Disseminated intravascular coagulation (DIC) is a condition characterized by accelerated intravascular coagulation and increased consumption of platelets and plasma clotting factors. It is caused by bacterial, viral or fungal infections, tissue injury, or other conditions like sepsis or trauma. Clinically, it presents with bleeding from sites of injury or procedures, petechiae, ecchymosis, and other bleeding symptoms. Diagnosis involves laboratory tests showing thrombocytopenia, prolonged prothrombin time, elevated D-dimer and fibrin degradation products, and low fibrinogen levels. Treatment focuses on managing the underlying condition through replacement therapy, heparin, and other medical interventions while also monitoring for complications and providing

1. DISSAMINATED
INTRAVASCULAR
COAGULOPATHY
Moninder Kaur
Assistant Proff.
Mahabir CON, Ambala

2. DEFINITION
Disseminated intravascular coagulation (DIC)
is a state /syndrome which is characterized by
accelerated intravascular coagulation
associated with increase consumption of
platelet and plasma clotting factors.

3. CAUSES
1. Bacterial
2. Viral
3. Fungal
4. Tissue injury
5. Neonatal cases
6. Miscellaneous

4. PATH PHYSIOLOGY
Generation of thrombin and
plasmin
Consumption of platelets, fibrins,
coagulation factors

5. Contd…
Severe bleeding
Activation of fibrinolytic
mechanisms

6. CLINICAL FEATURES
• Bleeding from site of injections
• Petechiae/ ecchymosis
• Epistaxis
• Fever
• Tissue necrosis
• Confusion, disorientation
• Cough/ dyspnoea
• Mucosal bleeding

7. CONDITIONS ASSOCIATED
WITH DIC:-
• Infection- sepsis
• Burns
• Trauma
• Snake bite
• Shock
• Severe transfusion reaction
• Severe hepatic failure

8. ASSESSMENT
• Clinical observation reveals a petechial,
purpuric rash, local ischemia from
intravascular thrombi, and oozing or
frank bleeding from surface or wound.
• Children present with bleeding at one or
more sites, epitaxis , gastrointestinal
bleeding.

9. DIAGNOSTIC EVALUATION
• Peripheral smear:- thrombocytopenia,
• Prothrombin time prolonged( more than 50- 100
sec)
• APTT prolonged
• D-dimer assay is the most sensitive test- elevated
• Assay for fibin degradation products- elevated
• Fibrinogen level is low
• Platelet count is frequently below 150,000/mm3

10. TYPES OF DIC
• Acute:- sepsis , burns
• Chronic: acute promyelocytic leukemia,
retention of dead fetus

11. DIFFERENTIAL DIAGNOSISA
• Similar laboratory finding are present in
children with acute fulminant liver failure,
hemolytic uremic syndrome. In fulminant liver
failure factor VIIIC level are elevated while
level of factor VII and IX are reduced.
Presence of renal failure or chronic renal
disease hemolytic uremic syndrome.

12. MEDICAL MANAGEMENT
• Replacement therapy
• Exchange transfusion
• Heparin

13. NURSING MANAGEMENT
• ASSESSING FOR CLINICAL
MANIFESTATION.
• PROVIDING CARE DURING
MEDICAL MANAGEMENT
• PROVIDING EDUCATION AND
SUPPORT FOR FAMILY MEMBERS.

14. • DIC is a crisis state and its gravity should
not be minimized. Although it is most
often managed without major residua,
occasionally bleeding or clot deposition
is uncontrollable.