DIC Flashcards
Thrombosis Neuro s/s (3)
- AMS
- Delirium
- Coma
Thrombosis Integumentary (2)
- focal ischemia
- gangrene
Thrombosis Renal (2)
- oliguria
- azotemia
Thrombosis Pulmonary (1)
- ARDS
Thrombosis GI (1)
- Paralytic Ileus
Fibrinolysis Neuro (2)
- Intracerebral bleeding
- AMS
Fibrinolysis Integumentary (3)
- Petechiae
- Echymoses
- Bleeding from IV site
Fibrinolysis Renal (1)
- Hematuria
Fibrinolysis Pulmonary (3)
- respiratory congestion
- dyspnea
- hemoptysis
Fibrinolysis Mucous Membranes (2)
- epistaxis
- gingival oozing
Fibrinolysis GI (1)
- massive bleed
Thrombin generation leads to 3 activities
- intravascular fibrin deposition
- plasminogen activation
- platelet consumption
DIC Diagnostics - prolonged (3)
- PT
- INR
- aPTT
Related to clotting factor depletion
DIC Diagnostics - decreased (4)
- Platelets
- Factor Assay
- Fibrinogen
- Anti-thrombin
DIC Diagnostics - increased (2)
- FDP (byproduct of fibrinolytic activity)
- D Dimer (presents with fibrinolysis)
When to transfuse platelets
- bleeding and < 50,000
- high risk of bleeding and < 20,000
When to transfuse FFP
- bleeding and PT/aPTT > 1.5 normal
- fibrinogen < 1.5 g /dL
When to transfuse fibrinogen concentrate or cryoprecipitate
- bleeding and hypofibrinogenemia < 1.5 g/dL despite FFP replacement
Normal Fibrinogen
- Clotting Factor 1
- Non-vitamin K dependent
200-400 mg/dL
When is Fibrinogen increased?
In sepsis (because inflammation causes clotting!), burns, inflammatory and collagen diseases
Normal D Dimer
- Fibrin-split product
- Presence represents fibrinolysis specific to DIC, PE, DVT, and arterial thrombosis (MI)
- Normally not present
Normal Fibrinogen Degradation split Product (FDP)
- Byproduct of fibrinolytic activity
- Reflects primary fibrinolysis
< 10 mcg / mL
Normal PT
- clotting factor 2
- vitamin K dependent
- think COUMADIN!
11-16 seconds
