CASE: DISSEMINATED INTRAVASCULAR COAGULATION
DEFINITION OF THE CASE
A serious condition characterized by abnormal blood clotting throughout the body's blood vessels.
DIC can be detected through laboratory tests that assess blood clotting factors and platelet counts.
There are two types of DIC:
Acute DIC is often triggered by severe infections, trauma, or complications during pregnancy.
Chronic DIC is associated with underlying conditions like cancer.
Prompt recognition and treatment of the underlying cause are crucial in managing DIC effectively to
prevent life-threatening complications.
ANATOMY AND PHYSIOLOGY (MAJOR ORGAN ONLY)
Blood vessels are crucial components of the circulatory system, responsible for transporting blood
throughout the human body. They play a vital role in delivering oxygen, nutrients, and blood cells to
body tissues while removing waste products and carbon dioxide. The circulatory system consists of
various types of blood vessels, each serving a specific function in maintaining the body's overall
health.
Types of Blood Vessels:
Arteries: Carry blood away from the heart.
Arterioles: Small branches connecting arteries to capillaries.
Capillaries: Thin-walled vessels facilitating the exchange of substances between blood and
tissues.
Venules: Small vessels collecting blood from capillaries.
Veins: Carry blood from capillaries back towards the heart.
ETIOLOGY
Disseminated intravascular coagulation (DIC) is a complex condition with various triggers and risk
factors. Its exact cause can be multifactorial, often involving a combination of factors that lead to
widespread activation of the coagulation cascade throughout the body. These includes
Underlying Conditions: Sepsis, trauma, cancer, obstetric complications, liver disease, burns, and
shock can trigger DIC.
Procoagulant Substances: Release of substances like tissue factor and proinflammatory
cytokines contributes to coagulation activation.
Endothelial Damage: Injury to blood vessel lining exposes procoagulant substances and initiates
clot formation.
Dysregulated Fibrinolysis: Impaired fibrinolysis leads to fibrin clot accumulation, worsening
microvascular thrombosis.
Genetic Factors: Inherited thrombophilias or deficiencies in anticoagulant proteins may predispose
to DIC.
SYMPTOMATOLOGY
1. Bleeding: Includes easy bruising, nosebleeds, bleeding gums, and gastrointestinal bleeding.
2. Petechiae and Ecchymosis: Small red or purple spots and larger bruises on the skin.
3. Organ Dysfunction: Symptoms related to affected organs, such as confusion, shortness of
breath, decreased urine output, jaundice, or hypotension.
4. Disseminated Microvascular Thrombosis: Can lead to ischemic injury in various organs,
contributing to multi-organ dysfunction.
And/or can be uncontrollable and dangerous bleeding, bruises, vomiting, blood in the stool, and
organ failure.
GENERAL PATHOLOGY
PDF: PCF:
Age (any ages in general even Sepsis, trauma, cancer,
in maternal) obstetric complications, liver
disease, burns
Clotting cascades
are triggered
excessive formation of the
thrombin
Results to continues
activation of coagulation
The body will use up all the platelet,
fibrinogen, and clotting factors
impaired blood flow to the tissues and organs
(resulting to a microvascular thrombosis)
Organ dysfunction and failure
Bleeding / hemorrhage
MEDICAL MANAGEMENT
LABORATORY MEDICATION SURGICAL
CBC Heparin (for Acute- fast onset of action) N/A
particularly platelet (drug of choice)
count, and also, it is
important to check the But also, and/or can be,
hemoglobin level) Vitamin K (for chronic used - slow onset
of action)
Blood Typing
For possible BT Blood (RBC) and or Platelet, and
(RBC), but most plasma transfusion
cases, just platelet (stabilizing hemostasis and preventing
and plasma and bleeding complications in DIC)
transfused alone
NURSING MANAGEMENT
Establish rapport
Monitor Vital signs
Monitor Intake and outputs
Provide comfort and emotional support
Administration of medication and for blood transfusion as prescribed
Encouraged rest periods
PROGNOSIS
IF TREATED IF NOT TREATED
Address the underlying cause poor prognosis
manage coagulopathy leading to multiorgan failure
prevent complications death
good prognosis
