Disseminated Intravascular Coagulation (DIC) Brya

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Disseminated Intravascular Coagulation (DIC)

• Bryan Imayanagita

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Background

• Pathological activation
• Formation of clots throughout the body in the
  blood vessels
• Leads to abnormal bleeding can cause clots that
  disrupt blood flow to organs
• Multiple organ failure and death

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Causes

• Sepsis (most common)
• endothelial cell damage (heat stroke, shock)
• obstetrical complications
• neoplasias
• trauma

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Pathophysiology

• fire/fire extinguisher analogy in normal
  coagulation
• Thrombin (fire) generation at the site of injury
• The endothelium (fire extinguisher) expresses
  antithrombin molecules which will bind to
  thrombomodulin
• No endothelium at damaged tissue site allows
  coaguation. Stopped once thrombin reaches healthy
  tissue.
• In DIC, coagulation and anti-coagulation out of
  balance

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Diagnosis

• Bleeding from 3 unrelated sites
• History of blood loss, hypovolemia
• DVT, microvascular thrombosis

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Main Features of DIC
Features Affected Patients,
Bleeding 64
Renal dysfunction 25
Hepatic dysfunction 19
Respiratory dysfunction 16
Shock 14
Central nervous system dysfunction 2
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Treatment

• Determined if patient is bleeding or needs an
  invasive procedure
• If either is positive fresh frozen plasma or
  cryoprecipitate can be given
• Folic acid
• Heparin treatment not established
• May not be effective needs anti-thrombin for
  anticoagulant activity, reduced by DIC

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Prognosis

• 10-50 mortality rate
• DIC with sepsis significantly higher than DIC
  with trauma

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Sources

• http//www.medstudents.com.br/terin/terin2.htm
• http//emedicine.medscape.com/article/779097-overv
  iew

• http//www.medstudents.com.br/terin/terin2.htm
• http//emedicine.medscape.com/article/779097-overv
  iew