Disseminated Intravascular Coagulation (DIC)

Question 1

What 2 ways can it be triggered?

What does it lead?

It uses up clotting factors. What does this later lead to?

Answer 1

Systemic inflammatory response
Release of procoagulants (e.g. tissue factor) from trauma or cancer

Ischaemia and infarction

Widespread haemorrhaging, tissue hypoperfusion and organ dysfunction

Question 2

Causes:

What are the 3 most common causes?

What 3 obstetric complications could cause this?

Answer 2

Sepsis
Cancer
Trauma

Placental abruption
Amniotic fluid embolism
Eclampsia

Question 3

S+S:

What will you notice first?

There is just widespread organ dysfunction. Why is this?

Answer 3

Widespread bruising and bleeding

Due to widespread micro-vascular thrombosis

Question 4

Investigations:

What blood tests would you do and what would you expect to find?

Answer 4

Raised PT and aPTT

Lowered platelets and fibrinogen

VERY HIGH D-dimers **

DONT FORGET D-DIMER FOR DIC

Question 5

Management:

Treat underlying cause and give blood products if actively bleeding:
- What can be given?

What can be given to support the production of clotting factors?

Answer 5

Platelets if they are low

FFP or prothrombin concentrate complex

Vit K IV