DIC Flashcards
What does DIC stand for?
Disseminated Intravascular Clotting
What is DIC?
Unregulated clotting and lysis
What causes DIC?
Trauma
Cytokines
Infection (gram -ve)
What is the pathophysiology of DIC?
The TF is no longer hidden away and is instead showing to all the clotting cascade meaning lots of blood clots can occur
This uses up the coagulation factors.
There is then more fibrinolysis leading to release of FDPs and inhibition of clot formation until the time that coagulation factors have been remade
BAD CYCLE
What is the cycle of DIC?
More blood clots = more ischaemic = more inflammation = more blood clotting
What happen to the coagulation factors?
They get used up at a higher rate than they can be made
What happens to the FDPs?
They are produced in large numbers so then prevent clotting for a while
Which other compounds are produced during DIC and how does this affect it?
Kinins
Plasmin
These are both vasodilators and therefore cause the shock that is commonly seen in DIC
What does DIC look like clinically?
Can look like acute coagulopathy of trauma from dilution
What is the distinction in clinical practice between DIC and acute coagulopathy?
Look to see if the FDPs are up
Why does FFP take so long to come?
They need to be defrosted
What do we still have to think about the patient aside from fluids?
Keep the patient warm
Sort out the cause
Reverse any drugs they are on
Reduce fibrinolysis
Why have shock packs been made?
So that you don’t have to remember all the things you need, you can just request one thing - “shock pack”
What monitoring targets do we aim for?
BP 60-70 Haematocrit - 0.3 Plt 75 Fibrin 1 Temp >35.5
What is TEG?
It is a process that produces patterns (onenote) depending on the different clotting processes
