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Disseminated intravascular coagulation.

Venugopal A - Indian J Anaesth (2014)

Bottom Line: An effective scoring system helps to detect an overt DIC and a high score closely correlates with mortality.Treatment of DIC is aimed at combating the underlying disorder followed by supportive management.Early diagnosis and prompt treatment backed by laboratory support can reduce the morbidity and mortality associated with it.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Regional Cancer Centre, Medical College Campus, Thiruvanathapuram, Kerala, India.

ABSTRACT
Disseminated intravascular coagulation (DIC) is a reflection of an underlying systemic disorder which affects the coagulation system, simultaneously resulting in pro-coagulant activation, fibrinolytic activation, and consumption coagulopathy and finally may result in organ dysfunction and death. Though septicaemia is the most common cause of DIC, several other conditions can also lead to it. A diagnosis of DIC should be made only in the presence of a causative factor supported by repeated laboratory tests for coagulation profile and clotting factors. An effective scoring system helps to detect an overt DIC and a high score closely correlates with mortality. Treatment of DIC is aimed at combating the underlying disorder followed by supportive management. Low molecular weight heparin is advocated in special situations whereas anti-thrombin III and activated protein C are of doubtful value. Early diagnosis and prompt treatment backed by laboratory support can reduce the morbidity and mortality associated with it. The methodology of search for this review article involved hand search from text books and internet search using Medline (via PubMed) using key words DIC, thrombosis, fibrin degradation products, anti-thrombin and tissue factor for the last 25 years and also recent evidence-based reviews.

No MeSH data available.


Related in: MedlinePlus

The clinical picture of disseminated intravascular coagulation
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Figure 1: The clinical picture of disseminated intravascular coagulation

Mentions: The coagulation system in the body consists of clotting and fibrinolytic mechanisms. The function of the former is to prevent excessive blood loss, whereas the latter is to ensure circulation within the vasculature. Following an insult, the activated coagulation cascade adequately balances the naturally occurring anti-coagulant systems and the fibrinolytic system (which generates plasmin) to maintain a normal circulation. In disseminated intravascular coagulopathy (DIC) like syndrome, there is widespread activation of the blood coagulation system leading to excessive generation and disseminated deposition of fibrin clots in small and midsize vessels, which alters the microcirculation leading to ischaemic necrosis in various organs particularly in kidney and lung resulting in organ failure.[1] There can be concomitant consumption of platelets and coagulation factors resulting in serious haemorrhagic complications which sometimes may be the most striking clinical presentation. Hence, a patient with DIC can present as thrombotic and bleeding problem simultaneously [Figure 1].


Disseminated intravascular coagulation.

Venugopal A - Indian J Anaesth (2014)

The clinical picture of disseminated intravascular coagulation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260307&req=5

Figure 1: The clinical picture of disseminated intravascular coagulation
Mentions: The coagulation system in the body consists of clotting and fibrinolytic mechanisms. The function of the former is to prevent excessive blood loss, whereas the latter is to ensure circulation within the vasculature. Following an insult, the activated coagulation cascade adequately balances the naturally occurring anti-coagulant systems and the fibrinolytic system (which generates plasmin) to maintain a normal circulation. In disseminated intravascular coagulopathy (DIC) like syndrome, there is widespread activation of the blood coagulation system leading to excessive generation and disseminated deposition of fibrin clots in small and midsize vessels, which alters the microcirculation leading to ischaemic necrosis in various organs particularly in kidney and lung resulting in organ failure.[1] There can be concomitant consumption of platelets and coagulation factors resulting in serious haemorrhagic complications which sometimes may be the most striking clinical presentation. Hence, a patient with DIC can present as thrombotic and bleeding problem simultaneously [Figure 1].

Bottom Line: An effective scoring system helps to detect an overt DIC and a high score closely correlates with mortality.Treatment of DIC is aimed at combating the underlying disorder followed by supportive management.Early diagnosis and prompt treatment backed by laboratory support can reduce the morbidity and mortality associated with it.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Regional Cancer Centre, Medical College Campus, Thiruvanathapuram, Kerala, India.

ABSTRACT
Disseminated intravascular coagulation (DIC) is a reflection of an underlying systemic disorder which affects the coagulation system, simultaneously resulting in pro-coagulant activation, fibrinolytic activation, and consumption coagulopathy and finally may result in organ dysfunction and death. Though septicaemia is the most common cause of DIC, several other conditions can also lead to it. A diagnosis of DIC should be made only in the presence of a causative factor supported by repeated laboratory tests for coagulation profile and clotting factors. An effective scoring system helps to detect an overt DIC and a high score closely correlates with mortality. Treatment of DIC is aimed at combating the underlying disorder followed by supportive management. Low molecular weight heparin is advocated in special situations whereas anti-thrombin III and activated protein C are of doubtful value. Early diagnosis and prompt treatment backed by laboratory support can reduce the morbidity and mortality associated with it. The methodology of search for this review article involved hand search from text books and internet search using Medline (via PubMed) using key words DIC, thrombosis, fibrin degradation products, anti-thrombin and tissue factor for the last 25 years and also recent evidence-based reviews.

No MeSH data available.


Related in: MedlinePlus