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Disseminated intravascular coagulation (DIC)
Definition
DIC is a disorder of the "clotting cascade." It results in depletion of clotting factors in the blood.
Alternative Names
Causes
DIC is when your body's 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 real tissue injury. Clot dissolving mechanisms are also increased.
This disorder has variable effects, and can result in either clotting symptoms or, more often, bleeding. Bleeding can be severe. DIC may be stimulated by many factors. These include 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 bruising
Exams and Tests
- Fibrinogen or fibrin - high degradation products
- Serum fibrinogen - low
- Prothrombin time (PT) - high
- Partial throboplastin time (PTT) - high
- Platelet count
- Thrombin time test
Treatment
The goal is to determine the underlying cause of DIC and provide treatment for that.
Replacement therapy of the coagulation factors is achieved by transfusion of fresh frozen plasma. Cryoprecipitates may also be used if fibrinogen is significantly low. Heparin, a medication used to prevent thrombosis, is sometimes used in combination with replacement therapy.
Outlook (Prognosis)
The underlying disease that causes the disorder will usually predict the probable outcome.
Possible Complications
- Severe bleeding
- Stroke
- Lack of blood flow to arms, legs, or organs
When to Contact a Medical Professional
Go to the emergency room or call 911 if you have continued bleeding of unknown cause.
Prevention
Get prompt treatment for conditions known to bring on this disorder.
Reviewed By: Rita Nanda, MD., Department of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.
