21/03/2025
đŠDIC
Disseminated intravascular coagulation (DIC) is a systemic disorder characterized by widespread activation of the coagulation cascade, leading to microvascular thrombosis and consumption of platelets and clotting factors, that results in both hemorrhagic and thrombotic manifestations..
Presents with bleeding from IV sites or catheter or body orifices.
đ°Etiologies:- Trauma, Sepsis, Tumor, APML, Obstetric complications and Acute pancreatitis.
đ°Pathophysiology:-
1. Tissue factor (released from endothelial cells) activates coagulation pathway (i.e. leads to thrombosis).
2. t-PA (released from endothelial cells) activates fibrinolytic pathway (i.e. leads to fibrinolysis); There is increase in plasma activator inhibitor-1 (PAI-1) which prevents the inhibition of fibrinolysis.
Diagnosis:-
1. CBC shows low platelet count (i.e. thrombocytopenia).
2. Coagulation profile shows elevated bleeding time, PT, aPTT, D-dimer and fibrin degradation products and low clotting factors and fibrinogen.
3. PBS shows schistocytes.
4. Deranged RFT and LFT.
đĸTreatment:-
1. Treat the underlying disease.
2. Platelet transfusions, FFP, cryoprecipitate if active bleeding.
3. Prophylactic anticoagulation with heparin or low molecular weight heparin (LMWH) should be given in patients who are not actively bleeding.
đ°Laboratory findings of DIC:- elevated PT, aPTT, and bleeding time; elevated D-dimer, fibrin degradation products; decreased platelets, clotting factors, and fibrinogen.
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