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DIC (disseminated intravascular coagulation)
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| Definition: |
A disorder of diffuse activation of the clotting cascade that results in depletion of clotting factors in the blood.
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| Alternative Names: |
Consumption coagulopathy
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| Causes, incidence, and risk factors: |
Disseminated intravascular coagulation occurs when the blood clotting mechanisms are activated throughout the body instead of being localized to an area of injury. Small blood clots form throughout the body, and eventually the blood clotting factors are used up and not available to form clots at sites of tissue injury. Clot dissolving mechanisms are also increased. This disorder is variable in its clinical effects, and can result in either clotting symptoms or, more often, bleeding. Bleeding can be severe. DIC may be stimulated by many factors including infection in the blood by bacteria or fungus, severe tissue injury as in burns and head injury, cancer, reactions to blood transfusions, and obstetrical complications such as retained placenta after delivery.
Risk factors are recent sepsis, recent injury or trauma, recent surgery or anesthesia, complications of labor and delivery, leukemia or disseminated cancer, recent blood transfusion reaction, and severe liver disease. |
| Symptoms: |
- bleeding, possibly from multiple sites in the body
- thrombosis formation evidenced by bluish coloration of the fingers
- sudden onset of bruising
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| Treatment: |
The objective of treatment is to determine the underlying cause of DIC and provide treatment for it.
Replacement therapy of the coagulation factors is achieved by transfusion of fresh frozen plasma. Cryoprecipitates may also be used if fibrinogen is significantly decreased. Heparin, a medication used to prevent thrombosis, is sometimes used in combination with replacement therapy. |
| Expectations (prognosis): |
| The underlying disease that causes the disorder will usually predict the probable outcome. |
| Complications: |
- severe bleeding
- stroke
- ischemia (lack of blood flow) of extremities or organs
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| Calling your health care provider: |
| Go to the emergency room or call the local emergency number (such as 911) if continued bleeding of unknown cause is present. |
| Prevention: |
| Get prompt treatment for conditions known to precipitate the disorder. |
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Review Date: 10/19/2001
Reviewed By: Rebecca Elstrom, M.D., Division of Hematology-Oncology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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