Disseminated intravascular coagulation is a condition in which
small blood clots develop throughout the bloodstream, blocking small
blood vessels. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding.
What are the findings for disseminated intravascular coagulation?
Laboratory findings suggestive of DIC include
a low platelet count, elevated D-dimer concentration, decreased fibrinogen concentration, and prolongation of clotting times such as prothrombin time (PT)
.
What complications are associated with DIC?
- Acute kidney injury.
- Change in mental status.
- Respiratory dysfunction.
- Hepatic dysfunction.
- Life-threatening thrombosis and hemorrhage (in patients with moderately severe–to–severe DIC)
- Cardiac tamponade.
- Hemothorax.
- Intracerebral hematoma.
What happens to PT and PTT in DIC?
PROTHROMBIN TIME AND ACTIVATED PARTIAL THROMBOPLASTIN TIME
Both PT and aPTT seem prolonged in about 50% of DIC cases which is attributed to the
consumption of coagulation factors
but can also be prolonged in impaired synthesis of coagulation factors and in massive bleeding.
Which laboratory result will be elevated in a patient with disseminated intravascular coagulation?
Patients with DIC can present with a wide range of abnormalities in their laboratory values. Typically, prolonged coagulation times, thrombocytopenia,
high levels of fibrin degradation products (FDPs)
, elevated D-dimer levels, and microangiopathic pathology (schistocytes) on peripheral smears are suggestive findings.
Which of the following conditions is most likely to be associated with disseminated intravascular coagulation?
People who have one or more of the following conditions are most likely to develop DIC:
Sepsis
(an infection in the bloodstream) Surgery and trauma. Cancer.
What is meant by intravascular?
Definition of intravascular
:
situated in, occurring in, or administered by entry into a blood vessel intravascular thrombosis an intravascular injection
.
Does DIC cause thrombocytopenia?
Severe, rapid-onset DIC causes severe thrombocytopenia
, prolonged prothrombin time and partial thromboplastin time, a rapidly declining plasma fibrinogen level, and a high plasma D-dimer level.
Does disseminated intravascular coagulation leads to Hypocoagulation?
DIC is characterized by the systemic activation of coagulation, leading to widespread microvascular thrombosis, which compromises organ perfusion and can contribute to organ failure. The ongoing activation of coagulation may exhaust platelet and coagulation factors, resulting in a hypocoagulable state and bleeding.
Which event that occurs during disseminated intravascular coagulation DIC may predispose a patient to hemorrhage?
Consumption of clotting factors and platelets in DIC
can result in life-threatening hemorrhage. Derangement of the fibrinolytic system further contributes to intravascular clot formation, but in some cases, accelerated fibrinolysis may cause severe bleeding.
How can disseminated intravascular coagulation DIC cause ischemia thrombosis and bleeding?
As DIC progresses, the overactive clotting uses up platelets and clotting factors, which are proteins that help with normal blood clotting. Without these platelets and clotting factors, DIC can cause
bleeding just beneath the skin
, in the nose or mouth, or deep inside the body.
Which clinical manifestation of disseminated intravascular coagulation are due to the depletion of clotting factors?
Acute DIC is a haemorrhagic disorder characterised by
multiple bruises
(ecchymoses), bleeding from mucosal sites (such as lips and genitals) and depletion of platelets and clotting factors in the blood. Purpura fulminans is a severe and rapidly fatal form of acute DIC.
Why does DIC increase PT and PTT?
Schistocytes are seen in approximately 50% of cases of DIC. Patients with DIC will present with both the PT and PTT
prolonged due to decreased levels of coagulation factors in both the intrinsic and extrinsic pathways in
a Protime and Partial Thromboplastin Time study.
What suppresses fibrinolytic activity in the pathogenesis of disseminated intravascular coagulation DIC )?
However, this profibrinolytic response is almost immediately followed by suppression of fibrinolytic activity due to a sustained increase in plasma levels of PAI-1 ; these effects are mediated by
TNF-2 and IL-1
.
