disseminated intravascular coagulation

• related: Hemeonc, DIC vs liver disease
• tags: #note

Common Causes

Common Causes

• sepsis: not that common
• most common: malignancy (APL), B cell malignancies
• pregnancy/delivery, amniotic fluid

Pathogenesis

• exposure to TF => thrombosis => clotting
• dysregulation of coagulation system: everything ramped up. More coagulation and fibrinolysis

Stage 1

• PT/PTT: normal/low
• microthrombi, schisctocytes
• AC: heparin gtt

Stage 2:

• factors low
• Protein C inhibits cascade and shuts down cascade
• PT/PTT high, fibrinogen low, very high D-Dimer
• bleeding
• give cryoprecipitate first, 10-15u, can help with accurate PT/INR check
• give plasma, 1u
• give FFP

Stage 3

• Protein C low
• more plugs and thrombi
• only antithrombin left: lysis of old clots, oozing from old wound
• give plt, cryo, FFP