Flashcards in Disseminated Intravascular Coagulation (DIC) Deck (8)
What are the types of DIC?
- Acute overt form: bleeding and depletion of platelets and clotting factors
- Chronic non-overt form: thromboembolism is accompanied by general activation of coagulation system
what are the risk factors for DIC?
- infection (gram -ve sepsis)
- obstetric complications (missed miscarriage, placental abruption, severe pre-eclampsia, amniotic emboli)
- malignancy (acute = acute promyelocytic leukaemia, chronic = lung, breast, GI malignancy)
- severe trauma or surgery
what is the pathophysiology of acute DIC?
- simultaneous activation of clotting cascade and fibrinolysis system
- depletion of substances/ factors
- massive bleeding in SC tissues, skin and mucous membranes
- occlusion of blood vessels by fibrin = microangiopathic HA and ischaemic organ damage
what is the pathophysiology of chronic DIC?
- identical to acute DIC but at a slower rate with compensatory responses
- compensation diminishes likelihood of overt bleeding
- but leads to hypercoagulable state
- thrombosis can occur
what is the presentation of DIC in general?
- fever, severely ill, evidence of shock
what is the presentation of acute DIC?
- mucosal bleeding
- overt haemorrhages
- end organ failure
- respiratory distress
- oliguria (2nd to renal failure)
what is the presentation of chronic DIC?
- DVT or arterial emboli/thrombi
- superficial venous thrombosis