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Disseminated Intravascular Coagulation (DIC) - PowerPoint PPT Presentation


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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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Presentation Transcript
background
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
Causes
  • Sepsis (most common)
  • endothelial cell damage (heat stroke, shock)
  • obstetrical complications
  • neoplasias
  • trauma
pathophysiology
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
diagnosis
Diagnosis
  • Bleeding from 3 unrelated sites
  • History of blood loss, hypovolemia
  • DVT, microvascular thrombosis
treatment
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
prognosis
Prognosis
  • 10%-50% mortality rate
  • DIC with sepsis significantly higher than DIC with trauma
sources
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