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Disseminated Intravascular Coagulation (DIC)

Overview


A condition affecting the blood's ability to clot and stop bleeding.

In disseminated intravascular coagulation, abnormal clumps of thickened blood (clots) form inside blood vessels. These abnormal clots use up the blood's clotting factors, which can lead to massive bleeding in other places. Causes include inflammation, infection and cancer.

Symptoms include blood clots and bleeding, possibly from many sites in the body.

The goal is to treat the underlying cause and provide supportive care through intravenous fluids and blood transfusions.



Symptom 

One classic symptom is uncontrolled bleeding from several areas of your body. Other symptoms are:

1.Bruising.

2.Blood clots.

3.Confusion, memory loss or change of behavior.

4.Difficulty breathing.

5.Fever.


What causes disseminated intravascular coagulation (DIC)?

Disseminated intravascular coagulation has been linked to certain medical treatments or conditions. Medical treatments that can cause DIC include:

1.Blood transfusion reactions.

2.Recent surgery or anesthesia.

3.Complications from labor and delivery.


Medical conditions that can cause DIC include:

1.Cancer, especially certain types of leukemia.

2.Pancreatitis.

3.Blood infections.

4.Liver disease.

5.Severe tissue injury including burns and head injuries.

6.Unformed blood vessels called hemangioma.



Treatment 

Your healthcare provider’s first step is treating the underlying condition that caused you to develop DIC. They might use supportive treatments to improve blood flow if you have blood clots or to slow your blood loss. Those treatments are:

1.Plasma transfusions to reduce bleeding. Plasma transfusion replace blood clotting factors affected by DIC.

2.Transfusions of red blood cells and/or platelets.

3.Anti-coagulant medication (blood thinners) to prevent blood clotting.



How is DIC diagnosed?

DIC may be identified through various tests related to your levels of platelets, clotting factors, and other blood components. However, there isn’t a standard procedure.


The following are some tests that may be conducted if your doctor suspects DIC:

1.CBC. This test measures platelets as well as red and white blood cells.

2.CBC smear. A CBC smear looks at the size and shape of your blood cells, including mean platelet volume (MPV).

3.Tests on your blood’s ability to clot. Partial thromboplastin time and prothrombin time tests both help determine how long it takes for your blood to clot.

4.D-dimer test. The D-dimer test looks for blood clots. A higher level can be associated with DIC.

5.Serum fibrinogen test. This test measures low fibrinogen proteins that may indicate DIC.

6.Measures of clot-dissolving substances in your blood. Elevated results on a test to examine fibrin degradation products could indicate DIC.

7.Metabolic panel. A metabolic panel can look for possible kidney and liver damage caused by DIC.

In addition to blood testing, a doctor may also perform a physical exam to check for visible signs of bleeding or blood clots. They may also ask if you’ve had any recent surgeries, injuries, or medical problems.


Complications of DIC

DIC can cause complications, especially when it isn’t treated properly. Complications can occur from both the excessive clotting that happens in the early stages of the condition and the absence of clotting factors in the later stages. Complications may include:

1.heart attack

2.stroke

3.failure of vital organs, such as your liver or kidneys

4.bleeding in your gastrointestinal (GI) tract

5.excessive bleeding (hemorrhage) that may lead to death

6.shock

7.acute respiratory distress syndrome (ARDS), which develops from low blood oxygen to your lungs

8.blood clots in your lungs (pulmonary embolism)

9.blood clots in your legs (deep vein thrombosis)

10.death


What does it mean when a patient goes into DIC?

Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become overactive.


Do patients survive DIC?

The long-term outlook for people who have DIC depends on how much damage the clots may have caused to the body's tissues. About half of those with DIC survive, but some may live with organ dysfunction or the results of amputations.


What are the three most common conditions associated with DIC?

DIC is linked to medical conditions such as cancer, pancreatitis and liver disorders. Unfortunately, that means there's very little you can do to prevent DIC.





















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