DIC is an acquired syndrome characterized by systemic intravascular coagulation and thrombosis. It has multiple potential causes including infection, cancer, trauma, and obstetric complications. The morbidity and mortality of DIC depends on the extent of thrombosis and bleeding from depletion of platelets and coagulation factors. Diagnosis involves evaluating for a condition associated with DIC, signs of thrombosis or bleeding, and abnormal lab tests like low platelet count and elevated D-dimer. Treatment focuses on treating the underlying cause and providing supportive care like plasma or platelet transfusions.

2.  An acquired syndrome characterized by systemic
intravascular coagulation
 Coagulation is always the initial event.
 Most morbidity and mortality depends on extent of
intravascular thrombosis
 Multiple causes
DIC is Syndrome ;not disease per se

3. Conditions Associated With
DIC
 Malignancy
 Leukemia
 Metastatic disease
 Cardiovascular
 Post cardiac arrest
 Acute MI
 Prosthetic devices
 Hypothermia/Hyperthermia
 Pulmonary
 ARDS/RDS
 Pulmonary embolism
 Severe acidosis
 Severe anoxia
 Collagen vascular disease
 Anaphylaxis

4. Conditions Associated With DIC
• Infectious/Septicemia
– Bacterial
• Gm - / Gm +
– Viral
• CMV
• Varicella
• Hepatitis
– Fungal
• Intravascular hemolysis
• Acute Liver Disease
• Tissue Injury
– trauma
– extensive surgery
– tissue necrosis
– head trauma
• Obstetric
– Amniotic fluid emboli
– Placental abruption
– Eclampsia
– Missed abortion

5. Procoagulant
Anticoagulant

6. SYSTEMIC ACTIVATION
OF COAGULATION
Intravascular
deposition of
fibrin
Depletion of
platelets and
coagulation
factors
Thrombosis of
small and med.
size vessels
Bleeding
Organ failure DEATH
Procoagulant
Anticoagulant

7. Presence of disease associated with DIC
Appropriate clinical setting
 Clinical evidence of thrombosis, hemorrhage or both.
Laboratory studies
 no single test is accurate
 serial test are more helpful than single test
Diagnosis of DIC

8. ORGAN ISCHEMIC HEMOR.
Skin Gangrene
Acral cyanosis
Petechiae
Echymosis
Oozing
CNS Delirium/Coma
Infarcts
Intracranial
bleeding
Renal Oliguria/Azotemia
Cortical Necrosis
Hematuria
Cardiovascular Myocardial Dysfxn
Pulmonary Dyspnea/Hypoxia
Infarct
Hemorrhagic
lung
GI
Endocrine
Ulcers, Infarcts
Adrenal infarcts
Massive
hemorrhage.

9. Microscopic findings in DIC
 Fragments
 Schistocytes
 Paucity of platelets

10.  Severe liver failure
 Vitamin K deficiency
 Liver disease
 Thrombotic thrombocytopenic purpura
 Congenital abnormalities of fibrinogen
 Etc…….,,,,,,,
Differential Diagnosis…before DIC

11. Laboratory Tests Used in DIC
 D-dimer/ Fibrin Degradation Prod
 Platelet count
 Thrombin time
 Fibrinogen levels
 Prothrombin time
 Activated PTT
 Coagulation factor levels

12.  Stop the triggering process .
 The only proven treatment!
 Supportive therapy
 No specific treatments
 Plasma /platelet therapy
 Anticoagulants—careful !
Treatment of DIC

13.  Indications
 Active bleeding
 Patient requiring invasive procedures
 Patient at high risk for bleeding complications
Platelet therapy