Disseminated Intravascular Coagulation

Question 1

What is disseminated intravascular coagulation?

Answer 1

Simultaneous activation of coagulation and fibrinolysis, leading to microvascular thrombosis and subsequent consumption of clotting factors and platelets

Question 2

What conditions are associated with DIC?

Answer 2

Sepsis
Malignancy
Trauma
Obstetric complications
Acute haemolytic transfusion reactions
Organ transplant rejections

Question 3

What are the symptoms of DIC?

Answer 3

Bleeding from wounds
Haematuria or haematochezia
Epistaxis
Dyspnoea
Chest pain

Question 4

What are the clinical signs of DIC?

Answer 4

Petechiae
Prolonged bleeding
Altered mental status
Focal neurological deficits

Question 5

What investigations are used in the diagnosis of DIC?

Answer 5

FBC - thrombocytopenia
Clotting studies - prolonged PT and aPTT
Fibrinogen levels - decreased levels
D- dimer - elevated
Blood cultures - identifying and treating underlying cause

Question 6

What is the first line management of DIC?

Answer 6

Treating underlying cause
Blood product transfusion
- Packed red blood cells
- Fresh frozen plasma
- Platelets
Anticoagulants
- Low dose heparin in severe cases with predominant thrombotic features

Question 7

What is the second line treatment of DIC?

Answer 7

Recombinant activated protein C

Question 8

What are the complications of DIC?

Answer 8

Intracranial bleeding
Life-threatening haemorrhage
Multi-organ failure
Gangrene