How can you prevent disseminated intravascular coagulation?
- Plasma transfusions to reduce bleeding. Plasma transfusion replace blood clotting factors affected by DIC.
- Transfusions of red blood cells and/or platelets.
- Anti-coagulant medication (blood thinners) to prevent blood clotting.
How does sepsis cause disseminated intravascular coagulation?
During sepsis,
inflammation diffusely activates the coagulation system, consuming multiple clotting factors
and resulting in DIC [10, 11].
What is intravascular administration?
An intravascular administration set is
a device used to administer fluids from a container
.
to a patient’s vascular system through a needle or catheter inserted into a vein
. The device may include the needle or catheter, tubing, a flow regulator, a drip chamber, an infusion line filter, an I.V.
What happens in thrombocytosis?
Thrombocytosis refers to
having too many platelets in your blood
. Platelets are blood cells in plasma that stop bleeding by sticking together to form a clot. Too many platelets can lead to certain conditions, including stroke, heart attack or a clot in the blood vessels.
Does IV stand for intravascular?
Intravenous means inside the vein or into the vein that carries blood towards the heart that is easily seen as a bluish tortuous vessel on the back of your hand as peripheral veins are superficial.
Intravascular means inside or into a blood vessel
, could be a vein or artery — a non specific term.
What is intravascular injection?
Inadvertent intravascular injection is
unintended injection of a large dose of local anesthetic into a blood vessel within the epidural space
. This may occur during a single injection through the epidural needle or following even small fractionate doses of local anesthetic through an epidural catheter.
Is LDH elevated in DIC?
We recently reported that patients with hemophagocytic lymphohistiocytosis (HLH) who developed DIC and/or hepatobiliary dysfunction (HBD) have increased risk of death
4
.
LDH is elevated in patients with HLH
, but the clinical significance of this laboratory value is unknown.
Is LDH high in DIC?
In the laboratory schistocytes are prominent in the blood smear and
LDH levels usually more pronounced than in DIC
, while most conventional coagulation markers are normal.
When does disseminated intravascular coagulation occur?
When you are injured
, proteins in the blood that form blood clots travel to the injury site to help stop bleeding. If these proteins become abnormally active throughout the body, you could develop DIC. The underlying cause is usually due to inflammation, infection, or cancer.
Which is the most important goal for the patient with disseminated intravascular coagulation DIC?
The goals of pharmacotherapy in cases of disseminated intravascular coagulation (DIC) are
to reduce morbidity and to prevent complications
. Therapy should be based on etiology and aimed at eliminating the underlying disease.
Why does DIC cause hematuria?
Signs and Symptoms of Bleeding. In DIC, the
increased clotting activity
uses up the platelets and clotting factors in the blood. As a result, serious bleeding can occur.
What is disseminated intravascular coagulation in pregnancy?
DIC is characterised by
widespread blood clotting
(coagulation) in the blood vessels. It is an emergency in pregnant women as it can lead to organ dysfunction and bleeding because of depletion of platelets and coagulation factors with the ongoing activation of blood clotting (deposition of fibrin).
Why do you give heparin in DIC?
Heparin, as an anticoagulant, which, not only inhibits the
activation of the coagulation system
, but is also an anti-inflammatory and immunomodulatory agent, has been widely used during DIC treatment and in the prevention and treatment of thrombotic diseases.
Can DIC cause hematuria?
In conclusion, massive haematuria is a
life-threatening condition
and can be a unique clinical symptom of DIC.
Which condition places a patient at risk for developing chronic or subacute disseminated intravascular coagulation disorder?
Risk factors for disseminated intravascular coagulation include
severe pre-eclampsia
, amniotic fluid embolism, sepsis, placental abruption, and prolonged retention of fetal demise.
What is the most common cause of DIC in pregnancy?
Acute obstetrical hemorrhage
is one of the leading causes for DIC in pregnancy and is one of the most avoidable etiologies of maternal death.
