Disseminated intravascular coagulation (DIC) is a widespread blood clotting disorder occurring within blood vessels, associated with a wide range of clinical circumstances (bacterial sepsis, obstetric complications, disseminated malignancy, massive trauma), and manifested by purpura fulminans (cutaneous infarctions and/or acral gangrene) or bleeding from multiple sites. The spectrum of clinical symptoms associated with DIC ranges from relatively mild and subclinical to explosive and life-threatening.
Causes of Disseminated Intravascular Coagulation
Uncontrolled activation of coagulation results in thrombosis and consumption of platelets/clotting factors II, V, VIII. Secondary fibrinolysis. If the activation occurs slowly, excess activated products produced, predisposing to vascular infarctions/venous thrombosis. If the onset is acute, hemorrhage surrounding wound sites and IV lines/catheters or bleeding into deep tissues is usually seen.
Symptoms of Disseminated Intravascular Coagulation
- Bleeding, possibly from multiple sites in the body
- Thrombosis formation evidenced by bluish coloration of the fingers
- Sudden bruising
Diagnosis
Clinical suspicion confirmed by coagulation studies.
Treatment
Correct reversible cause. Vigorous antibiotic therapy for infections. Control bleeding or thrombosis: heparin, pentoxyphyllin. Prevent recurrence in chronic DIC.
Transfusions of blood cells and other blood products may be necessary to replace blood that has been lost through bleeding and to replace clotting factors used up by the body.
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