DIC Flashcards
DIC
Disseminated Intravascular Coagulation
Disseminated Intravascular Coagulation
Activation of the coagulation system that leads to inappropriate hypercoagulation and secondary hemorrhage
What is Disseminated Intravascular Coagulation secondary to?
Sepsis and endotoxemia
Why do Equine have a propensity for Disseminated Intravascular Coagulation?
Lower levels of Antithrombin III activity
SIRS
Activation of coagulation and vascular endothelial disruption
What are the clinical pathologic abnormalities of Disseminated Intravascular Coagulation?
Procoagulant activation
Fibrinolysis activation
Inhibitor consumption
Organ damage
Clinical presentation of DIC during SIRS
Petechiation Prolong bleeding following surgical procedure Gastrointestinal tract Spontaneous bleeding Rapid death without bleeding
Clinical signs of DIC
Hemorrhagic diathesis
epistaxis and hematuria
hemorrhagic tendency after venipuncture
Thromboembolism
What is the most common complication of DIC?
Jugular thrombophlebitis
What type of catheter causes less reaction?
Polyurethane
How do you diagnose DIC?
Platelet count: Thrombocytopenia
Decrease plassma antithrombin or protein C
increase D-dimers
How do you detect coagulation factor consumption?
Prolong Prothrombin Time (PT)
Activated partial thromboplastin (aPTT)
What is sensitive for the diagnosis of DIC?
AT
D-dimers
indicate the amount of fibrin formation within the vasculature
What must be altered to diagnose DIC?
Platelets count Prolong prothrombin (PT) Activated partial thromboplastin (aPTT) Fibrinogen concentration AT activity D-diner concentration
How do you detect coagulation factor activation?
increase thrombin-antithrombin complex (TAT)
How do you treat DIC?
Control the underlying disease
Anti-microbial therapy
Hetastarch
What is the benefit of Hetastarch?
Restores endothelial permeability and albumin linking
Reduces platelet activation and subsequent hypercoagulation
What is the treatment for the Hypercoagulable phase of DIC?
Unfractioned heparin
Low molecular weight heparin
Dalteparine
Enoxaparin
What is the detrimental effect of unfractioned heparin?
RBC agglutination that can lead to extravascular hemolysis and thrombocyopenia effect
Low molecular weight heparin
Reduce excessive fibrin deposition
Reduce excessive coagulation consumption
What is the treatment for the Hypocoagulable phase of DIC?
Plasma transfusion
Yunnan Baiyao
well known traditional chinese herbal remedy
What is Yunnan Baiyao used for?
treating hemorrhages and wounds
What are the DIC consequences?
Hypercoagulation
Fibrin microthrombi deposition in capillaries resulting in hypoxia and MODS/MOF death
What is contraindicated in DIC?
Antifibrinolytics
Hypertonic saline
Hetastarch
