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Disseminated Intravascular Coagulation (DIC)

Disseminated Intravascular Coagulation (DIC). Bryan Imayanagita. Background. Pathological activation Formation of clots throughout the body in the blood vessels Leads to abnormal bleeding; can cause clots that disrupt blood flow to organs Multiple organ failure and death. Causes.

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Disseminated Intravascular Coagulation (DIC)

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  1. Disseminated Intravascular Coagulation (DIC) Bryan Imayanagita

  2. Background • Pathological activation • Formation of clots throughout the body in the blood vessels • Leads to abnormal bleeding; can cause clots that disrupt blood flow to organs • Multiple organ failure and death

  3. Causes • Sepsis (most common) • endothelial cell damage (heat stroke, shock) • obstetrical complications • neoplasias • trauma

  4. Pathophysiology • fire/fire extinguisher analogy in normal coagulation • Thrombin (fire) generation at the site of injury • The endothelium (fire extinguisher) expresses antithrombin molecules which will bind to thrombomodulin • No endothelium at damaged tissue site; allows coaguation. Stopped once thrombin reaches healthy tissue. • In DIC, coagulation and anti-coagulation out of balance

  5. Diagnosis • Bleeding from 3 unrelated sites • History of blood loss, hypovolemia • DVT, microvascular thrombosis

  6. Main Features of DIC

  7. Treatment • Determined if patient is bleeding or needs an invasive procedure • If either is positive: fresh frozen plasma or cryoprecipitate can be given • Folic acid • Heparin treatment not established • May not be effective; needs anti-thrombin for anticoagulant activity, reduced by DIC

  8. Prognosis • 10%-50% mortality rate • DIC with sepsis significantly higher than DIC with trauma

  9. Sources • http://www.medstudents.com.br/terin/terin2.htm • http://emedicine.medscape.com/article/779097-overview • http://www.medstudents.com.br/terin/terin2.htm • http://emedicine.medscape.com/article/779097-overview

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