Īcute DIC Clinical findings Multiple bleeding sites Ecchymoses of skin, mucous membranes Visceral hemorrhage Ischemic tissue Ĭhronic DIC Clinical findings Signs of deep venous or arterial thrombosis or embolism Superficial venous thrombosis, especially without varicose veins Multiple thrombotic sites at the same time Serial thrombotic episodes Thrombosis: It is most commonly manifested by digital ischemia and gangrene, renal cortical necrosis and hemorrhagic adrenal infarction may occur. Bleeding :84%~95% It may occur at any site, but spontaneous bleeding and oozing at venipuncture sites or wounds are important clues to the diagnosis.Symptoms and Signs Bleeding Thrombosis Hypotension or shock Organ dysfunction Stimulation of Coagulation Intravascular thrombosis Consumption of coagulation factors Secondary activation of thrombolysis Hypoperfusion to tissues and organs Inability to form a stable clot Release of anticoagulants Ischemic damage Bleeding Bleedingĭiagnosis Long-term therapy with low-molecular-weight heparin may be a solution to this problem until the underlying cause can be brought under control. Thromboembolism occurs in this setting, and when oral anticoagulants are given following heparin therapy, there is a tendency for it to recur. These changes in the blood can be detected by testing the coagulation system. Usually there is time for compensatory responses to take place, which diminish the likelihood of bleeding but give rise to a hypercoagulable state. ![]() In chronic DIC, the process is the same, but it is less explosive. Bleeding into the subcutaneous tissues, skin, and mucous membranes occurs, along with occlusion of blood vessels caused by fibrin in the microcirculation. In acute DIC, an explosive generation of thrombin depletes clotting factors and platelets and activates the fibrinolytic system. The response of monocytes and endothelial cells to injury is to generate tissue factor on the cell surface, activating the coagulation cascade. Pathophysiology DIC occurs when monocytes and endothelial cells are activated or injured by toxic substances elaborated in the course of certain diseases. systemic disease (malignant hypertension, Acute respiratory distress syndrome, hemolytic transfusion reaction).The increased risk of DIC after head trauma is understandable in view of the relatively large amount of tissue factor in the cerebral compartment. severe tissue injury 1%~5% (burn, heart shock, fracture and so on) Head trauma in particular is strongly associated with DIC both local and systemic activation of coagulation may be detected after such an event.obstetric complications 4%~12% (amniotic fluid embolus, septic abortion, retained fetus and so on).cancer 24%~34% (Acute promyelocytic leukemia, acute myelomonocytic or monocytic leukemia, disseminated prostatic carcinoma Lung, breast, gastrointestinal malignancy).However, systemic infections with other microorganisms, such as viruses and parasites, also may lead to DIC. infectious disease 31%~43% (bacterial, viral, rickettsial, parasitic diseases and so on) Bacterial infection, in particular septicemia, is commonly associated with DIC.Infectious disease 31%~43% cancer 24%~34% obstetric complications 4%~12% severe tissue injury 1%~5% systemic disease Įtiology DIC is not a primary disease, but a disorder secondary to numerous triggering events such as serious illnesses. Chronic DIC: it happened slowly and last several weeks, thrombosis and clotting may predominate mainly seen in cancer. Ĭlassification Acute DIC :It happened rapidly, the coagulopathy is dominant and major symptoms are bleeding and shock, mainly seen in severe infection, amniotic fluid embolism. If the stimulus to coagulation is too great, these control mechanisms can be overwhelmed, leading to the syndrome of DIC. Ĭoagulation is usually confined to a localized area by the combination of blood flow and circulating inhibitors of coagulation, especially antithrombin Ⅲ. It is a syndrome characterized by massive activation and consumption of coagulation proteins, fibrinolytic proteins and platelets. It is essentially an imbalance between the coagulation process and anticoagulation process. ![]() General Considerations DIC is not a kind of independent disease, but a middle process or complication of some diseases. ![]() Disseminated Intravascular Coagulation WangXin Department of Emergency Medicine Tianjin Medical University General Hospital
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |