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    Disseminated Intravascular Coagulation: Presented By: Saraswati Neupane MN2 Year (2016)

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    Elisha Joshi
    Disseminated intravascular coagulation (DIC) is a condition where the blood clots in small vessels throughout the body. It is caused by an underlying condition such as infection, cancer, trauma, or pregnancy complications. DIC leads to microclots forming in organs which can damage them and cause bleeding issues due to depleted clotting factors. Treatment focuses on treating the underlying cause, replacing clotting factors, and using blood thinners. DIC outcomes depend on the severity but can include organ failure and death if not properly managed.

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    Disseminated Intravascular Coagulation: Presented By: Saraswati Neupane MN2 Year (2016)

    Uploaded by

    Elisha Joshi
    47 views21 pages
    Disseminated intravascular coagulation (DIC) is a condition where the blood clots in small vessels throughout the body. It is caused by an underlying condition such as infection, cancer, trauma, or pregnancy complications. DIC leads to microclots forming in organs which can damage them and cause bleeding issues due to depleted clotting factors. Treatment focuses on treating the underlying cause, replacing clotting factors, and using blood thinners. DIC outcomes depend on the severity but can include organ failure and death if not properly managed.

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    Presentation of DIC

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    Disseminated intravascular coagulation (DIC) is a condition where the blood clots in small vessels throughout the body. It is caused by an underlying condition such as infection, cancer, trauma, or pregnancy complications. DIC leads to microclots forming in organs which can damage them and cause bleeding issues due to depleted clotting factors. Treatment focuses on treating the underlying cause, replacing clotting factors, and using blood thinners. DIC outcomes depend on the severity but can include organ failure and death if not properly managed.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    47 views21 pages

    Disseminated Intravascular Coagulation: Presented By: Saraswati Neupane MN2 Year (2016)

    Uploaded by

    Elisha Joshi
    Disseminated intravascular coagulation (DIC) is a condition where the blood clots in small vessels throughout the body. It is caused by an underlying condition such as infection, cancer, trauma, or pregnancy complications. DIC leads to microclots forming in organs which can damage them and cause bleeding issues due to depleted clotting factors. Treatment focuses on treating the underlying cause, replacing clotting factors, and using blood thinners. DIC outcomes depend on the severity but can include organ failure and death if not properly managed.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 21

    Disseminated Intravascular

    Coagulation

    Presented By: Saraswati neupane


    MN 2nd year(2016)
    Introduction
    • Disseminated intravascular coagulation (DIC) is
    characterized by systemic activation of blood coagulation,
    which results in generation and deposition of fibrin,
    leading to microvascular thrombi in various organs and
    contributing to multiple organ dysfunction syndrome
    (MODS).[
    •  Consumption and subsequent exhaustion of coagulation
    proteins and platelets (from ongoing activation of
    coagulation) may induce severe bleeding, though
    microclot formation may occur in the absence of severe
    clotting factor depletion and bleeding.
    Definition
    • The subcommittee on DIC of the International
    Society on Thrombosis and Haemostasis has
    suggested the following definition for DIC: “An
    acquired syndrome characterized by the
    intravascular activation of coagulation with loss
    of localization arising from different causes. It
    can originate from and cause damage to the
    microvasculature, which if sufficiently severe,
    can produce organ dysfunction
    • DIC is estimated to be present in as many as
    1% of hospitalized patients.
    •  DIC is not itself a specific illness; rather, it is a
    complication or an effect of the progression of
    other illnesses.
    • It is always secondary to an underlying
    disorder and is associated with a number of
    clinical conditions
    Causes
    Causes
    • Infections – 31- 43% - Gram -ve infections,meningococccmia,
    histoplasmosis, malaria etc.
    • Malignancy – 24-34%- acute promyelocytic leukemia,
    carcinoma of pancreas
    • Obstetric complications- 4-12%- septic abortion, amniotic
    fluid embolism, abruptio placenta, retained dead fetus,
    toxaemia.
    • Massive tissue injury- 1-5%- trauma, burns, extensive surgery.
    • Systemic disease- 1-5%
    • Others- shock, snake bite.
    Prevalence of DIC
    • DIC may occur in 30-50% of patients with sepsis, and it develops in
    an estimated 1% of all hospitalized patients. DIC occurs at all ages
    and in all races, and no particular sex predisposition has been
    noted.
    • The prevalence of DIC in pregnancy ranges from 0.03 to 0.35
    percent in population-based studies , or 12.5 per 10,000 delivery
    hospitalizations in one study .
    • Although the overall prevalence of DIC is low in pregnancy, the
    frequency of DIC in women with specific pregnancy complications
    can be quite high. In a review of 53 cases of amniotic fluid
    embolism, DIC was observed in approximately two-thirds.
    Pathophysiology
    Clinical features
    CLINICAL FEATURES
    • GI signs include the following:
    • 1. Hematemesis
    • 2. Hematochezia
    • Genitourinary signs include the following:
    • 1. Signs of azotemia and renal failure
    • 2. Acidosis
    • 3. Hematuria
    • 4. Oliguria
    • 5. Metrorrhagia
    • 6. Uterine hemorrhage
    • Dermatologic signs include the following:
    • 1. Petechiae
    • 2. Jaundice (liver dysfunction or hemolysis)
    • 3. Purpura
    • 4. Hemorrhagic bullae
    • 5. Acral cyanosis
    • 6. Skin necrosis of lower limbs (purpura fulminans)
    • 7. Localized infarction and gangrene
    • 8. Wound bleeding and deep subcutaneous hematomas
    • 9. Thrombosis
    Features Affected Patients, %
    •   Bleeding 64%
    • Renal dysfunction 25%
    • Hepatic dysfunction 19%
    • Respiratory dysfunction 16%
    • Shock 14%
    • Central nervous system dysfunction 2%
    DIAGNOSIS
    TREATMENT
    • Treatment of underlying disorder.

    • Pharmacologic therapy:

    – Unfractionated heparin therapy

    – Low molecular weight heparin therapy- Dalteparin,

    enoxaparin ( selective effect and long ½ life)

    – Warfarin therapy- Antagonist of Vit k (INR check)


    • Replacement Therapy
    • Coagulation factor deficiency require
    replacement with FFP.
    • Fibrinogen replacement is done with
    cryoprecipitate.
    NURSING MANAGEMENT
    • Proper explanation about the condition and importance of giving accurate
    health history to health care provider.
    • Avoid activities that promote circulatory stasis: Immobility, crossing legs.

    • Exercise and ambulation frequently through out the day


    • Avoid concomitant risk factors such as smoking.

    • Assessing frequently for the sign and symptoms of thrombus formation:


    DVT, PE.
    • Use of elastic compression stockings.
    • Encourage that siblings and children should be tested.
    PROGNOSIS
    • The prognosis of patients with DIC depends on
    the severity of the coagulopathy and on the
    underlying condition that led to DIC.
    • Septic abortion with clostridial infection and
    shock associated with severe DIC has a
    mortality of 50%
    Complications of DIC include the following:

    • Acute kidney injury


    • Change in mental status
    • Respiratory dysfunction
    • Hepatic dysfunction
    • Life-threatening thrombosis and hemorrhage (in patients with
    moderately severe–to–severe DIC)
    • Cardiac tamponade
    • Hemothorax
    • Intracerebral hematoma
    • Gangrene and loss of digits
    • Shock
    • Death

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