Disseminated intravascular coagulation (DIC) is a condition where blood clots form throughout the small blood vessels throughout the body, consuming clotting factors and increasing the risk of bleeding. It is caused by malignancy, infection, trauma, or obstetric complications, and results in low platelets and clotting factors, high fibrin degradation products, and the presence of schistocytes on a blood smear. Treatment focuses on treating the underlying cause, replacing platelets or clotting factors if low, and using activated protein C for severe sepsis or multi-organ failure cases.

1. Disseminated intravascular
coagulation

2. Introduction
• Widespread activation of coagulation,from release of procoagulants
into the circulation
• Clotting factors are consume
• Increase risk of bleeding
• Fibrin strands fill small vessel
• Haemolysis passing RBCs
• Fibrinolysis is also activated

4. Causes
• Malignancy
• Leukemia
• Commonest leukemia associated with DIVC is acute promyelocytic leukemia
• Sepsis
• Trauma
• Obstetric events

5. Signs
• Bruising
• Bleeding anywhere (venepuncture sites)
• Renal failure

6. Tests
• Platelets low
• PT prolonged
• APTT prolonged
• Fibrinogen low (correlates with severity)
• D-dimers (fibrin degradation products) high
• Full blood picture
• Schistocytes (broken RBCs)

7. Treatment
• Treat the cause
• Replace platelets if <50 x 1000000000/L
• Cryoprecipitate to replace fibrinogen
• FFP to replace coagulation factors
• Activated protein C
• Reduces mortality in patient with severe sepsis or multi organ failure