Disseminated Intravascular Coagulation ~ Pureheal96

Disseminated Intravascular Coagulation:

In this condition clots are formed in the body, followed by multiple organ dysfunction syndrome.

It is an acute complication of severe sepsis, hematologic malignancies, severe trauma, and placental abruption.

Etiology:

· Associated with septic condition; mainly due to gram negative bacteria

· Metastasized adenocarcinoma

· Aortic aneurysm

· HELLP syndrome

· Trauma

· Pancreatitis

· Malignancy

· Snake bites

· Transplant rejection, transfusion reaction

· Complication after surgery

Pathophysiology:

There is imbalance between coagulation and bleeding. Tissue factors, get released in circulation in case of trauma, sepsis or cancer treatment.

This in turn activates coagulation factor. Thrombin and fibrin are responsible for clot formation. This may impair coagulation cascade.

End result is excessive bleeding due to clotting factor impairment.

Signs and symptoms:

· Bleeding from multiple sites

· Due to renal failure: Hematuria, oliguria or anuria

· Pulmonary haemorrhage leads to: Dyspnoea, Hemoptysis,

· Chest pain is due to arterial occlusion

· Skin condition develops like: Ecchymosis (bruise), hematoma, jaundice, necrosis or gangrene

· Purpura

· Petechia

· Cynosis

Work-up:

· DIC profile

· Increased prothrombin time

· Increased activated partial prothrombin time

· Decrease fibrinogen level

· Decrease hematocrit and platelet count

· Increase level of D-dimer

Treatment and Management:

· Antibiotics

· Fresh frozen plasma: 15 ml/kg to 30 ml/kg; Cryoprecipitate transfusion

· Heparin / Low molecular weight heparin

· Human activated protein C

Differential Diagnosis:

· Dysfibrinogenemia

· Hemolytic uremic syndrome

· Heparin induced thrombocytopenia

· Thrombotic Thrombocytopenic Purpura

To know more click on the following link:

https://www.ncbi.nlm.nih.gov/books/NBK441834/

Disseminated Intravascular Coagulation

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