Disseminated intravascular coagulation

Disseminated intravascular coagulation (DIC), also called consumptive coagulopathy, is a pathological process in the body where the blood starts to coagulate throughout the whole body. This depletes the body of its platelets and coagulation factors, and there is a paradoxically increased risk of hemorrhage. It occurs in critically ill patients, especially those with Gram-negative sepsis (particularly meningococcal sepsis) and acute promyelocytic leukemia

Causes

There are a variety of causes of DIC, all usually causing the release of chemicals into the blood that instigates the coagulation.

• Sepsis, particularly with gram-negative bacteria.
• Obstetric complications (most common cause), with chemicals from the uterus being released into the blood, or from amniotic fluid embolisms, and eclampsia can be causes. Another obstetric condition which can cause DIC is abruptio placentae.
• Tissue trauma such as burns, accidents, surgery or shock.
• Liver disease
• Incompatible blood transfusion reactions or massive blood transfusion (more than the total circulatory volume)
• Malignant cancers, or widespread tissue damage (e.g. burns), or hypersensitivity reactions all can produce the chemicals leading to a DIC.
• Viral hemorrhagic fevers bring about their frank effects, paradoxically, by causing DIC.
• Envenomation by some species of venomous snakes, such as those belonging to the genus Diagnosis

Although numerous blood tests are often performed on patients prone to DIC, the important measures are: full blood count (especially the platelet count), fibrin degradation products or D-dimer tests (markers of fibrinolysis), bleeding time and fibrinogen levels. Decreased platelets, elevated FDPs or D-dimers, prolonged bleeding time and decreased fibrinogen are markers of DIC.

Date: 2015-01-12; view: 641