DIC Flashcards
What is DIC?
pathologic disruption of the finely balanced process of hemostasis eventually leading to multiple organ dysfunction
DIC labs include:
CBC - platelet Prothrombin time (PT) Fibrinogen Fibrin related markers (FRMs) (D-dimer) PBS
Differential diagnosis for DIC
Massive blood loss HIT Vitamin K Deficiency Liver Insufficiency Thrombotic microangiopathy
What are fibrin split products?
the substances left behind when clots dissolve in the blood
Normal fibrinogen by trimester
1st 244-510
2nd 291-538
3rd 373-619
Complications of DIC
Acute kidney injury.
Change in mental status Respiratory dysfunction Hepatic dysfunction Life-threatening thrombosis and hemorrhage Cardiac tamponade Hemothorax Intracerebral hematoma
DIC management
1 pRBC:1 FFP:1 platelet
What is in FFN?
Volume is 250 ml
Fibrinogen
Anti-thrombin III
Factors V and XIII
1U of FFP raises fibrinogen by ___ mg/dL
10
What is in cryoprecipitate?
Volume is 20 ml Fibrinogen Factor VIII Factor XIII von Willebrand factor
What is TRALI?
Transfusion related acute lung injury
Fluid build-up in the lungs/acute injury following transfusion with no other explanation
Diagnostic criteria for TRALI
- Acute onset
- PCWP = 18 mm Hg
- CXR: bilateral infiltrates
- PaO2/FiO2 = 300 mmHg
How do you manage TRALI?
Stop transfusion
WBC and CXR
Notify blood bank
Goal O2 sat % range following supplementation?
92-98%
Intubation Indications
pO2 = 60 pCO2 >/= 34 pH < 7.35 maternal exhaustion altered consciousness
