Please enable JavaScript.
Coggle requires JavaScript to display documents.
Disseminated Intravascular Coagulopathy (DIC) :blossom: (:earth_africa:…
Disseminated Intravascular Coagulopathy (DIC)
:blossom:
:earth_africa:
Etiology
Widespread activation of Coagulation mechanism
Usu. assoc. with
shock
Severe illness
alters normal hemostasis
(balance between Hemorrhage & thrombosis) ➯ activation of Coagulation mediated by
thrombin
and Fibrinolysis mediated by
plasmin
Coagulation factors (esp plt, fibrinogen, FII, FV, FVIII) — are consumed
Anticoagulant proteins (esp antithrombin, protein C, and plasminogen) are also consumed
Endothelial injury, Tissue release of thromboplastic procoagulant factors or rarely—exogenous factors (snake venoms)
directly activate the Coagulation mechanism
:frame_with_picture:
Clinical manifestations
Dx by suspected clinically & Confirmed Dx by Laboratory findings— :arrow_down:
plts & fibrinogen
, :arrow_up:
PT, PTT, D-dimer
note that: fibrinogen is clotted ➯ D-dimer is formed ➯ then degraded by plasmin
Some pt:
DIC may evolve slowly & may hv some degree of compensation
In
severely, ill pt
these suggests Dx of DIC
Sudden occurrence of bleeding from Venipuncture or Incision site
GI or Pulmonary hemorrhage
Petechiae or Ecchymosis
Evidence of peripheral gangrene
Thrombosis
:green_heart:
Rx
:star: Rx the
disorder that inducing DIC first
Support pt by correct hypoxia, acidosis and poor perfusion
Replace blood-clotting factors, plts and anti-Coagulation proteins by
Transfusion
Treat significant Arterial or Venous thrombotic ds with
Heparin
:warning:
except life-threatening bleeding co-exist
Drotrecogin (recombinant activated protein C) ➯ :arrow_down: mortality rate in adult with DIC & sepsis
(not confirmed in children yet)