DIC
Disseminated intravascular coagulation (DIC) is a complex medical condition characterized by the widespread activation of blood clotting, which results in the formation of blood clots in the small blood vessels throughout the body. This process can lead to multiple organ dysfunction syndrome (MODS) as it limits blood flow to various organs, leading to their damage. Concurrently, the consumption of clotting factors and platelets can cause severe bleeding, a condition known as consumptive coagulopathy.
DIC can be triggered by a variety of conditions, including infection, particularly by bacteria or viruses; significant trauma; cancer; obstetric complications; and inflammation. The underlying mechanism involves the excessive activation of the body's clotting cascade, primarily due to an inflammatory response or direct damage to the endothelium (the inner lining of blood vessels).
The diagnosis of DIC is based on a combination of clinical findings and laboratory tests. Laboratory findings indicative of DIC include a low platelet count, prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), elevated levels of fibrin degradation products or D-dimers, and reduced levels of fibrinogen.
Treatment of DIC focuses on addressing the underlying cause, supporting the patient's organ functions, and managing the coagulopathy. This may involve the use of antibiotics to treat underlying infections, transfusions of platelets or fresh frozen plasma to correct coagulopathies, and in some cases, the administration of heparin, an anticoagulant, to inhibit further clot formation.
Prevention of DIC primarily involves the early treatment of its underlying causes, such as infections or cancer, to prevent the activation of the coagulation cascade.
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Contributors: Prab R. Tumpati, MD