Disseminated Intravascular Coagulation

Question 1

What is disseminated intravascular coagulation?

Answer 1

When haemostats runs out of control and lots of blood clots form in the small vessels of the body

Question 2

What happens as a result of the blood clot formation?

Answer 2

Organ ischaemia, necrosis and damage

Low platelet and clotting factors left - so other parts of the body continue to bleed

Question 3

What are the steps of the clotting pathway?

Answer 3

1. Primary haemostasis – formation of platelet plug
2. Secondary haemostasis - Then coagulation cascade occurs and ends in fibrinogen turning into fibrin to create a plug over the platelets
3. Fibrinolysis – breaking down of clots

Question 4

Which organs require the highest blood supply and are at most risk of DIC?

Answer 4

Kidneys
Liver
Brain
Lungs

Question 5

What happens as a result of the increased fibrinolysis?

Answer 5

The products of clot breakdown are released into the blood and they interfere with further clot formation

Question 6

What are the investigation findings?

Answer 6

Prolonged PT time
Decreased Fibrinogen and platelets
Increased D dimer

Chronic DIC - can have normal results due to physiological compensation

Question 7

What does increased D dimer show?

Answer 7

Its a fibrin degradation product made when fibrin clots are broken down

Question 8

What is the treatment for DIC?

Answer 8

Treat underlying cause
Ventilator
Transfusions