disseminated intravascular coagulation
- related: Hematology, Factor 8 is elevated in liver disease and decreased in DIC
- 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