Disseminated intravascular coagulation, or DIC syndrome, is not a separate disease entity, but a syndrome secondary to a wide variety of diseases and clinical conditions. It can develop in the course of e.g. heat stroke, cancer or detachment of the placenta, as well as after organ transplantation. What is disseminated intravascular coagulation? What are its causes and symptoms? What is the treatment of patients with DIC syndrome?

Diffuse intravascular coagulation

Disseminated intravascular coagulationorDIC syndrome(DIC syndrome) is classified as a thrombo-haemorrhagic syndrome. The essence of the disease is the activation of blood clotting processes to produce a large amount of fibrin. Platelets begin to stick together, causing blood clots to form in the tiny vessels, which by blocking blood flow contribute to ischemia and, consequently, to the development of organ failure. At the same time, generalized clotting causes excessive use of clotting factors, which leads to bleeding.

Disseminated intravascular coagulation - triggers for DIC syndrome

DIC syndrome may develop in the course of sepsis, hemorrhagic fever, heat stroke, neoplasms, e.g. leukemia, or vascular malformations (large aortic aneurysms, giant hemangiomas). Extensive trauma, organ damage (e.g. acute pancreatitis), and severe liver disease can also be triggers for DIC. Other clinical conditions in which disseminated intravascular coagulation may develop include obstetric complications (e.g., premature detachment of the placenta, amniotic fluid embolism, dead fetus syndrome), as well as acute poisoning and immune reactions (e.g., post-transfusion reactions, organ transplant rejection reaction). , bites by poisonous snakes).

Disseminated intravascular coagulation - symptoms

Acute disseminated intravascular coagulation is rapid, with symptoms:

  • haemorrhagic diathesis (i.e. heavy, simultaneous bleeding, e.g. from wounds, puncture sites, mucous membranes, genital tract), which is the result of the consumption of platelets, fibrinogen and other coagulation factors inclot formation process
  • organ failure caused by ischemia. In the case of renal ischemia, these will be anuria or oliguria. In turn, pulmonary insufficiency will be characterized by dyspnoea, coughing and hemoptysis. The consequence of cerebral ischemia will be disorientation and problems with concentration. Symptoms of impaired blood flow through the brain often appear in the form of seizures, disturbances of consciousness, and even coma

In turn, the mild form of DIC syndrome is characterized by mild symptoms of bleeding disorders in the form of recurrent mucosal (nose and mouth) bleeding, without organ ischemia, because the body is able to partially compensate for pathological clotting. The hallmark of mild DIC syndrome is a tendency to bruise. It is not uncommon for DIC to be completely asymptomatic.

Disseminated intravascular coagulation - diagnosis and treatment

In order to diagnose DIC syndrome, it is necessary to detect a disease in the course of which systemic blood clotting has been activated. Therefore, in the diagnostic process, a panel of several laboratory tests is used, the result of which would clearly confirm or exclude the presence of the disease (blood serum determines, among others, the number of platelets, the concentration of D-dimers, blood clotting times, the concentration of fibrinogen in the blood )

The primary approach is to combat the underlying disease in which DIC has developed. In addition, substitution treatment is used, which includes the administration of red blood cell concentrate (in case of significant blood loss), platelet concentrate (in case of low platelet levels), as well as heparin, activated protein C and, very rarely, antifibrinolytics.

Category:

Cardiology