Disseminated intravascular coagulation

Question 1

DIC

Answer 1

An acquired coagulation disorder which results from the intravascular activation of both the coagulation and fibrinolytic system causing simultaneous Thrombosis and Hemorrhage

Question 2

Associated conditions of DIC

Answer 2

* malignant neoplasms, infections, sepsis
Liver disease
Massive trauma
Extensive burns
Shock
OB complications
Acute leukemia

Question 3

Pathophysiology of DIC

Answer 3

 thrombin causes conversion of fibrinogen to fibrin producing fibrin clot‘s

Coagulation factors are thus reduced ( fibrinogen, PT, platelets, factors V VIII)

Circulating plasmin activates the fibrinolytic systems which lysis fibrin clot into fibrin degradation products ( FDPs)

Hemorrhage results from the anticoagulant activity of FTPs and the depletion of coagulation factors

Question 4

Signs and symptoms of DIC

Answer 4

Varies greatly in clinical severity
Patients presenting in acute DIC demonstrate profound disturbances and hemostasis with Ekhymosis, oozing from vina puncture sites and petechiae to mucous membranes

Question 5

Lab and diagnostics for DIC

Answer 5

Platelets < 150
Fribrinogen < 170
Low RBC 
Increased FDP > 45
PT > 19 sec
PTT > 42 sec 
D dimer positive

Question 6

Management of DIC

Answer 6

Platelet transfusion ( thrombocytopenia)

Fresh frozen plasma ( to replace clotting factors)

Cryoprecipitate ( to maintain fibrinogen levels)

Therapy is aimed at Sisation of bleeding, increasing plasma fiper in the gin and the platelet count, and decreasing fibroid degradation products