measure of?
Extrinsic and common pathways of coagulation
What happens to PT and APTT in DIC?
Both prolonged
What pathways is APTT a measure of?
Intrinsic and common pathways
What happens to fibrinogen levels in DIC?
Usually decreased as fibrinogen is converted to fibrin in intravascular thrombosis
What happens to d-dimer in DIC?
Typically raised providing evidence of degradation of fibrin clots around the body
What are the 2 stages of treatment in DIC?
• Treat underlying disorder to stop the triggering process
• Supportive treatment to restore normal coagulation
