Disseminated intravascular coagulation

 Disease class: Blood coagulation disorders

Disease class: Haemorrhagic disorders

Disease class: Thrombophilia

Pathology

This involves inappropriate activation of the coagulation pathways in the blood around the body. This causes the formation of unnecessary clots (thrombosis) throughout the body.

The clots themselves cause problems because they can obstruct blood vessels. With obstruction, ischaemia, infarction, and necrosis can occur.

The process also depletes the supply of coagulation factors. The pro-coagulation reactions of the blood fall, leaving anti-coagulation largely unopposed. This results in prolonged clotting times (e.g. prothrombin time) and widespread haemorrhage.

 

Causes

• Sepsis 
• Major trauma
• Surgery 
• Cancer 
• Complicated pregnancy 
• Burns 
• Frostbite 
• Snakebites 

 

Management

The underlying cause of the DIC must be addressed.

Platelets, fresh frozen plasma, cryoprecipitate,  and other blood components may be transfused into the patient to promote coagulation and reduce bleeding.

It is difficult to treat the thrombosis because this is likely to increase the bleeding.

DIC secondary to sepsis is associated with a more dire prognosis than DIC secondary to trauma.